Welcome to the superb 64th 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
- Haney Mallemat not only receives Joe’s pick of the week – but he also get ours with his talk on Who needs a Central Line? This talk is packed full on all the pearls and pitfalls you need to know about resuscitating the hypotensive septic patient in the ED- and is a must listen to for all ED docs and nurses.
The LITFL Review Top 20 of the Week
- Bypass the OR: ECMO in the ED - awesome case presented here on the use of ECMO in a patient with out of hospital cardiac arrest – ground breaking stuff and its were the future of resuscitation is heading.
- New LBBB after Cardiac Arrest - What was the cause the hyperkalaemia or the adrenaline that caused the ST -elevation? Learning point: Post cardiac arrest, the ECG may have transient ST abnormalities.
Emergency Medicine Literature of Note
- Reducing ED Overcrowding Reduces Mortality - Highlights some of the work being done to improve access block and improve the flow and journey of patients through the ED, with a bonus positive effect on mortality and morbidity!
- Trick of the Trade: Stabilizing mandibular relocations - bandages don’t work, so why not just put them in a semi-rigid collar- makes sense.
- Michael shares with use the McGiver approach to making a rapid infusion system in - How To Jerry Rig A Rapid Infusion System.
- Skull fractures in severe TBI - Often seams insignificant when compared to the brain injury, but this study showed having a skull fracture increased mortality by 30% in severe TBI – a fact worth knowing!
- Transdermal fentanyl overdose: don’t let the pharmacokinetics fool you - Take home point: Patients who experience respiratory depression from fentanyl patches should be observed in a monitored setting for at least 24 hours after patch removal.
- Andy gives us a look at Steroids for Kawasaki disease. Remember: think Kawasaki in pre-school child with prolonged fever, funny rash, funnytongue, lymph nodes and conjunctivitis. It’s important cause it causes coronary artery aneurysms
- End-Tidal CO2 as a Predictor of Cardiac Arrest Survival - The conclusion from this study: “EtCO2 values should be included as important variables in protocols to terminate or continue resuscitation in the prehospital setting“.
- Time to help a brothda out with a case Is this Brugada syndrome?
- Another great airway videocast from EMcrit on Airway Tips and Tricks with Jim DuCanto, MD - an anaesthetic guru- with a world of knowledge and experience on the difficult airway.
- Although Roc -Rocks it sucks when you don’t provide effective post intubation care with adequate sedation and analgesia. Scott has a good rant about this in Pain and Terror as Effective Pressors.
- Ian highlights a recently published study on Oxygen therapy for treatment of headaches - its seems it works!
- Leon shares with us another fascinating case that will have you thinking differently the next time you see a patient with abdominal pain and also is taking an ACE inhibitor. Puzzling abdominal pain and vomiting? Consider ACE inhibitor-induced visceral angioedema.
- A case of drowning in ‘Blue-lights and Sirens…’ highlight’s the epidemiology of this issue, the pathophysiology and some management pearls on the drowning victim.
- PHARM Podcast 11 – Rapid Sequence Airway with Dr Darren Braude - Minh has a chat with Darren Braude on “the new black” of airway management - remember RSI is old school and RSA is what all the cool kids are now talking about.
- Azithromycin – Not Guilty of Murder - Ryan takes a hammer to another controversial NEJM study. Sums it up well with: There are lots of reasons not to prescribe azithromycin, but this study isn’t the one that should change your practice.
- ICU guru Mathew Mac Partlin shares with us a case and provides us with and evidence based thought provoking discussion on neuroprognostication post cardiac arrest in ICN Hot Case #8.
- Earlier in the week they hit us with some hard hitting questions on Nephrolithiasis, Questions from what analgesia is best, through to when to CT vs ultrasound? Find out how well you did answering these questions Nephrolithiasis, “Answers”.
- Graham share with us the daily battle of “making it work” as emergency departments in the USA do battle with drug shortages. Emergentology: Sorry, That’s on Back Order.
- Another great Anatomy for Emergency Medicine #15 – SMA Syndrome video by Andy:
The LITFL Review Shout Out of the Week
Being a medical student these day’s is a tough few years, but is it easier these days with the amount of blogs and online resources these students have available to them? This weeks shout out goes to The Short Coat a blog by Lauren Westafer who is a medical student’s attempting to integrate clinical tidbits and cases from the wards and literature, with an emphasis on Emergency Medicine, and she also seems to be a big fan of LITFL.
Check out some of her post below:
- Fellow Students, Lend Me Your Ears – EM Oriented Podcasts
- I See Right Through You – Intro to EM Ultrasound
Twee-D and Twitical Care
News from the Fastlane
- LITFL has joined forces with Emergency Medicine Australasia were we will be hosting short editorial comments on the key papers from each issue of the journal – and encouraging the publishers to allow us access to the full-text version online of these articles.
- Want to win a Complete Copy of Emergency Medicine Diagnosis and Management Online Version - find out how in Emergency Medicine Mobile App Competition.
- Michelle delivers us another splendid physiology philes with a look at Cell membrane resting potential.
The Final Words
- “Stay Hungry – Stay Foolish”
-Steve Jobs
- “Being the richest man in the cemetery doesn’t matter to me. Going to bed at night saying we’ve done something wonderful, that what matters to me.”
-Steve Jobs
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

























