That’s it folks, another funtabulous year in the fast lane is coming to a close. In keeping with LITFL tradition it’s time for a recap of the year that was, and to announce LITFL’s ‘Greatest Hits’ for 2011.
But before we get stuck in, we must humbly thank our readers for their incredible loyalty and support, which amazingly sees LITFL achieve an average of over 10,000 page views daily (!). We must also recognise the encouragement and inspiration we receive from our families, colleagues and friends around the world. Without you all we wouldn’t be able to keep working on this labour of love and to keep serving up free edutainment for anyone, anywhere, anytime.
That’s enough soppy stuff… What happened to LITFL in 2011?
- The LITFL Review —
By the end of 2010 it was clear that the sheer volume of social media resources appearing on the web ‘week-in week-out’ was becoming overwhelming for even the seasoned EM/CC social media maven, never mind the newbie. We felt that it was time for a ‘one stop shop’ to collate, curate and filter the fire hydrant of social media education relevant to emergency medicine and critical care. And, with that, The LITFL Review was born. Kane Guthrie has been tasked with this mammoth job and he has shown that he’s more than up to it. If you’re new to social media education resources and didn’t know where to start… you do now!
- R&R in the FASTLANE —
If you hate hunting through journals looking for stuff worth reading from the emergency medicine and critical literature, this is for you. A weekly recommended reading list — including cutting edge research, classic reviews, and forgotten pearls from the past — created by the collaborative efforts of some of the best and brightest emergency docs and intensivists from around the the world. This is social media in action! We’re looking forward to providing the world with a free weekly dose of ‘eminence-based evidence‘ throughout 2012. Also, a big thanks to Rob Rogers for featuring this project at the end of EMRAP:EE’s podcasting episode.
- American ER Doc Gone Walkabout —
Few crews are more motley than the LITFL team. And it got a whole lot ‘motleyer’ when we welcomed Denver-based emergency physician Rick Abbott aboard. His series of insights into variations in emergency medicine practice, and healthcare in general, from Tasmania and the United States are quickly becoming classics for their honesty, veracity and laugh-out-loud hilarity.
- Emergency Medicine Update —
Yosef Leibman has been sifting through the emergency medicine literature for more years than the LITFL team have had censures for their illegible handwriting. Every month he collates his newly acquired wisdom into an iconoclastic monthly review called EMU. It didn’t seem right that EMU had barely a handful of subscribers in Australasia, so we’re making webified LITFL versions to help spread the word.
- Postcards from the Edge —
A great way to find out about the adventures you could be having on foreign soil and the challenges of global health. If you’re ‘on the edge’, send us a postcard!
LITFL regulars know that we’re more than just a blog. The site has a huge backend (we take that as a compliment). Examination resources (ACEM and CICM) are continually being updated and improved, and we’re always working to develop our role as curators of free web-based social media education resources for emergency medicine and critical care.
- The searchable podcast database ties in podcasts and audio recordings from all around the world (including access to Joe Lex’s Free Emergency Medicine Talks) and means you can find just the talk you want, when you want it.
- The LITFL emergency medicine blog database remains the ultimate place to find a blog to suit your own peculiar tastes!
- In ECGstasy we recently highlighted the progress made with the ECG Library, and the great work on this project by Ed Burns and LITFL newcomer John Larkin. This is as good as any ECG resource for emergency medicine and critical care I’ve seen — and, as always, its completely free!
- We also continue to offer high quality reusable resources including clinical images, radiology images, ECGs and multimedia resources through the Image databases.
- LITFL now has a hub for International Emergency Medicine and is closely affiliated with the IEM (Australasia) Facebook group (administrated by our very own Bishan Rajapakse).
The Blogging Team
|Dr Gerard “Junior” Fennessy MB ChB PGDipComEmMed
Kiwi ICU Registrar working at the Austin Hospital, Melbourne, as an ACEM and CICM advanced trainee. Toyed with Skifield Medicine on Mt Ruapehu and Ocean Medicine in USA/Mexico. Interests include shoulder dislocations, ECGs and organ donation. ‘Junior’ is a signed up member of the Beige Brigade and spends his spare time hacking and repairing iPhones, cracking wireless networks and building chicken hutches. – *Read Posts*
|Dr Rick Abbott MD
Rick Abbott (aka American ER doc gone walkabout) has been an ER Doc since 1973 and has bad wanderlust. He is currently Assistant Clinical Professor in a University teaching hospital in Denver, Colorado and has occasional trips to practice in an 8 bed ER at an Indian Health Service Hospital. He also likes to see medicine from the other side, which he achieves by crashing his bicycle on a regular basis…
|Dr Yosef Leibman MD
Yosef Leibman is currently a senior attending in the ED at Meir Hospital in Kfar Sava, Israel and is affiliated with the Tel Aviv University of Medicine. A prolific author and speaker in both Israel and the United States, Yosef was the founder and first Editor-in-Chief of the Israeli Journal of Emergency Medicine. Since 1998 he has produced the amazing Emergency Medicine Update.
|Dr Michelle Johnston FACEM
Michelle Johnston has worked as an Emergency Physician in her beloved Royal Perth Hospital, a down and dirty inner city hospital, for over a decade. She is heavily involved in teaching and loves clinical work, but when it comes to social media, she is like the syndromic cousin in the corner who gets brought out and patted on the head once in a while. Michelle is also the creator of #Path140 and specialises in all things quirky, weird and wonderful. - *Read Posts*
|Dr John Larkin MB ChB MCEM(UK)
John Larkin is an Emergency Medicine Registrar, originally from Liverpool in the UK, now training in Western Australia. His work interests include emergency orthopaedics, ECGs, medical education, and the future of emergency medicine training. When time permits, John’s non-work related interests include MMA, continually fixing his PC, mindless cinema and helping cobble together the ECG library.
Meanwhile, in 2011, Mike got to meet some of our best buddies from the world of social media education over at the Essentials of Emergency Medicine in San Francisco:
The beginning of the year was frenetically frantic for Mike (to be fair, the rest of the year was as well!), as we saw the publication of new editions of his popular texts:
- Toxicology Handbook (2nd edition) by Lindsay Murray, Frank Daly, Mark Little and Mike Cadogan
- Marshall & Ruedy’s On Call Principles and Protocols (2nd edition) by Mike Cadogan, Anthony F T Brown and Antonio Celenza
- Emergency Medicine Diagnosis and Management (6th edition) by Anthony F T Brown and Mike Cadogan
Mike has put in untold Kadogjen hours into these little beauties, and consumed countless cartons of chocolate milk in the process. Furthermore, various members of the LITFL team have helped in one way or another. We’re proud to provide a living, breathing web-based extended resource for readers of these superb texts and invite you to get reading!
Meanwhile, 2011 has seen some interesting primary research publications from members of the LITFL team:
- Flower O, Smith M. The acute management of intracerebral hemorrhage. Curr Opin Crit Care. 2011 Apr;17(2):106-14. Review. PMID: 21169826.
- Rajapakse BN, Thiermann H, Eyer P, Worek F, Bowe SJ, Dawson AH, Buckley NA. Evaluation of the Test-mate ChE (Cholinesterase) Field Kit in Acute Organophosphorus Poisoning. Ann Emerg Med. 2011 Dec;58(6):559-564.e6. PMID: 22098995.
- Sinha P, Flower O, Soni N. Deadspace ventilation: a waste of breath! Intensive Care Med. 2011 May;37(5):735-46. Epub 2011 Mar 11. Review. PMID: 21394623.
I was going to include Paul Young‘s publications from the past year as well, but there have been way too many… If you’ve been wondering why he hasn’t written many LITFL posts recently its because he’s turned himself into a research machine! (see Wellington ICU Publications) Paul is heading the ANZICS HEAT trial (The Permissive HyperthErmiA Through Avoidance of Paracetamol in Sepsis Trial) which is going to be very, very interesting…
The Boundless Future
The LITFL team has always got plenty of projects on the boil. Here are some things to look out for in 2012:
- more of the same, but bigger and better..!
- development of the CICM exam resources for intensive care — with a couple of the LITFL team thinking about finally sitting their Fellowship exams this is becoming a pressing priority…
- more evidence-based resources to complement EMU and R&R in the FASTLANE.
- the creation of more original audio and multimedia resources to enrich the blog posts.
- and there are strong rumours about a trauma/ ortho library (along the lines of the ECG Library) in the works….
Finally, LITFL is always on the look out for new contributors and ways of collaborating with our friends around the world. It’s a real privilege to be part of the social media meducation revolution. Let’s keep it going!
The Greatest Hits 2011
In past years (2010 and 2009) we presented LITFL’s greatest hits as those with the most page views. This year we’re going for quality not quantity. We pulled together the LITFL team (those that could be torn aware from their Christmas pavlovas at least… which is a New Zealand invention by the way…) to work out what we think were the best LITFL blog posts of 2011.
These were the rules:
- LITFL team members had to rank their 5 favourite blogposts.
- They were only allowed to nominate blogposts written by other team members — not their own!
- The 5 posts were given points based on their 1st-to-5th ranking: 10-7-5-3-1
- All the points were added up… and voila!
- The Storm is here! — Tim Minchin’s brilliant beat poem recounting a clash between skepticism and brainless alternativism gets animated.
- PE: Pain, Puzzles and PERC — Part commentary on the online duel between EMCrit’s Scott Weingart and SMARTEM’s David Newman on the subject of PE, part highlights package, and part curation of LITFL PE resources.
20. Cunningham’s Shoulder Relocation
The quick, painless, easy and sedation-free way to relocate a dislocated shoulder. Neil Cunningham’s method has to be seen to be believed. The post includes a nifty video featuring LITFL’s Gerard Fennessey in action and plenty of links to ShoulderDislocation.net.
19. Planes, Pregnancy and Bleeding
Minh Le Cong is a retrievalist extraordinaire based in Queensland with the RFDS. In his first LITFL guest post he shows why retrieval in remote Australia deserves respect… This case-based Q&A left me feeling nice and safe in my cosy emergency department.
18. Super Axis Man
Gerard’s unique approach to understanding the ECG axis is ideal for newcomers to ECGology. If you haven’t met SAM (Super Axis Man) yet, you’re missing out!
17. FFFF 70: Art of Emergency Medicine
It is probably fair comment to criticise LITFL for being a bit blokey. But steps have been taken to redress the balance, what with Michelle Johnston joining the team. Michelle looks at the world of emergency medicine through a different set of goggles to most of us, as this post on the art (as in paintings) of emergency medicine confirms.
16. Shock, Syncope, Sweating… And Severe Chest Pain!
Ed spends most of his time slaving away behind the scenes on the ECG Library, so he is somewhat under-represented on this hit list. This case-based Q&A is just one of a number high quality posts from the ECG Exigency series. They’re not to be missed.
15. Own the Oxylog 3000!
George Douros from the Austin in Melbourne, and EDteaching.com, was kind enough to share with us the cheat sheets he created for the Oxylog 3000. Print out the pdfs and attach them to your machine so that anyone can ‘own the oxylog’.
14. Six True Emergencies
Every doctor or nurse should read this before attending their first code or MET call. Gerard adheres to the KISS principle in this guide to the Six True Emergencies — the diagnosis and management of which will get you out of most sticky situations.
13. Art of MI Localisation
Even though Tor still watches betamax videos and is still trying to fit CDs into his tape deck so that he can listen to Abba, the LITFL team are lucky to have such a great medical illustrator as part of our crew. Art and medicine combine in this post as we see how Tor visualises the localisation of myocardial infarctions.
12. A Motorcyclist’s Irreparable Injury
Breaking things is part and parcel of owning a motorcycle. On this occasion, broken bones aren’t the issue. This case-based Q&A is a parody of itself, and considers the management and prevention of injuries to your third most vital organ…
11. Adding insult to injury?
If for some reason you’ve read all the key literature on when and why to pop a finger up a trauma patient’s bottom, it seems only appropriate to create a case-based Q&A on the topic. This is the end result.
10. Learning by Spaced Repetition
I finally put this technique for learning and memorization to use in 2011. I recommend you give it a try. This post explains how spaced repetition works, and how you can put it into practice.
9. Waiting Room Medicine
UCEM’s waiting room design was given new life with this post. A classic of it’s kind, featuring key treatment areas such as the coronary chair unit (CCU), the imminent collapse unit (ICU), the rarely assessed or monitored patient (RAMP) area and a whole lot more…
8. FAST HUGS IN BED Please!
Not sure how this made it to Number 8 on the list, but it turns out some people quite like my modification of the FAST HUGS mnemonic for addressing the issues in the supportive care of the critically ill patient.
7. Why are there so many emergencies? THIS is an ER!
Rick Abbott has eclipsed Neil Armstrong’s achievement in becoming the first American on the Moon, by becoming the first American on LITFL — a far more alien world. But boy did he hit the ground running with this one, the first in his American ER Doc Gone Walkabout series. I don’t often laugh out loud at a blogpost, but I must admit to a few snorts and chuckles with this.
6. FFFF 51: First Lines in Literature
The FFFF series may not be to everyone’s taste… after all not everyone’s an uber geek! But if you are, and you fancy yourself as a bit of a bibliomaniac, the 51st edition is irrestible. Can you name the 10 LITFL/ medicine-related books from which the opening lines or paragraphs are taken?
5. Does Roc Rock? Does Sux Suck?
Hell yeah! Make no mistake this case-based Q&A is pro-Roc. It tackles all the major issues affecting the pros-and-cons of using rocuronium and suxamethonium for rapid sequence intubation in an emergency setting. It pays homage to Reuben Strayer (Emergency Medicine Updates) and features his perfect screencast presentation on this selfsame topic.
4. The LITFL Review 001
It is hard to pick one out of a series of blogposts, but the LITFL team are all addicted to The LITFL Review. Kane does most of the grunt work in putting this together, and if you’re not using it, you’re a MUPPET and always will be… We’ve picked out the first edition because there is no better place to start than the beginning.
3. Own The Airway
Inspired by an airway session workshop, I wanted to see what videos I could find on online that were practical, useful, free, high quality, and would help both novices and the more seasoned veteran to really ‘own the airway!’. To my surprise there was plenty of buried treasure to be found, making this page one of the LITFL team’s favorite airway resources.
2. Choose Your Own Resus Adventure
Gerard sent me this and asked if I reckoned it could be made into a blogpost. My first thought was ‘are you kidding?’. But the concept of a ‘choose your own adventure’ step-by-step approach to a difficult cardiac arrest resuscitation scenario was mind blowing. Thanks to Gerard’s distinctively madcap style and unique sense of humor, this is one of the great educational blogposts of all time!
1. Power Of Social Media Leads To Reversal
For me, this post exemplifies what social media in education is all about. Christopher Watford spotted an unusual finding on an ECG from a past emergency medicine exam question on LITFL, that wasn’t included in the model answer. We looked at it and had to agree. But to make sure, we got onto Twitter and asked a few of our cardiology/ electrophysiology buddies in the USA to check it out. This post tells the story of what unfolded and teaches important lessons about calling Emperors naked, the fallibility of any examination process, how to interpret ECG lead reversals and the undeniable power of social media.