Welcome to the stimulating 29th edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team will cast the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle.
The Most Fair Dinkum Ripper Beaut of the Week!
Top spot this week heads up north to Casey Parker with his brilliant take off of the hit song “If you are happy and you know it.” If you’ve just come of a weekend of dealing with drunks, punks and personality disorders your bound to be singing this all the way to your next shift. Maybe we could even use the song as a preventative health measure and play it in the waiting room?
If you are angry and you know it, punch a pillow.
If you are angry and you know it, punch a pillow.
Don’t punch your wife, or the fridge or a window -
If you are angry and you know it punch a pillow!
If you are sad and you know it, call a friend.
If you are sad and you know it, phone a friend.
Don’t drink, cut yourself or a seizure pretend.
If you are sad and you know it phone a friend.
If you are crazy and you know it, you are probably not crazy.
If you are crazy and you know it, you are probably not crazy.
Maybe you ego is a bit hazy, or your coping mechanisms: lazy.
If you are crazy and you know it, you are probably not crazy.
If you’re a Junky and you know it – try and be smart.
If you’re a Junky and you know it – try and be smart.
Don’t turn up to ED, look needy, hoping I’ll have a heart.
If you’re a Junky and you know it – try and be smart.
- If it barks like a seal, is it a seal? A paediatric diagnostic dilemma set to challenge the most experienced clinicians…What would you do?
- Life and limb (not life OR limb) is it time to review the new evidence and the use of tourniquets in the ED trauma patient.
The Usual Suspects
- Seems that the E-FAST for pneumothorax is beginning to be to dominate force in diagnosis, rather than the time honoured CXR.
- Check out the 10 most potential Practice Changing Abstracts to impact the practice of emergency physicians, from the Society for Academic Emergency Medicine’s Annual Meeting was held June 1-5, 2011 in Boston, Massachusetts.
- Organ Donation in the ED, although not something the ED Critical Care specialist does everyday, this short, straightforward, and informative video is right on the money for everything you need to know on diagnosing brain death.
- Special Report: From the Tox Files: Pharmacobezoar, Sparkle Lamp Ingestion, and Tetrodotoxin Loen gives us an update with whats happening in toxicology.
- Diagnosis Deconstructed: The One Thing that Doesn’t Fit - a diagnostic challenge with the aid of ultrasound.
- This weeks talk of the week is By David Newman yes he is everywhere from SMART EM, Annals of Emergency Medicine Podcast, EMCrit and the NNT and now gets Joe’s pick of the week with a talk on Understanding Diagnostic Testing.
Academic Life in Emergency Medicine
- Trick of the trade: Head lacs are always difficult to bandage and keep the bandage in place - mainly because the patient is either confused or intoxicated. Well it doesn’t have to be a challenge anymore check out this trick of the trade and start making a beanie hat and have your patients haemostasis and coolness under control.
- Paucis Verbis: Can’t always remember the indication and contraindications for Fibrinolytics for PE, time to save this handy little card to your phone for quick reference.
- Struggling with inspiration lately -have a listen to Conan O’Brien graduation speech…If it doesn’t give you inspiration it sure will give you a laugh.
- Neurological changes and hip prosthesis: consider cobalt toxicity. The key take-home lesson here: Any patient with a history of hip replacement and any neurological symptoms should be evaluated to determine the exact prosthesis involved, as well as cobalt levels.
- Is the initial lactate level helpful in managing patients with carbon monoxide poisoning? It might be, although the flaws in paper were to big to come to that conclusion. What we do know is, lactate levels can be helpful in these patients — especially those with smoke inhalation — as an indicator of concomitant cyanide toxicity.
- The lad’s are back from a break with How to Get Promoted in Academic Emergency Medicine. If you want to know how it’s done….you must check out this episode.
The Rest Of The Best
- Advice following occupational exposure (needle stick). We hope it never happens to us or our colleagues but it good to be armed with the facts if it does. Also worth looking at MD Calc at its HIV Needle Stick Risk Assessment Stratification Protocol (RASP).
- Why methaemoglobinaemia is a good thing, we heard last week why its bad, this week Andy has a look why its good. Maybe need week it will be time for why its ugly?
- We have heard an abundance of information on Pulmonary Embolus from the emergency medicine world of late -now its time for the ICU perspective.
- Oli brings us a new feature to his blog with scan of the week. Have a look at this week’s scan and see if you can spot the major findings…
- Dr G follows up from his top spot last week with another fantastic post looking at Myasthenic Crisis: My patient is seriously weak!
Emergency Medicine Literature of Note
- Watch out capnography the new gold standard for tube placement could be Endotracheal Tube Verification Via Ultrasound.
- “Narcotic Bowel Syndrome” Take home message - The key feature in this particular diagnosis, as described in their case, is they had extensive follow-up evaluation, were weaned from their narcotics, and had resolution of symptoms.
Emergency Physicians International
- This months issue highlights, Australia’s own Peter Cameron writing about “Embracing the Role Of specialist”.
This week pearl is by Dr Michael Winters with a look at Blood Pressure in the Critically Ill Obese Patient:
- Recall that incorrectly sized cuffs can significantly overestimate blood pressure, especially in obese patients.
- In fact, some studies show that false BP readings can occur in up to 75% of obese patients.
- By relying solely on noninvasive BP measurements, many of your critically ill obese patients may actually be hypotensive and under perfused.
- When you’ve got a sick obese patient, strongly consider early placement of an arterial line to assess and monitor blood pressure.
- Novel Approaches in the Management of DKA - has a look at the initial insulin bolus in DKA- bottom line the risk seems to outweigh the benefits!!
- Chest Tube Tips pure awesomeness, you would be surprised how complex this piece of pipe is.
- Looks like the doughnut of death can now come to us - Portable CT Scanning For Trauma Patients.
- Brain Injury and Chemical Prophylaxis for DVT, although its only a small study, it appears safe and effective.
- When will Palliative Care and Hospice discussions be considered normal? When we allow it to be and feel comfortable initiating and having these discussions.
- For something different this week The LITFL R/V give’s a shout shout-out to our friends the X-Ray Tech with their fascinating blog post looking at 10 Interesting Facts About the History of X-Ray Technology , from the discovery of the electron all the way through to the use of X-rays in space.
Twee-D and Twitcal Care
EMCrit wants to know, what you want to know about sepsis -looks like a new podcast is on the horizon.
News from the Fastlane
- The team at LITFL extend our congratulations to our friend ZDoggMD and to Mrs ZDogg on their new arrival to the ZDogg family.
The Final Words
- Nothing is a waste of time if you use the experience wisely.
-Auguste Rodin
- “Your perceived failure can become a catalyst for profound reinvention.”
-Conan O’Brien
That’s it for now… Hopefully this roundup of the world of electronic emergency medicine and critical care education for everyone helps you to deal with anyone, anything, anywhere at anytime for at least another week! If you’d like to suggest something for inclusion in the next edition of The LITFL Review, email our roving reporter:kane AT lifeinthefastlane.com
About Kane Guthrie
Great review as always. On a side note what happened to the mobile interface???
Thanks mate
I think the mobile interface should be back up and running now…
Cheers Aaron,
Thanks for all your support as always.
Kane