Planning to write the next great FOAM post on hyperkalemia, but not sure what’s already been done? Or maybe a less popular topic, that you hope has minimal coverage? Or are you a resident, medical student, or even a curious attending searching for the latest, best FOAM regarding a specific topic?

If so, then we have great news for these answers are here in the recently published second Systematic Online Academic Resource (SOAR) Topic Review.1 This series aims to identify and evaluate online education resources by topic. The inaugural entry has already revealed the FOAM landscape related to the renal and genitourinary organ system.2 We can now share results for endocrine, metabolic and nutritional disorders.

We developed search terms specific to endocrine, metabolic and nutritional Disorders from the American Board of Emergency Medicine’s Model of the Clinical Practice of Emergency Medicine (MPCEM). We then performed a systematic search of both FOAMSearch as well as each site within the social media index top 50.3,4 We then assessed the quality of those resources using the revised METRIQ score and designated learner levels for each resource.5

The search yielded 36,346 resources, of which 756 met the criteria for quality assessment. Table 1 displays the 121 posts identified as high quality (rMETRIQ ≥ 16). Overall, the most covered subtopic was potassium disorders, representing 15% of all posts. Subtopics that did not have a high-quality resource identified include metabolic alkalosis, respiratory alkalosis, fluid overload, phosphorus metabolism, hyperglycemia, malabsorption, malnutrition and thyroiditis. Table 2 graphically describes the number of high-quality posts by subtopic coverage and recommended target audience. Of note, resources that were better categorized under a different MCPEM category were generally not included. For example, fluid overload content specific to heart failure was not included.

We hope that educators and learners can use this information to find relevant educational resources, and that FOAM content creators can use this information to help identify topics to produce new content.

SubtopicName of First AuthorName of Blog PostLevel of Trainee  Recommendation
Metabolic AcidosisFarkas, JoshPulmCrit: pH-guided fluid resuscitation & BICAR-ICUIntern, Junior, Senior, Attending
Metabolic AcidosisFarkas, JoshIs correcting hyperchloremic acidosis beneficial?Intern, Junior, Senior, Attending
Metabolic AcidosisRusyniak, DanTox & Hound – aka AKAIntern, Junior, Senior, Attending
Metabolic AcidosisMultipleAlcoholic ketoacidosis – WikEMClerk, Intern, Junior, Senior
Metabolic AcidosisSpiegel, RoryCC Nerd-The Case of the Neutral DocumentsClerk, Intern, Junior, Senior, Attending
Respiratory AcidosisChan, WendyVBG vs ABG in HypercarbiaClerk, Intern, Junior, Senior
Acid Base (Mixed)Farkas, JoshFluid selection using pH-guided resuscitationIntern, Junior, Senior, Attending
Acid Base (Mixed)Weingart, ScottAcid Base in the Critically Ill – Part V – Enough with the Bicarb AlreadyIntern, Junior, Senior, Attending
Corticoadrenal InsufficiencyLong, BritMimics of Sepsis: What do ED Physicians Need to Know?Intern, Junior, Senior
Corticoadrenal InsufficiencyFarkas, JoshAdrenal crisis – EMCrit ProjectIntern, Junior, Senior, Attending
Corticoadrenal InsufficiencyGaillard, FrankAdrenal hemorrhage | Radiology Reference Article | Radiopaedia.orgIntern, Junior, Senior, Attending
Cushing’s SyndromeMultipleCushing syndrome | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
CalciumLong, BritOncologic Emergencies Part I: Pearls and PitfallsIntern, Junior, Senior, Attending
CalciumSwaminathan, AnandHypercalcemiaIntern, Junior, Senior, Attending
CalciumMultipleHypocalcemia – WikEMIntern, Junior, Senior, Attending
CalciumTaliaferro, DustinEM@3AM: Hyper- and HypoCaIntern, Junior, Senior, Attending
HypovolemiaAstin, MattThe SPLIT Trial: Saline vs Plasma-Lyte Fluid TherapyIntern, Junior, Senior, Attending
HypovolemiaRezaie, SalimSMART Trial Part 2: Secondary Analysis of Balanced Crystalloids vs Saline in SepsisClerk, Intern, Junior, Senior
HypovolemiaRezaie, SalimIs the Great Debate Between Balanced vs Unbalanced Crystalloids Finally Over?Clerk, Intern, Junior, Senior
HypovolemiaRezaie, SalimDoes Lactated Ringers (LR) Raise Serum Lactate?Clerk, Intern, Junior, Senior
HypovolemiaFarkas, JoshPulmCrit- Get SMART: Nine reasons to quit using normal saline for …Intern, Junior, Senior, Attending
HypovolemiaFarkas, JoshIBCC chapter & cast – Fluid selection & pH-guided fluid resuscitationIntern, Junior, Senior, Attending
HypovolemiaFarkas, JoshThe SPLIT trial: Internal vs. external validityIntern, Junior, Senior, Attending
HypovolemiaRezaie, SalimBalanced vs Unbalanced Fluids in Pediatric Severe SepsisClerk, Intern, Junior, Senior
HypovolemiaMultipleFluid Choice in Sepsis: Does it matter?Clerk, Intern, Junior, Senior, Attending
HypovolemiaKenny, Jon-EmileAre balanced crystalloids better than saline? SMART Talk with Dr …Intern, Junior, Senior, Attending
HypovolemiaFarkas, JoshPulmCrit- Overcoming occult diuretic resistance: Achieving diuresis …Attending
HypovolemiaMultipleCT hypoperfusion complex | Radiology Reference Article …Clerk, Intern, Junior, Senior, Attending
HypovolemiaMultipleDehydration (peds) – WikEMClerk, Intern, Junior, Senior, Attending
HypovolemiaRezaie, SalimThe Great Debate Between Balanced and Unbalanced Crystalloids ContinuesJunior, Senior, Attending
HypovolemiaMorgenstern, JustinIV fluid choice part 1: The SPLIT trialClerk, Intern, Junior, Senior, Attending
HypovolemiaDrenzla, AdamSALT OF THE EARTH (PART 1)Clerk, Intern, Junior, Senior
PotassiumMeyers, PendellCritical Hyperkalemia by H. Pendell Meyers, EMCrit Intern – EMCritJunior, Senior, Attending
PotassiumFarkas, JoshHyperkalemia – EMCrit ProjectClerk, Intern, Junior, Senior
PotassiumFarkas, JoshManagement of severe hyperkalemia in the post-Kayexalate eraIntern, Junior, Senior, Attending
PotassiumSwaminathan, AnandIs Kayexalate Useful in the Treatment of Hyperkalemia in the …Clerk, Intern, Junior, Senior
PotassiumSingh, ManpreetHyperkalemia – The Great ImitatorClerk, Intern, Junior, Senior
PotassiumMultipleTumor Lysis Syndrome – Diagnosis and TreatmentClerk, Intern, Junior
PotassiumMultipleManagement of the Sick Dialysis/ESRD Patientclerk, intern, Junior, senior
PotassiumMeyers, PendellA young man with back spasmsIntern, Junior, Senior
PotassiumHelman, AntonEmergency Management of Hyperkalemia | EM Cases PodcastJunior, Senior, Attending
PotassiumLong, BritUpdates in Management of HyperkalemiaClerk, Intern, Junior, Senior
PotassiumWeingart, ScottTreatment of hyperkalemia in the EDClerk, Intern, Junior, Senior
PotassiumFarkas, JoshPulmCrit- BRASH syndrome: Bradycardia, Renal failure, Av blocker …intern, Junior, senior, attending
PotassiumFarkas, JoshMyth-busting: Lactated Ringers is safe in hyperkalemia, and is …Junior, Senior, Attending
PotassiumMultipleInsulin Dosing in HyperkalemiaIntern, Junior, Senior, Attending
PotassiumRezaie, SalimECG Changes of HyperkalemiaClerk, Intern, Junior, Senior
PotassiumSantistevan, JamieemDOCs.net – Emergency Medicine EducationSubtle ECG findings …Clerk, Intern, Junior, Senior, Attending
PotassiumMorton, A. RossManagement of Hyperkalemia with ECG Changesclerk, intern, Junior, senior
PotassiumAwad, NadiaThyroid Storm: Treatment StrategiesIntern, Junior, Senior, Attending
PotassiumGrock, AndrewBicarbonate: Completely Useless?Junior, Senior, Attending
PotassiumHayes, Bryan DHyperkalemia Management: Preventing Hypoglycemia From InsulinSenior, Attending
SodiumSmarandache, AndreiWhen and how to treat hyponatremia in the EDIntern, Junior, Senior
SodiumFarkas, JoshHypernatremia & dehydration in the ICU – EMCrit ProjectSenior, Attending
SodiumFarkas, JoshEmergent treatment of hyponatremia or elevated ICP with bicarb …intern, Junior, senior, attending
SodiumFarkas, JoshTaking control of severe hyponatremia with DDAVPAttending
SodiumHelman, AntonEmergency Management of Hyponatremia | EM Casesintern, Junior, senior, attending
SodiumFarkas, JoshUnconventional therapies for hyponatremia: Thinking outside the …intern, Junior, senior, attending
SodiumFarkas, JoshPulmCrit- Controlled aquaresis: Management of hypervolemic or euvolemic hyponatremia with oral ureaJunior, senior, attending
MagnesiumMorgenstern, JustinTorsades de Pointes: Approach to resuscitationintern, Junior, senior
MagnesiumMultipleHypermagnesemia – WikEMClerk, Intern, Junior, Senior, Attending
Diabetic KetoacidosisLodeserto, FrankPediatric DKA: Do Fluids Really Matter? – REBEL EM – Emergency …Clerk, Intern, Junior, Senior
Diabetic KetoacidosisMorgenstern, JustinIV fluids do not cause cerebral edema in pediatric DKA – First10EMClerk, Intern, Junior, Senior, Attending
Diabetic KetoacidosisFarkas, JoshBlood gas measurements in DKA: Are we searching for a unicorn?Intern, Junior, Senior, Attending
Diabetic KetoacidosisFarkas, JoshAnatomy of a DKA resuscitation – EMCrit ProjectClerk, Intern, Junior, Senior
Diabetic KetoacidosisHughes, DarrelIs There Any Benefit to an Initial Insulin Bolus in Diabetic …Clerk, Intern, Junior, Senior, Attending
Diabetic KetoacidosisAbela, NikkiFluid Type and Infusion Rate in Paediatric DKAClerk, Intern, Junior, Senior, Attending
Diabetic KetoacidosisMultipleCerebral edema in DKA – WikEMClerk, Intern, Junior, Senior, Attending
Diabetic KetoacidosisLubberdink, AshleyTREKK Series | Diabetic KetoacidosisClerk, Intern, Junior
Diabetic KetoacidosisFarkas, JoshPulmCrit- Dominating the acidosis in DKAIntern, Junior, Senior, Attending
Diabetic KetoacidosisFarkas, JoshPulmCrit – Four DKA PearlsIntern, Junior, Senior, Attending
Diabetic KetoacidosisMultipleemDOCs.net – Emergency Medicine Education Diabetic …Clerk, Intern, Junior, Senior, Attending
Diabetic KetoacidosisMultipleDiabetic ketoacidosis | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Diabetic KetoacidosisMultiplePEM Pearls: Treatment of Pediatric Diabetic Ketoacidosis and the Two-Bag MethodJunior, Senior, Attending
Diabetic KetoacidosisMonette, DerekPEM Practice Changing Paper: Clinical Trial of Fluid Infusion Rates for Pediatric DKAJunior, Senior, Attending
Hyperosmolar Hyperglycemic StateMultipleHyperosmolar hyperglycemic state – WikEMClerk, Intern, Junior, Senior, Attending
Hyperosmolar Hyperglycemic StateMultipleHyperosmolar hyperglycemic state | Radiology Reference Article …Clerk, Intern, Junior, Senior, Attending
Hyperosmolar Hyperglycemic StateMultipleNon-ketotic hyperglycaemic seizure | Radiology Reference Article …Clerk, Intern, Junior, Senior, Attending
HypoglycemiaMultipleHypoglycemic encephalopathy | Radiology Reference Article …Clerk, Intern, Junior, Senior, Attending
Insulin PumpMultipleInsulin Pumps: Complications and Emergency Department PresentationsIntern, Junior, Senior, Attending
Insulin PumpWeingart, ScottPodcast 198 – Insulin Pumps and Such with Josh Miller, MDClerk, Intern, Junior, Senior, Attending
Insulin PumpRezaie, SalimDiabetic Gastroparesis Needs HUGSIntern, Junior, Senior, Attending
Nutritional DisordersMultipleOsteoporosis | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Nutritional DisordersLong, BritProtein Shakes and Dietary Supplements: What are their ingredients and how much is too much?Senior, Attending
Vitamin DeficienciesMultipleRickets | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Vitamin DeficienciesGroth, MeghanMythbusting the Banana BagIntern, Junior, Senior, Attending
Wernicke-KorsakoffMultipleThiamine DeficiencyIntern, Junior, Senior, Attending
Wernicke-KorsakoffPescatore, RickShould You Prescribe Oral Thiamine for Chronic Alcoholics …Senior, Attending
Wernicke-KorsakoffMultipleWernicke-Korsakoff syndrome – WikEMClerk, Intern, Junior, Senior, Attending
Wernicke-KorsakoffMultipleWernicke encephalopathy | Radiology Reference Article …Clerk, Intern, Junior, Senior, Attending
Wernicke-KorsakoffSwaminathan, AnandWernicke’s Encephalopathy Archives – REBEL EM – Emergency …Junior, Senior, Attending
Parathyroid DiseaseMultipleParathyroid hormone | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Parathyroid DiseaseMultipleParathyroid glands | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Parathyroid DiseaseNewman, SamanthaPTH versus PTHrP — Small Differences, Big Implications – Clinical …Intern, Junior, Senior
Pituitary DisordersMultipleSheehan syndrome | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Pituitary DisordersMultipleemDOCs.net – Emergency Medicine EducationThunderclap …Intern, Junior, Senior
Pituitary DisordersMultiplePituitary gland | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Pituitary DisordersMultipleOptic pathway glioma | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Pituitary DisordersMultiplePituitary apoplexy | Radiology Reference Article | Radiopaedia.orgIntern, Junior, Senior, Attending
Pituitary DisordersMultipleEmpty sella | Radiology Reference Article | Radiopaedia.orgIntern, Junior, Senior, Attending
Pituitary DisordersMultipleElevated prolactin (differential) | Radiology Reference Article …Clerk, Intern, Junior, Senior, Attending
HyperthyroidMultipleThyroid storm – WikEMIntern, Junior, Senior, Attending
HyperthyroidLipp, ChrisCRACKCast E128 – Thyroid and Adrenal DisordersIntern, Junior, Senior, Attending
HyperthyroidMultipleHyperthyroidism – WikEMClerk, Intern, Junior, Senior
HyperthyroidMultipleThyroid Storm and Aortoiliac Occlusive DiseaseIntern, Junior, Senior, Attending
HyperthyroidMultipleBedside Rounds Series: Goiter – Clinical CorrelationsClerk, Intern, Junior, Senior
HyperthyroidLee, TerranceDiagnosing hyperthyroidism: Answers to 7 common questionsClerk, Intern, Junior, Senior
HypothyroidFox, SeanHypothyroidism and Myxedema Coma — Pediatric EM MorselsIntern, Junior, Senior, Attending
HypothyroidMultipleMyxedema coma – WikEMIntern, Junior, Senior, Attending
HypothyroidZhao, LeahSpot the Diagnosis! The case of the Pale WomanIntern, Junior, Senior
Tumors Of Endocrine GlandsMultipleParathyroid adenoma | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Tumors Of Endocrine GlandsMultipleCentral nervous system germinoma | Radiology Reference Article …Intern, Junior, Senior, Attending
Tumors Of Endocrine GlandsMultipleCraniopharyngioma | Radiology Reference Article | Radiopaedia.orgJunior, Senior, Attending
Tumors Of Endocrine GlandsMultipleCarcinoid tumor | Radiology Reference Article | Radiopaedia.orgIntern, Junior, Senior, Attending
Adrenal TumorMultiplePheochromocytoma | Radiology Reference Article | Radiopaedia.orgIntern, Junior, Senior, Attending
Adrenal TumorMultipleAdrenal adenoma | Radiology Reference Article | Radiopaedia.orgIntern, Junior, Senior, Attending
Adrenal TumorMultipleAdrenal cortical carcinoma | Radiology Reference Article …Intern, Junior, Senior, Attending
Pituitary TumorMultipleAcromegaly | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Pituitary TumorMultiplePituitary adenoma | Radiology Reference Article | Radiopaedia.orgClerk, Intern, Junior, Senior, Attending
Thyroid TumorMultipleMedullary thyroid carcinoma | Radiology Reference Article …Clerk, Intern, Junior, Senior
Thyroid TumorMultipleAnaplastic thyroid carcinoma | Radiology Reference Article …Intern, Junior, Senior, Attending

 

 

References: 

Special thanks to SOAR co-authors Ryan Pedigo, Lisa Zhao, JooYeon Jung, Shirley W Bae, Teresa Chan, and Andrew Grock.

  1. Hsiao, JJ, Pedigo, R, Bae, SW, et al. Systematic online academic resource (SOAR) review: Endocrine, metabolic, and nutritional disorders. AEM Educ Train. 2021; 5:e10716. doi:1002/aet2.10716
  2. Grock A, Bhalerao A, Chan T, Thoma B, Wescott A, Trueger N. Systematic Online Academic Resource (SOAR) Review: Renal and Genitourinary. AEM Educ Train. 2019;3(4):375-386. doi:10.1002/aet2.10351
  3. Raine T, Thoma B, Chan T, Lin M. FOAMSearch.net: A custom search engine for emergency medicine and critical care. Emerg Med Australas. 2015;27(4):363-365. doi:10.1111/1742-6723.12404
  4. Thoma B, Sanders J, Lin M, Paterson Q, Steeg J, Chan T. The social media index: measuring the impact of emergency medicine and critical care websites. West J Emerg Med. 2015;16(2):242-249. doi:10.5811/westjem.2015.1.24860
  5. Colmers-Gray I, Krishnan K, Chan T, et al. The Revised METRIQ Score: A Quality Evaluation Tool for Online Educational Resources. AEM Educ Train. 2019;3(4):387-392. doi:10.1002/aet2.10376

 

Jonie Hsiao, MD

Jonie Hsiao, MD

Faculty Physician, Greater Los Angeles VA Healthcare System Associate Professor of Emergency Medicine UCLA Department of Emergency Medicine
Andrew Grock, MD

Andrew Grock, MD

Lead Editor/Co-Founder of ALiEM Approved Instructional Resources (AIR)
Faculty Physician, Greater Los Angeles VA Healthcare System
Assistant Professor of Emergency Medicine
UCLA Emergency Medicine Department