Greatest Hits 2010

We thought 2009 was a huge year for LITFL. It was.

But 2010 was even bigger. A hell of a lot has happened in 12 months! Let’s recap.

LITFL is now truly far more than ‘just’ a blog. The website now has a MASSIVE ‘back end’, with much of the content not appearing in the blog timeline. Indeed many of our most downloaded pages are not blog posts but permanent pages. For instance, the Visual Aid Questions [VAQ] page has had over 15,000 views this year and numerous other pages — like the ECG Library, Short Answer Questions [SAQ], Eponymous Fractures, MCQ Basic Sciences, and Clinical Cases — are all nearly as popular. Paul Young’s Critical Care Drug Manual is another great resource that came online this year. Mind you, we wouldn’t be LITFL if we only had serious stuff… We’ve now got our own LITFL Shop filled with crazy gear, and, amazingly, some weirdos actually wear this stuff!

Meanwhile, the immediate LITFL family continues to grow, despite the diabolical and dictatorial tendencies of Mike and yours truly. Over the past year we’ve welcomed a number of new fantastic contributors to the team: Edward Burns, Oliver Flower, Jarrad Hall/ Commander Harrison Biscuit III, Sean Rothwell and Tea Brennan.

The extended LITFL family has also gone forth and multiplied. Over 1,100 friends follow the blog on Facebook and we’ve also had the chance to strengthen ties with all of our blogging and podcasting mates from around the world. Thanks to the wonders of modern air travel we’ve even got to meet some of them in person! We also got to host SurgeXperiences 318 and the medical blog Grand Rounds Killer Posts.

From left: Anton Helman, Chris Nickson, Scott Weingart, Michelle Lin and Leon Gussow.

As expected, the Utopian College of Emergency for Medicine is also thriving. UCEM’s continued quest for world domination comes closer to reality with every passing moment. Sir Hubert Ignatius Thompson‘s current projections indicate that there will be 11 billion F.UCEMs on Planet Earth by 2013. In addition, the preparations for the Waiting Room Medicine Conference in Molvania are nearly finalised and, due to unprecedented demand, enrollments may soon have to close.

But, what does the future hold for LITFL?

You can expect more of the same. Case-based questions-and-answer scenarios, random medical musings, barely comprehensible medical satire from the UCEM corridors of power, the occasional rant, and opinions, insights and explanations from the crossroads of medicine, social media and the Web. The backend will get bigger and better — with the expansion of the ECG Library, an upsurge in quality ACEM Primary exam resources, and the addition of anaesthetics exam resources as we welcome Jeremy Fernando to the LITFL team. Also, new editions of the ‘Toxicology Handbook’, ‘On Call Principles and Protocols’ and ‘Emergency Medicine: Diagnosis and Management’ will soon be hitting the streets. Oh yeah, and then there’s the Rugby World Cup…

Enough idle chatter. In keeping with tradition, we present now LITFL’s ‘Greatest Hits 2010′ — the year’s most popular posts. Perrenial favourites from previous years that continue to attract attention — including Box Jellyfish (Chironex fleckeri) which clocked over 17,000 hits in one day to knock ‘All time worst non-emergencies‘ off the LITFL ‘all-time most viewed post pinnacle’ — are NOT included.

The countdown begins…

10. Chironex fleckeri envenoming

The world wouldn’t seem right without at least one jellyfish post in the LITFL top 10. This Toxicology Conundrum narrowly beat ‘It was the little octopus‘ to claim a place in the Top 10. The multi-tentacled box jellyfish is the baddest baddie of all the world’s most dangerous venomous animals. The management of severe envenomings are not for the faint of heart… Can you rise to the challenge?

9. Meow-Meow Mephedrone

The street drug scene is ever changing in this age of designer drugs and internet marketing. Fortunately, there are people like Leon Gussow around to help make sense out of the chaos.  LITFL has also tried to play its part in unraveling the complexity (see Life in the TOO fast lane?), and Kane Guthrie‘s comprehensive post on Mephedrone is a useful guide to the emergency management of the Meow-Meow-ing patient.

8. Antibiotic Therapeutic Guidelines Update 2010

A new edition of Australia’s Antibiotic Therapeutic Guidelines came out this year. Unfortunately, it’s hard to know what has changed without reading the entire book. This post by James Winton is a god-send — it tells you exactly what has changed and what you need to know.

7. Paralysis and a head lump

Another Aussie envenoming classic: the old tick paralysis conundrum. Yet another way Mother Nature likes to show who’s boss.

6. ED Thoracotomy: Is it Just the First Part of the Autopsy?

Cracking open a chest is the archetypal emergency procedure. Yet, emergency thoracotomy remains highly controversial. All the ins and outs are discussed by Kane Guthrie. Although it isn’t always the first part of the autopsy, it usually is.

5. Lost Under the Skin?

Wouldn’t it be great if anatomy could be reduced to a simple diagram, like the map of the London Underground? Sam Loman seemed to think so…

4. Muscular claustrophobia

Compartment syndrome is a true emergency. Diagnosing it can be tricky and treatment must be decisive. This case-based Q&A goes through all aspects step-by-step, including compartment pressure measurement and the drama of fasciotomy.

3. Risky Rhythyms

Edward Burns‘ arrival on the LITFL scene has been a real boon. Ed has an unhealthy love of squiggly lines drawn on sheets of paper covered with orange squares. He specialises in posts on ECG interpretation, and this just one of his growing number of brilliant posts.

2. Popular Misconceptions about Evolution

If you’re among those that thought only Jarrad Hall’s (aka Commander Harrison Biscuit III) immediate family read his posts seeing this in the number two position may be of some surprise. What has it got to do with emergency medicine or critical care you ask? Don’t worry, we forgive your naïveté, but you really should know that nothing in medicine makes sense except in light of evolution.

1. Radiological Pin-Up Calendar

Is beauty really just skin deep? The answer is provided by Ass-Prof Tor Ercleve in LITFL’s most popular XXX-ray-ted post of 2010.

Lastly, the LITFL team would like to thank our readers — as well as our friends and family — for the incredible support we’ve received over the past year. It is an incredible privilege to have such an intelligent, funny and kind readership. We can’t help but feel someone above has made a terrible mistake… surely we don’t deserve such support, but we’re thankful and will accept it all the same!

Bring on 2011.