HipPEMcrates FOAM Roundup | October 2026

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A monthly guide to the best new Pediatric Emergency Medicine FOAM

Welcome to the October HipPEMcrates FOAM Roundup! We’ve gathered a month’s worth of learning from across the PEM FOAM community, featuring podcasts, clinical reviews, infographics, diagnostic challenges, and literature appraisals to keep you current and bring fresh insights to your next shift.

Browse by clinical topic below, or start with the highlights if you only have a few minutes. Each summary is designed to help you decide where to spend your reading or listening time – and every title links directly to the original resource.

Overall Pearls from October’s PEM FOAM

  1. The first intubation attempt starts before the laryngoscope goes in. The pediatric airway discussion emphasizes preoxygenation, positioning, equipment preparation, and coaching. The physiologically difficult airway review adds another essential question: how will the patient tolerate induction and the transition to positive-pressure ventilation?
  2. Risk tools and thresholds need a clinical context. PERC-Peds addresses a selected population undergoing evaluation for possible pulmonary embolism; OxyKids examines oxygen saturation thresholds in children with respiratory distress. Before applying either, ask which patients were studied, what decision the evidence addresses, and how the child in front of you compares.
  3. A prescription needs a purpose and a plan. The shorter antibiotic course discussion challenges treatment durations driven by habit. The take-home ondansetron review extends that thinking beyond the ED: consider the expected benefit, potential harms, and instructions families need after discharge.
  4. An initially reassuring appearance does not finish an ingestion assessment. Iron poisoning can include apparent improvement before systemic toxicity develops. Calcium channel blocker exposures require attention to the specific agent, formulation, and timing. Match monitoring and disposition to the exposure, clinical course, and poison center guidance.
  5. Team performance deserves the same preparation as a procedure. The neonatal human factors reflection highlights named leadership, clear roles, fewer distractions, and deliberate pauses when the plan drifts. The debriefing and peer-support discussion reminds us that supporting the team should continue after the immediate emergency ends.

⚡ This Month in 30 Seconds

🌐 External resources featured: 32
📝 Blog posts, cases, and journal-club resources: 8
🎙️ Podcast episodes: 21
📊 One-page infographics: 3
🏛️ Additional resources from HipPEMcrates: 4

Beyond Average: New Benchmarks for Excellence in Pediatric Emergency Care

📝 Academic Life in Emergency Medicine | Research Review / Quality Improvement | Published: October 15

What should “good” pediatric emergency care look like? This review introduces achievable benchmarks based on high-performing clinicians and offers concrete ideas for teams choosing their next quality improvement target.

The PEM Podcast: Pediatric Intubation – Getting the First Attempt Right

🎙️ HipPEMcrates / The PEM Podcast | Podcast | Published: October 14

Dr. Bob Belfer speaks with Dr. Josh Nagler about preparing for pediatric intubation, improving first-attempt success, and balancing airway safety with education.

Jump to a Topic

🦠 Infectious Diseases & ENT

Pee-r Reviewed: New AAP UTI Guidelines!

🎙️ The Cribsiders | Podcast | Published: October 7

Dr. Brian Alverson joins the team to discuss urine testing, specimen collection, interpretation, treatment duration, and imaging in children with suspected UTI. The conversation also highlights constipation and bladder-bowel dysfunction, with attention to avoiding unnecessary testing and treatment.

The Protruding Pinna: Pediatric Mastoiditis

🎙️ The Cribsiders | Podcast | Published: October 21

Pediatric ENT physician Dr. Tali Lando reviews the presentation, evaluation, and treatment of mastoiditis, including when surgical management enters the picture. The episode and accompanying notes address mimics, imaging interpretation, and complications that matter in the ED.

PEM Rules #143: Vaccines, Vaccination Rates, Autism and Where It All Came From

🎙️ PEM Rules | Podcast | Published: October 26

Dr. Yaron Ivan speaks with Dr. John Snyder about vaccination rates, reasons families decline vaccines, and the origins of claims linking MMR vaccination with autism. A discussion relevant to clinicians navigating vaccine questions and misinformation with families.

PEAs on a Pod #9: Cutting the (abx) Course

🎙️ PEAs on a Pod | Podcast / Quality Improvement Review | Published: October 19

A discussion of a quality improvement project aimed at increasing use of shorter antibiotic courses for pediatric acute otitis media and community-acquired pneumonia. The episode examines prescribing habits, education, and feedback, with additional discussion of shorter treatment courses in the new UTI guidance.

🫁 Respiratory & Pulmonary Embolism

PERC-Peds: Bedside Exclusion of PE in Kids

🎙️ EM Pulse | Podcast / Research Discussion | Published: October 23

Drs. Jeffrey Kline and Angela Ellison discuss the BEEPER study and the PERC-Peds approach to evaluating suspected pulmonary embolism in children. The episode explores the pediatric criteria, the role of pretest probability, and strategies for limiting unnecessary diagnostic testing and radiation.

PEAs on a Pod #7: Low and Behold – The OxyKids Study

🎙️ PEAs on a Pod | Podcast / Critical Appraisal | Published: October 5

Drs. Seth Ball and Rusty Walker review the OxyKids trial of oxygen saturation thresholds in children with acute respiratory distress. The discussion considers how to interpret a low saturation alongside the child’s overall clinical picture and the study’s findings.

🚑 Critical Care, Airway & Sedation

Normal saline is not normal and other nonsense that people love to spout (The PRoMPT trial)

📝 First10EM | Critical Appraisal | Published: October 12

Justin Morgenstern takes a critical look at PRoMPT BOLUS and the debate over balanced crystalloids versus saline in pediatric septic shock. The review separates biochemical differences from patient-centered outcomes and discusses what the trial can – and cannot – tell us about fluid selection.

EMCrit 436: Hemodynamically Neutral Intubation, Part 2

🎙️ EMCrit | Podcast / Expert Commentary | Published: October 18

Scott Weingart revisits the physiologically difficult airway, focusing on patients at risk of cardiovascular collapse during intubation. This general EM discussion offers a framework for thinking through hemodynamics and spontaneous ventilation; its proposed techniques and adult targets require careful pediatric adaptation.

EMCrit 435: Procedural Sedation – Guidelines, Definitions, and Boundaries in 2026

🎙️ EMCrit | Podcast / Guideline Review | Published: October 3

A review of the 2026 unscheduled procedural sedation guidance, including fasting, monitoring, risk assessment, and sedation terminology. The material addresses both adults and children, making it useful for reviewing which recommendations have pediatric evidence and where uncertainty remains.

🫀 Cardiology

PEM Rules #142: My List of “I Never Want to Miss It” – Myocarditis

🎙️ PEM Rules | Podcast | Published: October 12

Dr. Jay Fisher joins Dr. Yaron Ivan to discuss myocarditis as a challenging diagnosis to recognize and manage in the pediatric ED. The episode offers clinical insights, with accompanying references on pediatric presentation, evaluation, and risk assessment.

The Cribsiders #196: Psst… Do You Hear That? Understanding Cardiac Murmurs

🎙️ The Cribsiders | Podcast | Published: October 28

Pediatric cardiologist Dr. Colin Kane reviews how to distinguish innocent from pathologic murmurs, recognize concerning associated symptoms, and decide when testing or referral is appropriate. The conversation also covers neonatal murmurs and counseling families, with practical reminders to interpret the sound alongside the history and the rest of the examination.

🦴 Orthopedics & Musculoskeletal

Approach to Acute Pediatric Limp

📊 PedsCases | Infographic | Published: October 27

A one-page handout reviewing the presentation, diagnosis, and management of acute limp in children. A compact resource for reviewing an approach to a common pediatric ED presentation or using it in bedside teaching.

PEAs on a Pod #8: Hyper About Pronation

🎙️ PEAs on a Pod | Podcast / Evidence Review | Published: October 12

An 11-minute review comparing hyperpronation with supination-flexion for nursemaid’s elbow reduction. The hosts discuss recent literature and its implications for choosing a reduction technique at the bedside.

🧪 Toxicology

Toxicology: Iron

🎙️ PEM Currents | Podcast | Published: October 12

A six-minute refresher on pediatric iron poisoning, including deceptive early symptoms, the latent phase, and progression to systemic toxicity. The episode reviews elemental iron exposure, serum levels, abdominal radiographs, decontamination, chelation, and disposition.

Toxicology: Calcium Channel Blockers

🎙️ PEM Currents | Podcast | Published: October 19

This six-minute episode reviews a potentially dangerous toddler ingestion and the differences between calcium channel blocker classes. It covers recognition of cardiovascular toxicity, initial assessment, calcium and high-dose insulin therapy, vasoactive support, and escalation for refractory shock.

EMCrit 437: Massive Lithium Overdose

🎙️ EMCrit | Podcast / Expert Discussion | Published: October 29

Scott Weingart speaks with medical toxicologist and nephrologist Dr. Josh King about massive lithium overdose, including delayed toxicity, serial concentrations, gastrointestinal decontamination, and dialysis decisions. This general EM discussion is relevant to adolescent ingestions; its proposed management strategies require patient-specific interpretation with toxicology and nephrology input.

🧠 Neurology

Idiopathic Intracranial Hypertension

📊 PedsCases | Infographic | Published: October 4

A one-page reference summarizing the presentation, causes, and management of idiopathic intracranial hypertension. A compact review for learners working through pediatric headache and possible raised intracranial pressure.

👁️ Ophthalmology

Approach to Red Eye

🎙️ PedsCases | Podcast | Published: October 10

A structured approach to pediatric red eye using the history, examination, and anatomic location to narrow the differential. The episode includes urgent referral features and important infectious causes, including HSV keratitis and neonatal conjunctivitis.

Retinoblastoma

📊 PedsCases | Infographic | Published: October 18

A one-page infographic reviewing retinoblastoma, developed with a pediatric oncologist. A concise teaching resource for refreshing knowledge of an important childhood eye malignancy.

🫘 Nephrology

Proteinuria (Updated)

🎙️ PedsCases | Podcast | Published: October 18

An updated approach to distinguishing transient, orthostatic, and persistent proteinuria in children. The episode highlights features concerning for kidney disease and the initial investigations that help guide further evaluation.

🍽️ Gastroenterology & Nutrition

SGEM #523: Everything Grows and Grows…Until It Doesn’t – Faltering Weight

🎙️ The Skeptics’ Guide to Emergency Medicine | Podcast / Guideline Appraisal | Published: October 17

Dennis Ren and pediatric gastroenterologist Dr. Salina Khushal examine the new faltering weight guideline, including terminology, growth assessment, and targeted evaluation. Although the guideline primarily addresses outpatient care, the discussion is relevant when families are sent to the ED for a workup or admission.

PEAs on a Pod #10: Home Is Where the Zofran Is

🎙️ PEAs on a Pod | Podcast / Evidence Review | Published: October 26

The hosts examine the evidence behind take-home ondansetron prescriptions for children after ED discharge. The discussion considers effectiveness, safety, return visits, and concerns about masking an alternative diagnosis.

🔍 Diagnostic Challenges

PEMPix 2026 Online Case 4: I’m in a Glass Case of Emotion!

📝 PEMBlog | Image-Based Case | Published: October 1

A 15-year-old boy presents with fever and a large suprapubic mass that his parents only learned about that day. The history reveals a much longer course with recent rapid change – review the photograph and decide what belongs on your differential before revealing the answer.

🎓 Education, Human Factors & Clinician Wellbeing

Big Pitfalls for Tiny Patients

📝 Don’t Forget the Bubbles | Case Reflection / Human Factors | Published: October 20

A neonatal emergency in an unfamiliar environment exposes problems with leadership, task fixation, crowding, and communication. The reflection offers practical prompts for naming roles, resetting a drifting resuscitation, including parents, and making time for debriefing.

The Case for TRiM in Paediatric Pre-Hospital Care

📝 Don’t Forget the Bubbles | Clinician Wellbeing Review | Published: October 13

An introduction to Trauma Risk Management (TRiM), a structured peer-support approach following traumatic incidents. The article explores the psychological burden of pediatric prehospital care and distinguishes ongoing peer support from clinical debriefing and critical incident stress debriefing.

The One-Minute Preceptor: Making Every Patient Encounter a Teaching Opportunity

🎙️ REBEL EM / REBEL MIND | Podcast / Medical Education | Published: October 5

A practical review of the One-Minute Preceptor model for teaching during a busy shift. The episode walks through eliciting a learner’s assessment and reasoning, teaching a focused principle, and giving specific feedback without overwhelming the learner.

Neurodiversity: Not Just Our Patients

📝 Don’t Forget the Bubbles | Perspective / Clinician Wellbeing | Published: October 27

Louise Baker reflects on neurodivergence within the medical workforce, drawing on her experience as a late-identified neurodivergent doctor. The article discusses communication preferences, workplace barriers, and practical adjustments that supervisors and colleagues can consider when supporting individual needs.

PEM Rules #141: PEM Education, Beyond the Classroom and the Bedside, with Emily Rose

🎙️ PEM Rules | Podcast / Medical Education | Published: October 5

Dr. Emily Rose joins Dr. Yaron Ivan for a conversation about her work in pediatric emergency medicine education. An educator-focused listen on contributing to the development of the next generation alongside a busy clinical career.

📚 Quality Improvement & Literature Discovery

Beyond Average: New Benchmarks for Excellence in Pediatric Emergency Care

📝 Academic Life in Emergency Medicine | Research Review / Quality Improvement | Published: October 15

A PECARN Registry analysis asks what high-performing clinicians already achieve across common pediatric ED quality measures. ALiEM explains achievable benchmarks and their potential use in improving asthma care, pain management, antibiotic stewardship, and ED flow, while providing context about the participating sites.

The 106th Bubble Wrap × University Hospital Galway

📝 Don’t Forget the Bubbles | Journal Club / Literature Review | Published: October 7

Five reviews span pediatric ED readiness, asthma scores and admission prediction, nirsevimab, vaping, and language barriers in care. A useful starting point for a departmental journal club, with discussion of what each study adds and where its limitations matter.

Bubble Wrap PLUS: October 2026

📝 Don’t Forget the Bubbles | Curated Reading List | Published: October 2

A broad pediatric reading list drawn from 34 journals, with highlighted studies on emotional symptoms after concussion, pediatrician burnout, and childhood nutrition. Use it to find original papers for a deeper read or a future journal club.

SGEM Xtra: Dr. Gordon Guyatt – Legend of Evidence-Based Medicine

🎙️ The Skeptics’ Guide to Emergency Medicine | Podcast / Evidence-Based Medicine Interview | Published: October 31

Ken Milne interviews Dr. Gordon Guyatt about the origins of evidence-based medicine, the Users’ Guides, and GRADE. Their discussion explores how evidence, clinical expertise, and patient preferences inform decisions, with questions about guideline interpretation and the future role of AI in evidence appraisal.

🏛️ New on HipPEMcrates

The PEM Podcast: Pediatric Intubation – Getting the First Attempt Right with Dr. Josh Nagler

🎙️ HipPEMcrates / The PEM Podcast | Podcast | Published: October 14

Dr. Bob Belfer and Dr. Josh Nagler discuss preoxygenation, apneic oxygenation, video laryngoscopy, positioning, and the NEAR4PEM checklist. They also explore preparation for hypotension and the balance between first-attempt success and training the next generation of airway clinicians.

Trauma Pearls: E-Bike Injuries

📊 HipPEMcrates / CHOP Trauma Committee | Infographic | Published: October 20

The CHOP Trauma Committee’s monthly Trauma Pearls infographic brings its focus on e-bike injuries to the broader HipPEMcrates community. Shared with help from Dr. Christine Liverpool, this visual resource is available to review and share with your team.

Pediatric Cardiogenic Shock: A JournalFeed Feature

📝 HipPEMcrates / JournalFeed | Guideline Summary / Cross-Post | Published: October 27

This JournalFeed feature, reproduced with permission, summarizes the American Heart Association’s scientific statement on pediatric cardiogenic shock. It introduces a framework for recognition, staging, management, and monitoring, emphasizing timely treatment tailored to the child’s hemodynamic presentation.

Epic’s Pediatric Sepsis Alert: How Well Does It Perform in the ED?

📝 HipPEMcrates | Research Review / Author Perspective | Published: October 30

Dr. Chelsey Mitchell discusses her team’s JAMA Pediatrics evaluation of Epic’s pediatric sepsis alert across eight EDs. The post examines missed cases, timely detection, and differences across patient groups and settings, highlighting why an absent alert should not override a concerning bedside assessment.

Thank You to This Month’s PEM FOAM Contributors

Thank you to the educators and teams who make these resources freely available:

Have a resource we should include in a future Roundup? Share it in the comments or email HipPEMcrates@gmail.com.

Dr. Joshua Belfer, MD, is a Pediatric Emergency Medicine physician at the Children’s Hospital of Philadelphia, and is the Founder and Editor-in-Chief of HipPEMcrates. He can be reached at HipPEMcrates@gmail.com.

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