The LITFL Review has had a revamp — recently it has got too big to be a useful filter… The new format highlights the ripper of the week (as always) but now selects only the top 20 blogposts and podcasts from the past week as chosen by the LITFL team… Let us know what you think.
Welcome to the revamped 59th 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
- The High Flow Nasal Cannula in the Emergency Department — Reuben highlights a novel approach to preventing desaturation during RSI – a method that can delivered up to 60 litres of humidified oxygen. Also checkout the ScanCrit review of the literature surrounding Humidified nasal high-flow oxygen.
The LITFL Review Top 20 of the Week
1. Broome Docs
- RSI: made stupidly simple — Casey gives us the 3 biggest changes to the way we approach RSI over the past few years from the use of pre-oxygenation, to does cricoid pressure really make a difference, and finishes it with what paralytic is best.
- Michael Winters shares with us a Stepwise approach to managing the Crashing Ventilated Patient — this presentation is packed full of pearls to help us manage this often uncommon situation — a must check out post.
- Information Overload — some tips and tricks for trying to keep up with barrage of information we are all faced with in the name of “evidence based practice” – how much time do you dedicate each week to CME/reading journals or do you prefer to just get your information overload each week from the LITFL review?
- Ian provides us with insight behind the poster we all love and has so much meaning to what we do in the emergency department — the story behind the ‘Keep Calm and Carry On’ poster.
- EMCrit Live Show # 1 — Scott tries something very different and host a live show were he answers the listeners questions either from the blog or through Skype — another brilliant concept from the podcasting guru — have a listen for your self and stay tuned for the next podcast!
- Dobutamine for severe heart failure – more harm than good? — Bottom line on this study: A systematic review and meta-analysis of randomised controlled trials showed dobutamine is not associated with improved mortality in heart failure patients and in the case of severe heart failure there is some suggestion of increased mortality, although this did not reach statistical significance.
- Tasty Morsels of EM #27 – Head Injury — Just some handy pearls from handy Andy on head injury/trauma!
- One-Man Crusade For Steroids In Spinal Trauma — As Ryan points out this is a one-man promotion, its certainly not the standard of care in spinal cord injury management.
- Is chewing khat associated with worse outcomes in patients with acute coronary syndrome? — Although the study had a few flaws – it is not unreasonable to believe that khat use can increase the incidence of acute coronary syndrome (ACS) among users.
- Low haemoglobin arrival in the trauma patient: Believe it! — Is this startling new evidence or something we have known for a long time but haven’t wanted to believe?
- SMART Updates 2012 — David heads back in time and serves up the latest evidence on previous topics the podcast has covered from stress testing to SAH.
- Pediatric Airway 101 — This is a brilliant part 1 of a podcast series on securing and managing the airway in our paediatric patients. Remember: Whether it is pediatric or adult emergency medicine, the most important thing that we do as “emergentologists and resusitologists” is control the airway.
- Non-Invasive Ventilation in Community Acquired Pneumonia & Severe Acute Respiratory Failure — Amit reviews the latest research surrounding this often controversial area of NIV. Major take home point: When NIV was successful, it was associated with better survival!
- Why Do Trauma Patients Get Readmitted? —Remember a lot of the the readmissions are preventable and place further strain on the health care system and patients morbidity and mortality – worth reading this post for the interesting facts.
- Exertional Chest pain and Near Syncope in a Young Adolescent — Great case - not all chest pain in young adults is benign – take a good history and investigate appropriately.
- Phentolamine for neurogenic pulmonary oedema — Although this is a single case report might not be practice changing, but it’s helpful to know about this option – interesting case Cliff thanks for highlighting it.
- Colloid volume therapy for critically ill patients — The European Society of Intensive Care Medicine has produced a consensus statement on colloid volume therapy for critically ill patients, published in this month’s Intensive Care Medicine – with some interesting recommendations!
- The Problem with Pradaxa — an interesting case, followed up by some of the positive and negatives emergency department staff are going to be challenged with by patients taking this drug.
- An interesting visual case of painful red eye.
19. Broome Docs
- Paracentesis: are you stabbing in the dark? — Casey provides us with a succinct summary of the evidence and a few practical pearls that will have you dominating the engorged, coagulopathic, bouncing belly in no time!
The LITFL Review Shout Out of the Week
- Practical evidence was started as a means to get the important clinical policies and guidelines out there to the docs working in the pits. It recognises that journal publications do not address the learning needs of the current generation of Emergency Physicians and that asynchronous learning is where its at. The end result? Another fantastic (and short) podcast series (featuring the one and only Scott Weingart) that lives up to its name in delivering practical evidence.
Have a listen to the first episode on Penetrating Neck Trauma Guidelines.
Twee-D and Twitical Care
News from the Fastlane
- Minh gives us the answer to Where’s The ETT?… No Devices, No Monitors… The Answer!
- Chris produces another bumper edition of R&R In The FASTLANE 013 — with some excellent articles highlighted on managing the ventilated patient.
The Final Words
- “Experience is a harsh teacher because she gives the test first and the lesson afterwards”
-– Vernon Sanders Law
- ”Practicing emergency medicine is like carefully lining up a putt, dropping the putter, picking up a tennis racket to return a volley or two, quickly side-stepping an on-rushing tackler, and then returning to sink the putt.”
— An excerpt from Harwood-Nuss Clinical Practice of Emergency Medicine; source: Andy Neil
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