#FOAMed

The second-day EuSEM 2018 report brings together pulmonary care, early EcLiPSE trial findings, care of older patients and interactive paediatric cases. It also reflects on performing under pressure and celebrates the RCEM team’s joint win in the Euro Sim Cup.

What does ‘massive’ pulmonary embolism really tell us about a patient’s risk? In this case-based 2018 review, Dan Horner examines physiology, clot burden, clinical trajectory and bleeding risk, arguing for a fuller assessment and shared decisions rather than reliance on a single blood-pressure threshold.

This preview of the September 2018 World Sepsis Conference considers what a free online meeting can offer. Simon Carley reflects on access, diversity, patient voices and the environmental costs of travel, asking how conferences might share learning more widely while retaining the value of meeting in person.

Which advanced airway strategy should come first in out-of-hospital cardiac arrest? This 2018 review compares AIRWAYS-2 and PART, examining supraglottic devices and tracheal intubation. It considers trial outcomes alongside operator experience, training and the practical realities of prehospital resuscitation.

Psychologist Esther Murray joins the St Emlyn’s podcast to explore moral injury in emergency and prehospital care. The accompanying notes discuss research into medical students’ prehospital experiences and the psychological impact of witnessing traumatic events, while recognising the limits of the small study that prompted the conversation.

Fluids are drugs, with potential benefits and harms. Simon Carley examines a 2018 narrative review of intravenous fluids in critically ill adults, covering fluid choice, shock phases and evolving physiology. He also asks how to read expert reviews critically and remain open to evidence that challenges established practice.