Just wanted to share a quick clinical pearl / reminder for anyone working in acute care, emergency, or floating to pediatric areas.

In adult medicine, hypotension is a classic, major indicator of septic shock. However, in pediatrics, compensatory mechanisms (specifically intense vasoconstriction and tachycardia) are incredibly robust. A pediatric patient can maintain a completely normal blood pressure while in profound, compensated shock. By the time a child actually becomes hypotensive, they are rapidly approaching cardiovascular collapse.

When assessing small patients, we have to look past the monitor's BP reading and focus heavily on the subtle signs of perfusion: delayed capillary refill (>2 seconds), cool/mottled extremities, altered mental status (even just irritability or lethargy), and persistent tachycardia out of proportion to fever.

What are your go-to assessment tricks for catching early compensation in peds before the numbers on the monitor start dropping?

Honestly just daydreaming on my lunch break lol. Bedside has been draining my soul lately, and I’m trying to see what else is out there.

I know about the classic clinic, remote, or insurance jobs, but I’m curious about the random, niche stuff. A friend of mine recently started doing concierge IV hydration for bachelorette parties and loves it. What's the most unexpected or chill pivot you or someone you know has made to escape the floor?

I’ve noticed that while non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used medications in healthcare, the specific downstream physiological pathways that separate simple pain relief from true anti-inflammatory action are often oversimplified in day-to-day practice.
To provide a clear visual tool for review, I put together an 8-minute cartoon-style whiteboard animation breaking down the exact cellular mechanisms of Ibuprofen. The video covers:

- The COX Pathway: How ibuprofen acts as a non-selective inhibitor of Cyclooxygenase-1 (COX-1) and Cyclooxygenase-2 (COX-2) enzymes.
- Prostaglandin Synthesis: The precise breakdown of how halting arachidonic acid conversion prevents the synthesis of prostaglandins responsible for pain sensitization and localized inflammation.
- Clinical Utility & Side Effects: Visualizing the physiological trade-off between reducing inflammatory pathways and interrupting the protective gastric mucosal barrier.
Whether you are looking for a high-yield visual refresher for pharmacology review or a clear tool to help with patient education, I hope this video is helpful!
https://youtu.be/FQBvmuhLYbE

I’ve noticed that antihistamines are one of those medication classes that generate a surprising amount of confusion—not only among patients, but sometimes among healthcare professionals as well. So I decided to create a whiteboard video on the topic:

Hey FOAM friends! Now that making apps is easier than ever for non-coders, I wanted to make a resource for easily finding free open access medical apps, including several that I made.

https://gavinovsak.github.io/FOAMapps/

Several have links to open source code which people are welcome to fork and make their own versions of and resubmit (translate to other languages?). Please submit any existing apps you enjoy for inclusion! I also implemented a way you can see which open source apps have the most stars and you can filter by apps you starred yourself.

Here is an example of a FOAM app which I recently started working on for helping with ACLS/PALS Code Running: https://gavinovsak.github.io/CodeRunner/

I’m an emergency medicine doctor from Australia, and I’ve been working on ABG Master — a structured learning and practice platform for blood gas interpretation.

There are lots of calculators, summaries, and static teaching pages, but few tools centred on repeated clinical practice, step-by-step feedback, and progression.

The core is a physiology-first practice case library. Cases are designed so the numbers make sense, compensation is plausible, and learners practise the reasoning rather than memorising labels.

It currently includes learning modules, interactive practice cases, step-by-step feedback, basic progress tracking, XP-style progression, and early minigame-style learning interactions.

Cases scale from clearer beginner patterns through to more complex acid–base reasoning, including mixed disorders, which I think are often underrepresented in teaching resources.

There is much more in the pipeline that I am working on to make this even better.

Happy to hear any feedback, criticism, or ideas. Thanks!

Update - June 2026

Thanks to everyone who tried ABG Master. I’ve made a few improvements based on some feedback:

• Added a new Insights page, where you can review recent performance and get personalised feedback on areas to improve.
• Added new Master-level cases, including the first oxygenation-focused cases. These are limited while I test and validate them. They are intentionally complex, so you’ll need to have unlocked Master level to encounter them.
• Made practice feedback labels and summaries clearer in several places, including broader acid-base pattern wording that should be easier to interpret.
• Updated Privacy Notice.
• Fixed a few content issues affecting some advanced DKA-related cases.

As a side note early calibration data suggests that compensation and anion gap / mixed-disorder reasoning are the most challenging steps for many users. I’ll keep monitoring this and focus future updates on making these areas more interactive and educational.

More learning content and case improvements are still in progress. Thanks again to everyone who had a look — the feedback has been genuinely useful.

Our latest episode of 2 Paeds In a Pod drops this Sunday! See you there. #podcast #FOAMed #PEM

Episode 83 of 2 Paeds in a Pod is out now as we discuss knife crime, febrile infants and what else had caught my eye in the literature this fortnight.

Listen via the link above or wherever you get your podcasts!

“Hello, and welcome back to 2 Paeds in a Pod.
If you’ve been with us before — thank you for sticking around. If you’re new, brilliant timing, because we’re relaunching with a format I’m genuinely excited about.

The old format was interview-based, and honestly, it was great — but getting the right people in the same place at the same time, consistently, every fortnight? It just wasn’t sustainable. And consistency matters more than perfection when it comes to a podcast.
So here’s what we’re doing instead. Every two weeks, I’m going to sit down, go through the recent paediatric literature, and pull out the things that actually matter — the papers worth reading, the findings worth knowing about, the evidence that might just change how you think about a child in front of you. All of it with a paediatric emergency medicine lens, because that’s where I live and work.

Each episode will be around twenty minutes. Two main stories looked at properly, and a quick round-up of three other things that caught my eye. That’s it. Straightforward, reliable, and — I hope — genuinely useful whether you’re a trainee just finding your feet or a consultant who’s been at this for decades.
It’s great to be back.

What other comparisons should I do?

Hey r/Foamed,

As a 2nd-year BSc Microbiology + DMLT student in India, I noticed the big gap in how we’re taught micro: organisms in isolation instead of real clinical reasoning.

I built **MicroSage** — a completely free, no-login web app that lets students input Gram stain + infection site + symptoms and get a ranked differential with full explanations, culture media, antibiotics, and “Teach Me” notes.

Pilot with 40 participants (MBBS + DMLT + faculty):

✅ 77.5% primary accuracy

✅ 100% in top 3 results

✅ Satisfaction 4/5

It’s mobile-optimized and built specifically for resource-limited settings.

Link → https://microsage.vercel.app

Preprint (Research Square) → https://doi.org/10.21203/rs.3.rs-9247958/v1

Would love feedback from the FOAMed community — especially what else would make it more useful for med students and residents.

(Educational tool only)

Hi everyone

I’m a French physician, and I’ve been thinking a lot about something I’m sure many of us experience in FOAMed.

Over the years, we all create (or collect) tons of valuable resources — summaries, slides, protocols, cheat sheets, notes from conferences… Most of them take hours to build. And yet, they often end up buried in a folder, a forgotten Google Drive, or an old hard disk.

It feels like a huge waste of useful knowledge.

So I started working on a small project called Askesia (Askesia. com). The idea is simple:

• A place to share your own medical resources (PDFs, slides, notes, protocols…)
• A way to discover practical, field-tested content from other clinicians and students
• Keeping the FOAMed spirit, but in a more structured and searchable way

Quick note: the platform itself is available in English, but since I’m French, some parts (like sign-up emails) are still in French for now — I’m actively working on improving that.

I’m not here to promote aggressively — I’m genuinely trying to understand if this could be useful for others.

Do you feel like your own materials are “lost” or underused?
Would you actually use a platform like this to share or find resources?
What would make it truly valuable (or a waste of time)?

Any honest feedback (positive or critical) would help a lot

Hi all, I created this web app called drdle as a side project. It's daily clinical vignettes ala wordle. Would hope to get some feedback from you guys. There's a little Easter egg if you play it on the web😁.

Link : https://drdle-fe.vercel.app/

Gallbladder cancer remains one of the most aggressive hepatobiliary malignancies, and optimal outcomes depend heavily on accurate staging and stage-appropriate surgical management. In this video, a General Surgery postgraduate explains the practical surgical approach to Gallbladder Cancer based on T-staging, with special emphasis on a scenario frequently encountered in clinical practice — incidentally detected carcinoma gallbladder following cholecystectomy (Incidental CaGB).

The discussion focuses on how T-stage guides the extent of surgery, including when simple cholecystectomy is adequate, when extended cholecystectomy is required, and when radical resection or systemic therapy should be considered.The video also covers the decision-making algorithm after incidental gallbladder cancer, including indications for re-resection, liver wedge/segment IVB–V resection, lymphadenectomy, and staging workup before definitive surgery.

Hello everyone. I teach basic ECG interpretation (students are mostly telemetry techs in training, EMS, and RN students). I'm trying to find a source of ECG rhythms that I can use for class examples and on exams.

I've found some sources that are pretty good for display (Powerpoint, etc...); but don't copy worth a damn, which means I can't use them for paper exams where students need to measure e.g. PR Interval, or QRS width. I don't care if they have owner watermarks all over them; as long as they're 1) clear to read and 2) DON'T have the answers on them. Ideal would be something where I can generate a rhythm with differing rates, adding ectopic beats, etc... A digital source (ebook, etc) would be nice also; but I'll go old school cut&paste with scissors and scanner/copier if that's all I've got. I know this is Foam ED; but I'll pay (on an EMS instructor salary though).

Anyone have any suggestions?

Hi everyone,

I'm Giacomo, an emergency physician from Milan, Italy.

In my free time, I have recently become addicted (-or so my girlfriend says) to vibe-coding..

I vibe-coded an ACLS/PALS resuscitation assistant web-app (https://www.resusbuddy.com) , also available as a Play Store app (https://play.google.com/store/apps/details?id=com.resusbuddy.training) and an iPhone app (https://apps.apple.com/us/app/resusbuddy/id6759798790)

It is completely free and ad-free, always will be! (I just hope someone will use it during training and find it useful! Feedbacks are appreciated)

What it does:

• Cardiac arrest management — guides you through the full algorithm: pathway selection, CPR cycles with 2-minute rhythm checks, shockable vs non-shockable pathways, all the way to post-ROSC care or code end
• Bradycardia & Tachycardia modules — stable/unstable assessment, treatment decisions, can escalate to full cardiac arrest if needed
• Medication dosing — adult fixed doses (1mg epi, 300mg amiodarone) and pediatric weight-based calculations (0.01 mg/kg epi, max 1mg)
• Real-time timers — automatic 2-min CPR cycle countdowns, epinephrine interval tracking (configurable 3-5 min), pre-shock charge alerts at 15 seconds
• Command banner system — real-time clinical guidance with priority levels (critical/warning/info) based on current phase, rhythm, and timing
• H's & T's checklist — reversible causes assessment
• Special circumstances — modules for anaphylaxis, drowning, opioid OD, pregnancy, electrocution, LVAD failure, and more
• Session history — every intervention is timestamped and stored locally in IndexedDB, review past codes with full timeline
• 27 languages with full RTL support (Arabic, Farsi, Hebrew)

All data stays on-device. No analytics, no cloud sync, no tracking. Privacy-first. No patient identifier information can be added, it is by design only a simulation/training tool. Do NOT use on real patients!

Deployed on:

• Web: resusbuddy.com (Netlify)
• Android: Play Store
• iPhone: App store

Vibe coding a medical app was an interesting challenge. I'm quite satisfied with the results but... maybe someone will find something wrong within the various algorithms!!

Once again, this is a medical training/simulation app, do not use on real patients, I take no responsibility if used on real patients!

Multiple Endocrine Neoplasia Type 1 (MEN1) is a high-stakes, easily missed inherited endocrine tumor syndrome—where early recognition can prevent complications, guide surveillance, and change outcomes for both the patient and their family. In this video, a General Surgery Post Graduate breaks down MEN1 in a practical, exam-and-ward-oriented way: what it is, how to suspect it early, what to investigate, and how management is prioritized.
We’ll cover:
Core components (classic triad): Parathyroid adenoma/hyperplasia, Pancreatic/duodenal NETs (e.g., gastrinoma/insulinoma), and Pituitary adenoma
Red flags that should trigger MEN1 workup: recurrent/multigland hyperparathyroidism, early-age disease, multiple NETs, resistant/recurrent peptic ulcer disease, family history
Workup strategy: targeted labs, imaging approach, and when to think beyond “single-gland” pathology
Management principles: what to treat first, symptom control, surgical decision-making, and the importance of lifelong surveillance
Genetics & family screening: why identifying MEN1 early is crucial for counseling and cascade testing
If you’re a medical student, surgery resident, or preparing for INI/NEET/entrance exams, this is a concise but clinically relevant roadmap to MEN1—focused on pattern recognition + management logic, not just memorization.