Welcome to the sumptuous 68th 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 Beauts of the Week
- Emergency Department Intubation Checklist v13 — the latest version of Reuben Strayer’s fantastic checklist. I used an earlier version as the core of my own approach to airway management for the FACEM exam.
- Life, limb and sight-saving procedures — This article is an editorial that will be published in the EMJ. It is a follow up to a post featured in It’s up to us… regarding the life and limb saving procedures that emergency doctors need to be able to perform, and how to prepare for them even though we may rarely or never have to do them. This has MUST READ written all over it!
- An inspiring demonstration of spirit — Karateka Fred Ettish plumbed the depths following his defeat in UFC2 with a host of calamities that would have crushed lesser men. He overcame them, this is his story.
- Upper GI bleeding guideline update — A look at the recent UK guidelines, including interesting recommendations such as “in non-variceal haemorrhage, acid-suppression drugs (proton pump inhibitors or H2-receptor antagonists) before endoscopy are not recommended.” Well worth reading.
The LITFL Review Top Picks
- Trick of the Trade: Removing a tungsten ring — or how to break an “unbreakable” ring.
- It all started with an innocent little Socrates and Sophistry post by Michelle Johnston, and ended with remote/ retrieval medical titans jousting it out on the comments feed, on Twitter, and their own blogs and podcasts. Who says the social media meducation world is just a big” love in” with no one ever disagreeing? Find out what went down in Benzos, back pain, Descartes and depression and PHARM Podcast 27 – Benzos and Back Pain debate with Dr Casey Parker.
- Bubble Test to Confirm Central Line Placement — a cool and easy way of checking if you’re in the carotid or the jugular.
- Getting it right the first time – Exam Preparation — Sports Psychologist Patsy Tremayne talks about how she helps candidates through Fellowship exams, focussing on those who have failed in the past. Some great tips for all. Fellowship exams really are far more than a test of knowledge acquisition.
- Procedural Sedation Part 1- Preparation and Procedural Sedation Part 2- Medications — the fundamentals of how to provide painless and comfortable procedures.
- Left Ventricular Assist Devices (LVADs) — as always, more GOLD from Weingart.
- Keeping Children Happy — once you’ve seen a kid with an iphone or ipad in front of them, you know that this is the future of ‘procedural distraction’. Nice little review of a nice little paper.
- Special Report: The Beautiful Lowly Toxicology Case Report — Case reports are much derided, but although one of the lowest form of evidence, they are often the beginning of evidence — especially in Toxicology, as Leon Gussow points out. Great to see a mention of one of my favourite conditions, Marchiafava-Bignami disease (hat tip to Steve Dunjey for acquainting me with it some years ago).
- #FOAM – what is it? — Andy Neill briefly reflects on Twitter finger burnout post-ICEM2012 and features his video recording of Mike’s talk on social media which he has uploading to Vimeo:
- Sepsis: EGDT Continues to Deliver — Manny Rivers on why EGDT rocks, of course.
- The LVAD: Walking, Talking … and Pulseless — Stuart Swadron takes his turn to take on the LVAD.
- Pediatric Fever: Part 2 — Rob O has been emailing me for weeks singing the praises of the LUCAS mnemonic he came up with for sources of fever in kids…. Umm, way to go Rob However the rest of the interview with Andy Sloas is awesome.
- Joe’s pick this week is Chris Luke’s talk on Nightclub Medicine from ICEM 2012 in Ireland.
- Colloids: Details and Myths — Jeffrey Guy’s take on one half of the never-ending colloid versus crystalloid debate in the critically ill.
- Podcast 25: Interpretation of MRI in Critical Care — MRI interpretation is hardly my area of expertise… So this is quite simply my cup of tea.
- Residents: Please Read — wise advice from an outgoing EM Chief.
- Cancer-Related Medical Emergencies: Superior Vena Cava Syndrome — Concise overview of SVC obstruction in critical care.
- Tobin: “Minimal” PEEP and pressure support during SBT kills some patients — Tobin literally wrote the book on mechanical ventilation. This post is worth reading if only to see this quotation one more time:
“But here’s the rub. The challenge of clinical medicine is not about taking care of the great majority of patients who do well irrespective of the methods employed by their physicians. Instead, the goal is to take feasible steps that have a high likelihood of circumventing a catastrophe in a small number of instances.”
- How To Wield Physician Power and Avoid Leading Like an Evil Dictator (Or a Namby-Pamby) — Richard Winters blog is unique — half EM, half super-powered MBA. Read on for some interesting leadership insights.
- Excellent review of opioid toxicity — Boyer’s recent review in the NEJM will be widely read. As well as highlighting the pearls and pitfalls, Leon discusses a few of Boyers’ opinions that he takes issue with.
- Rib fractures in the elderly — they are easily underestimated and the patients can easily come to grief. Here are some solid tips on getting things right.
- Giving bad feedback or giving feedback badly? — Simon Carley gives his take on a difficult but commonplace task in the ED: telling a junior doctor that they got something wrong.
- Code Yellow — can you interpret LFTs like an emergency medical maestro? Click on this and find out.
- Episode 31 – Lung Ultrasound with Vicki Noble Part 1 — add lung ultrasound to your diagnostic arsenal… it is awesome!
The LITFL Review Shout Out of the Week
- SonoSpot — just when you thought there couldn’t possibly be another cool ultrasound resource out there, Laleh Gharahbaghian from Stanford serves up this seriously awesome blog…and a great use of the #GMEP media folder resource to boot!
News from the Fastlane
- The Critical Care Compendium is coming along nicely — topics covered so far include acid-base, monitoring and equipment, clinical governance and ethics… and more is being added all the time.
- I liked this little post from Domhnall Brannigan: @sandnsurf accessing his brain at #icem2012
- Meanwhile, I was trying to follow the #ICEM2012 on Twitter using my iphone at Uluru (Ayer’s Rock) …
The Final Words
- “When faced without a challenge, make one.”
— The 12th of Peter Safar’s Laws for the Navigation of Life
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
LITFL Review EM/CC Educational Social Media Roll Call
Academic Life in Emergency Medicine — A Life at Risk — All LA Conference — Broome Docs — CLIC-EM — Critical Care Perspectives in EM — CritIQ Podcast — DrGDH — Dr Smith’s ECG Blog — ED Exam — EDTCC — EM Basic — EM Core Content — EMCrit — EM Literature of Note — Emergency in the Shed — Emergency Medicine Cases — Emergency Medicine Education — Emergency Medicine News - Emergency Medicine Ireland — Emergency Medicine Updates — empem.org — EMpills — Emergency Physicians Monthly — EM Lyceum — EMRAP: Educators’ Edition — EMRAP.TV — ER CAST — Free Emergency Medicine Talks — Gmergency! — Greater Sydney Area HEMS — HQmeded.com — ICU Rounds — Impactednurse — Intensive Care Network — Keeping Up With Emergency Medicine — KeeWeeDoc — LipheLongLurnERdok — MDaware — MD+ CALC — MedEDMasters — Medical Education Videos — Medicina d’urgenza — Medicine for the Outdoors — Micrognome — Movin’ Meat — Pediatric EM Morsels — PEM ED — PHARM — Priceless Electrical Activity — PulmCCM.org — Resus.com.au — Resus.ME — RESUS Room — Richard Winters’ Physician Leadership — SCANCRIT — SCCM Blogs — SCCM Podcast — SinaiEM — SinaiEM Ultrasound — SMART EM —
SonoSpot — StEmylns — Takeokun — The Central Line — The NNT — The Poison Review — The Short Coat — The Trauma Professional’s Blog — The underneaths of EM — ToxTalk — TJdogma — Twin Cities Toxicology — Ultrasound Podcast — UMEM Educational Pearls — Ultrasound Village