So a general trash pull (ie not alot of aoe mobs)

fire : 1 totem of wrath 4 searing totems

water : 5 healing stream totems (I recently stopped laying 1 mana sping b/c I think life regen while gettiing hit is better than mana)

earth: 1 stoneskin 1 earthbind 3 stoneclaw (If you have a chance of getting feared stagger your tremor totems)

air: 1 wrath of air 4 grounding

That is what I have been doing. Haven't really messed around with it too much. What are you dropping?