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 casts 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 to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
- Joe’s top pick of the week is also our top pick. Its a great talk by Reuben Strayer on Contemporary Strategies in Airway Management that he presented at ICEM12 in Dublin. Reuben gives us his top 20 pearls from the literature on current concepts in airway management, from when to cric all the way through to some helpful hints on how not to use the laryngoscope as a murder weapon. For more ED/CC brilliance from Reuben check out his blog Emergency Medicine Updates.
The LITFL Review Top Picks
- Size matters when you’re sick - although a smaller ETT may give you better patient satisfaction scores in elective anaesthesia in the critically ill patient the bigger the ETT the better!
- Amit shares with us a great case of a Massive PE Secondary to Physiotherapy…. then provides us with a nice,neat and sharp review on the investigation’s and management of patients presenting with massive PE.
- Learning points from a first time emergency thoracotomy- Andy welcomes new blogger on board David Menzies, and certainly steps up to the plate will an excellent post, and shares with us the learning points he gained from doing his first emergency thoracotomy.
- Andy has recorded another brilliant talk from Mike at ICEM12, were he debates the The Textbook is Dead - great pearls and points from Mike on were medical education is heading. Worth watching as some other luminaries like Greg Henry and Joe Lex pipe in at the end to give there take on the textbook.
- Trying Hard – Trials in EM Research - Lauren shares with us some important thought provoking points on why evidence based medicine is different in emergency medicine. Great post Lauren!
- Tramadol: A Myth of Safety- is it as safe as most of us think it is?
- Vancouver Chest Pain Rule in Tehran - this study although had hardly enough patients to validate it properly, it does show some promise that this chest pain rule can be very effective for early discharging low risk chest pain patients from the ED.
- The “Peripheral” IJ - when the patient just needs access, but isn’t desperate for an IO. Radecki thinks its a good idea, but Weingart in his comments - has his concerns….Your own thoughts?
- Rob Rogers’ and the University of Maryland’s International Emergency Medicine Faculty Development Course is coming together by the looks… LITFL is sending Chris over to make sure we don’t miss out on anything.
- Death from methylone ingestion - Wow 3 deaths all attributed to methylone a canthinone found in baths salts. Presents very similar to amphetamine intoxication and should be treated the same, stop or prevent seizures, reduce temperature and agitation, and provided excellent supportive care.
- Lipid emulsion therapy for poisonings: a review - The evidence for ILE isn’t great but this review as Leon highlights is worth reading and keeping on file.
- The Minh and Seth tag team podcast is back again with another great episode tackling a very difficult topic ED chronic pain management. The lads provide us with a great approach to pain management in the ED, how to limit prescribing and what alternatives to opioids do you have- worth a listen!
- Treating Numbers: Pulse Oximetry - Bottom line: Don’t get into the habit of treating numbers without thinking about them. There are lots of reasons for the oximeter to read artificially low. Remember – think,examine, and then rationalise your reasons for doing something, don’t just follow the norm or in this case the number!
- Ocular Sonography Detects Intracranial Pressure - is the ultrasound probe the new ICP monitor?
- Early Ketamine Promising for Refractory Status Epilepticus - Dr Rob Orman…Yes the dude from ER CAST provides an excellent viewpoint on this recently published case report on ketamine used in a patient with refractory status epilepticus. Rob points out that this is a case report is just that, “still an n of one,” as he put it. This latest case report, however, puts “ketamine down as another arrow in the quiver as a potential third-line agent, a single arrow among many”.
- The Click of Medicine - are we forgetting how to think in medicine or should I say to rule of pathology, or is it just easier to investigate everyone even if there low risk? Graham lets us know his thoughts or should I say rant about this so called art of medicine!!!!
- The team at ALIEM welcome a new blogger to the team Dr Javier Benitez or as he is well know @jvrbntz on Twitter.
- Javier starts of with a cracking post highlighting some excellent points that are still very pertinent today from an article written by one of emergency medicine founding fathers Peter Rosen. Check out The essay of all essays: “The biology of emergency medicine” Part 1 and Part 2.
- This weeks Trick of the Trade: Massaging a mandibular dislocation back in- Check out the video below to find out how cool this technique is:
- You Snooze, You Ooze: Anticoagulation and Minor Head Injury - the NICE guidelines might not be so nice after all when it comes to the anticoagulated minor head injured patient!
- Subtle ECG, seen well in PVC’s, and 2 arteries are involved. - Can you pick the culprit lesions from this patients ECG’s!
- Nice review on Cocaine Chest Pain, “Answers”- Take home point to remember: When evaluating cocaine chest pain (CCP), vasospasm is at the forefront of most clinicians’ minds. Cocaine, however, has multiple haemodynamic and hematologic effects that increase the risk of myocardial ischemia, both acutely after each use and chronically over time.
- Tension Pneumothorax: Needle Vs Knife. Thomas points out that he prefers the knife approach in the tranquil environment of the ED, but when he’s on the side of a mountain the needle approach has its advantages to relieve a tension pneumothorax.
- A 42yo man is admitted to ICU through the emergency department, having presented with central abdominal pain, nausea and vomiting in Hot Case #9 , Mathew then serves us up a challenging blood gas, can you crack it and work out its clinical correlation?
- Vasculitis – making rash decisions? Casey gives us a case of what looks to be vasculitis, but he wants to be able work out the cause and what to do next….Can you help him finish of the case?
The LITFL Review Shout Out of the Week
- EMERJENCYWEBB new blog on the scene with some great content on a variety of emergency medicine topics,by ED resident Jeremy Webb!
- Tintinali Time: Cardiac Trauma - short, sharp and nifty review on cardiac trauma.
- Presidential Assassinations Part One: Abraham Lincoln - a bit of medical history for you and the medical report from the ED on the death of a president.
- For more on EMERJENCYWEBB follow him on Twitter @Emedwebb
Twee Dee and Twitical Care
News from the Fastlane
- Chris set all you LITFers a challenge with A Really Tricky ABG?, great response so far- stay tuned as the answer will be revealed and a new F.UCEM will be crowned!!!
- Michelle serve’s up a tricky blood gas for you to crack in a very hard patient….Check out A Most Discombobulating Gas!
- Chris wants to know is Is Throckmorton’s Sign Predictive?- it worries me what he will think of up next .
The Final Words
- “Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.”
— Atul Gawande
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 kane AT lifeinthefastlane.com
LITFL Review EM/CC Educational Social Media Round Up
123Sonography.com — Academic Life in Emergency Medicine — Adventure Medicine— A Life at Risk — All LA Conference — Al Sacchetti’s Youtube — Bedside Ultrasound — Better in Emergency Medicine — Broome Docs — CCM-L.org — CLIC-EM — Critical Care Perspectives in EM — Dave on Airways —DrGDH — Dr Smith’s ECG Blog — ECG Academy — ECG Guru — ECG of the Week—ED Exam — EDTCC — EKG Videos — EM Basic — EM Core Content — EMCrit — Emergency Medical Abstracts —EMERJENCYWEBB –EmergencyLondon — Emergency Medicine Cases — Emergency Medicine Education — Emergency Medicine News — Emergency Medicine Ireland — Emergency Medicine Tutorials—Emergency Medicine Updates —Emergucate —EM Literature of Note — empem.org — EMpills — Emergency Physicians Monthly — EM Lyceum — EMProcedures — EMRAP — EMRAP: Educators’ Edition — EMRAP.TV — EM REMS — ER CAST — Free Emergency Medicine Talks — GMEP — Gmergency! — Greater Sydney Area HEMS — HQmeded.com — ICU Rounds — Impactednurse — Intensive Care Network —iTeachEM - keepcaring — Keeping Up With Emergency Medicine — KeeWeeDoc — KI Docs — LipheLongLurnERdok — MDaware — MD+ CALC — MedEDMasters — Medical Education Videos — Medicina d’urgenza — Medicine for the Outdoors — Micrognome — Movin’ Meat — Neurointensive Care — Pediatric EM Morsels — PEM ED — PEMLit — PHARM — Practical Evidence — Priceless Electrical Activity — Procedurettes — PulmCCM.org — Radiology Signs — Radiopaedia — Resus.com.au — Resus.ME — RESUS Room — Richard Winters’ Physician Leadership —ruralflyingdoc — SCANCRIT — SCCM Blogs — SCCM Podcast — SEMEP — SinaiEM — SinaiEM Ultrasound — SMART EM — SonoSpot — StEmylns — Takeokun — thebluntdissection—The Central Line — The Ember Project —The Emergency Medicine Resident Blog — The NNT — The Poison Review — The Sharp End — The Short Coat —The Skeptics Guide to Emergency Medicine — The Sono Cave - The Trauma Professional’s Blog — underneathEM.com — ToxTalk — TJdogma — Twin Cities Toxicology — Ultrarounds — UMEM Educational Pearls — Ultrasound Village