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
- Its not something your come across every shift but when you do its guaranteed to give you a catecholamine surge! That’s right the troubling Post-Tonsillectomy Hemorrhage is one of the most challenging conditions you can come across. Sean has provided us with a short, sharp approach to managing this tricky presentation. Great post Sean , and well deserved for the top spot this week.
The LITFL Review Top Picks
- Graham provides with a link that gives us an amazing insights into what the ER faced when the Colorado shootings occurred, worth having a read off what the staff were confronted with in The Night the E.R. Staff Can Never Forget.
- Platelet Transfusion & Intracerebral Hemorrhage -It is not possible to say from the data whether the platelets do not show efficacy at treating the extension of the ICH, or whether the poor outcomes result from parallel transfusion-related complications. The article concludes that withholding platelet transfusion should be considered to be within the standard of care.- Your thoughts on this?
- Honey For Pediatric Cough - We have to worry about drug companies interfering with efficacy of studies…..But hang on now we have to worry about the Honey Board of Israel as well!!! However with that said it does seem somewhat of a reasonable intervention for kids with coughs.
- Uhmmmm, Maybe Groin Lines Are Not So Bad with Paul Marik aka the great debate between two great minds of EMCC. Think this sums it up well “The femoral route is for acute resuscitation, then the line comes out upon transfer to the receiving unit.”
- Individual Interactive Instruction - ok laggards take this: it is clear, we should all be embracing asynchronous learning and making it part of our training programs. Dont believe me read the post Chris makes some excellent points!
- Crocs, Stingers and Taipans! - Great teaching game that encourages us all to develop the ‘healthy paranoia’ that is essential for emergency medicine excellence.
- Flipping the Medical Classroom - lets not let medicine be last to adopt this method of teaching- its great that emergency medicine is leading the way here again!
- RANT! Asthma: A Forgotten Therapy. Excellent take home pearl: Some patients predominantly have airway edema – these are patients with poor underlying asthma control and probably should be on long acting bronchodilators and high dose inhaled steroids – identify these people as those who are getting the meds for treatment of bronchospasm, but they are not improving. You should give these people nebulized epinephrine. Epinephrine works because it targets the airway edema. It is a potent alpha agonist, it decreases respiratory mucosal hyperemia because it causes vasospasm, which decreases airway edema and can increase mucociliary clearance.
- Steve provides us with low down on identifying and managing the patient with Hyponatremia in this weeks podcast.
- What are the cause’s of radial nerve palsy - Ioana provides us with a list to consider and some treatment options- nice refresher!
- SUDEP aka the The phenomenon of Sudden Unexplained Death in Epilepsy. Remember: The most important ‘risk factors’ seem to be poor seizure control and seizures occurring during sleep.
- Woman poisons boyfriend with Visine - Take home point: Imidazoline poisoning should be considered when a patient presents with unexplained bradycardia and hypotension.
- Superb review of hemodialysis and other enhanced elimination techniques - Its not often Leon gives a such a positive review on an article and you can see why. The authors provide a fantastic review into enhanced elimination techniques in the critically ill poisoned patient- definitely worth reading!
- NO COUNTRY FOR LAY-MEN (MEH…) Is CPR getting harder or are we all getting more unfit?
- Minh tunes out some nifty pearls and pitfalls he has developed over the years on Recognition of the Sick Child - A must read post.
- A Flying Kiwi! - KeeWeeDoc takes to the skies with his first prehospital retrieval case, manages the patient well and even gets to check out some amazing scenery, mountains, sheep what more could a kiwi want in paradise!
- Paucis Verbis of the week covers Does this adult patient need blood cultures? bit more evidence on when to rationally order blood cultures.
- Trick of the Trade: Incision and loop drainage of abscesses a new better way of dealing with abscesses!
- Spontaneous Reperfusion and Re-occlusion – My Bad Thinking Contributes to a Death. Lesson: STEMI, even if it spontaneously resolves, is very high risk and must go to the cath lab. – A tough lesson even the expert had to learn!
- Graham poses the questions in this months article are we ready for The Geriatric Tsunami thats washing through our emergency departments doors. Brilliant thought provoking writing by Graham on a very tough, confronting and challenging topic we are currently facing in emergency medicine.
- Enoxaparin And Pregnancy Bottom line: It is probably safe to give enoxaparin to pregnant women after trauma. However, it is unclear if the dose needs to be increased to achieve adequate prophylaxis.
- If there isn’t enough awesome free medical resources out on the internet….Handy Andy has found another one the Emergency medicine handbook comes all the way from the republic of Cork!- Were’s that?
- Ay, There’s The Rub – The Mental Capacity Act in the ED - tough case!! Do you know your local mental health act? Would you be faced with the same issues as they were?
The LITFL Review Shout Out of the Week
Stumbled on another fairly new EM tumblr The Emergency Medicine Resident Blog By Bob Stuntzs a US emergency physician with a keen interest in resident education. You can follow Bob on Twitter @BobStuntz and check out some of his recent posts below:
- The first rule of Fight Club… a quick review on the fight bite!
- It even has a podcast attached to it! Check out episode 1 on tips for the new interns to make yourselves look like stars and avoid common resident pitfalls.
Twee Dee and Twitical Care
News from the Fastlane
- Mike has put together the ultimate collection of FOAM EMCC Podcasts into a database for your easy access and listening pleasure. Check it out-Its gold!
- Two great clinical post were published last week the fist on the ins and outs of Fingertip Injuries and the second is Getting A Leg Over highlight’s two great videos by George Douros on the application of a below knee plaster cast.
The Final Words
- “Intellectuals solve problems, geniuses prevent them.”
- “No problem can be solved from the same level of consciousness that created it.”
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