3. Kiwi-turned–Salt Lake City emergency physician Rob Bryant, MD (@RobJBryant13), tweeted: “TXA vial is tough to open & ironically sharp. If you cut yourself, pour a little on the lac, you’ll be fine pic.twitter.com/ExiGDAnpML.” The picture shows a small glass vial of tranexamic acid with a sharp edge after being broken off by hand. While the data for tranexamic acid for significant bleeding may still be a work in progress (the CRASH-3 trial is currently under way), a recent Annals of Emergency Medicine paper (Zahed et al. September 2013) suggests good outcomes for a usually less severe but certainly common emergency-department problem: epistaxis.

4. Emergency-medicine resident Lauren Westafer, DO (@LWestafer), tweeted: “AAEM practice guideline supports droperidol. Hip hip hooray! http://www.aaem.org/UserFiles/file/Safety-of-Droperidol-Use-in-the-ED.pdf … (updated black box summary http://shortcoatsinem.blogspot.com/2012/12/not-black-boxed-droperidol-as-anti.html …)” The newly published American Academy of Emergency Medicine’s policy states that the black-box warning on droperidol is unwarranted for doses under 2.5mg IV or IM and that electrocardiograms for such doses are unnecessary for the evaluation of QT interval. The guideline also states that IM doses of up to 10 mg are as safe and effective as the other medications in common use. Dr. Westafer’s own summary on her blog, Short Coats in EM (http://shortcoatsinem.blogspot.com/), which she started as a medical student, has a great slide deck on the topic, as well.

5. The University of Nevada School of Medicine Department of Emergency Medicine’s website and Twitter account (@LasVegasEM) has been putting out great stuff lately. This post takes a welcome shot at backboards and cervical collars: “Check out a new post in our FOAM blog. Dogma in EMS: Spinal Immobilization. What are your thoughts?? http://www.lasvegasemr.com/foam-blog.html #FOAMed” High-impact point: not only do backboards and c-collars provide no benefit, there may even be harm associated with their use, including respiratory compromise and difficulty with airway management. Other than for ease of transport, backboards should probably be banned!

Jeremy Samuel Faust MD, MS, MA, is an emergency medicine resident at Mount Sinai Hospital in New York and Elmhurst Hospital Center in Queens. He tweets about #FOAMed and classical music @jeremyfaust.