First10EM

The management of sepsis has evolved dramatically since I was a trainee, just after Manny Rivers published his seminal sepsis protocol.

Personally, I find the normal saline versus balanced fluid debate pretty boring.

One reason that clinical judgement regularly beats decision rules is that decision rules (at least as they are currently designed) are forced to use arbitrary cut-offs.

The use of heparin in acute coronary syndrome was one of the primary gateways into my hatred of guidelines.

Does N95 mask fitting really require you to me clean shaven?

The June 2026 First10em #FOAMEd Research Roundup Featuring appraisals of high quality recent RCTs, and for some reason Neanderthal dentistry The post Research Roundup – June 2026 appeared first on First10EM.

Strike 2 against whole blood.

One of the downsides of subscribing to more than 50 journal feeds is the huge number of interesting papers that I flag for later, but never find time to fully appraise.

It should be the easiest patient of the day.

Only a few weeks have passed since I last wrote about negative trials for invasive therapy in pulmonary embolism.

Despite incredibly underwhelming evidence from the outset, a massive amount of money was spent (or wasted) on Paxlovid during the COVID pandemic.