#FOAMed

What happens when the patient is someone you know? Iain Beardsell and Liz Crowe discuss caring for community members, friends and colleagues, exploring confidentiality, declaring personal connections, professional boundaries and supporting a team when personal and clinical responsibilities collide.

What changed when Sepsis-3 was introduced in 2016? This overview explains the shift towards organ dysfunction, the roles proposed for SOFA and qSOFA, and revised septic-shock definitions, while noting early concerns about applicability and performance across different clinical settings.

Can medical-grade skin adhesive reduce peripheral cannula failure? This 2016 appraisal examines a randomised trial of cyanoacrylate alongside standard dressings, considering the reported benefit, lack of blinding, follow-up methods, costs and the patient experience of removing the cannula.

Can website traffic and social-media popularity tell us how useful FOAMed is? This critique examines the Social Media Index’s measures and their limitations. A 2017 update softens the original criticism, recognising the index’s contribution to developing academic approaches to online education.

This 2016 teaching update explores fascia iliaca blocks for hip-fracture pain, combining anatomy, landmark and ultrasound approaches with discussion of local-anaesthetic safety and the supporting evidence. Videos and an infographic accompany the authors’ reflections on introducing regional analgesia into emergency department practice.

Why might the immediate fear of a missed diagnosis outweigh the less visible harms of unnecessary testing? Simon Carley explores ‘risk proximity’, distinguishing risks to patients from risks to clinicians and asking how their timing can distort decisions in the emergency department.