
Welcome to the extravagant 79th 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 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
- Top spot this week is taken out by Dr Gareth Hardy with a superb review on the use of ETCO2 in cardiac arrest management in: ALS: Airway, Breathing, Capnography???.
Check out some more ripper posts from the StEmylns team:
- What’s your NNT? – What does your NNT mean and can you compare it to say your colleges, or your wife even. If anything this post has you thinking that what you do, what benefit does it have?
- JC StO2 monitoring in the ED – Measuring tissue oxygenation in septic patients in the ED! Who’s using it? Who’s liking it? Bottom line the future looks promising but more research is needed.
- Tranexamic Acid for Everyone? - I think Simon and Casey are onto something… Time to think of TXA for trauma like ASA is for chest pain!
- Apply Some Pressure..? Traumatic Cardiac Arrest – Natalie shares with us her first case of traumatic arrest and provides a comprehensive review of the literature. Pure gold a must read!
The LITFL Review Top Picks
- Scott hits some serious home runs in Crack to Cure – ED Thoracotomy – it’s straight to the point on when and how to do it = brilliant.
- Holley on Transfusion - The latest evidence and approach to massive transfusion, together with slides and podcast.
- Delaney on EGDT, Surviving sepsis and ARISE - where sepsis is at in 2012, the role of albumin and much more.
- FOAMed Hangout on the hop - the awesome foursome of Chris, Haney, Minh and Matthew spend an hour hanging out to goof around, but also discuss NIV in asthma, the origins of FOAMed, and they touch on the measurement of fluid status in sick patients. Check out the hangout below:
- Postpartum headache – a troubling presentation to sort out… Jonathan Ramachandran tackles its diagnosis and management.
- Can’t Intubate, can ventilate …. for now – the bush approach to managing the difficult airway that turns into a surgical airway!
- Surviving sepsis. Serial scans for super-sick sheila - The ultrasound approach to diagnosis and management of sepsis – cool great FOAMed there!
- Casey shares a short sharp review post on NIV: thoughts and tips - worth reading!
- Pain management – we still haven’t got it right! - an area we all need to improve in, as we only get it right less than half of the time!
- Rob sits down with the PE guru in Jeff Kline talks D-dimer: is the cutoff too low? Should we be raising the threshold? Have a listen to find out the answer!
- Tachyarrhythmias on #FOAMEd - BASICS IN EM&CC series with Haney and Minh – looking forward to seeing more post in this series. Great start dudes!
- WHY VIDEO WILL NEVER KILL THE DIRECT LARYNGOSCOPE STAR! by Dr Rob Bryant - VL vs DL more evidence for the DL coroner…Will this go down as the great debate of this decade!
- A day in the life of a Flying doctor Part 3 – the conclusion - Minh really does show in this series how diverse and fascinating his job is!
- Trick of the Trade: IV ceftriaxone for gonorrhea - is as good if not better the the IM route!!
- Should we anti-coagulating all those patients in plaster casts? – Make sense too…But still not clear cut.
- Transient Inferior Injury Seen Clearly by Comparison Between First and Second ECGs. - Also an example of a Right Ventricular “Pseudoanteroseptal” MI
- Ketamine is also a pain reliever: did you know? - of course it is, a timely reminder for us!
- Effects of synthetic cannabinoids usually mild and self-limited - with tachycardia, agitation and vomiting being very common.
- Case series: sympathomimetic designer drug DMAA associated with cerebral hemorrhage - be aware!
- Jellyfish sting – evidence does not support peeing on it - and even vinegar is brought into question!
- A Tooth By Any Other Name – A Quick Overview of Dental Nomenclature. Great post John on the basics of dentistry for the EM doctor or nurse.
- CROCODILE Learning - Guest post by Casey Parker on their approach for examining errors and clinical incidents…Looks great!
- IV Course Expert Panel with tips, tricks and even an Q&A session by the experts on getting the lines in with the aid of the probe!
- Trauma Literature Update 2012 - where we are today with trauma management.
- Are ABG’s Mandatory for ICU Admission – Michael Winters gives his take and reviews the literature on this argument-inducing topic.
- Still no oil painting - poor Cliff, however the light at the end of the tunnel demonstrates that ultrasound compares favourably with both plain radiography(1) and computed tomography(2) in the diagnosis of nasal bone fractures.
- Surgical treatment for acute massive pulmonary embolism- Cliff’s take home point: “Massive pulmonary embolism fascinates me, because it’s seen in the ‘talk and die’ patient. It is a single, treatable pathology that if diagnosed and treated appropriately truly makes the difference between life and death. When medicine presents us with an opportunity ‘on a plate’ like that to save a life, we need to be prepared. I have had great saves with this diagnosis and sadly have seen disastrous failures to act. When the time comes, we need to ask: ‘have we explored all options?’”
- What is ‘hypotension’ in penetrating trauma? – Forget a BP of 90 systolic, its time to be concerned when the BP below 110 in both blunt and penetrating trauma.
- Echocardiography in Pulmonary Embolism - another cool hangout with some cool kids of EMCC!
- slowly, slowly… - Chris shares with us how to approach and speed up your symptomatic bradycardic patient.
- generally unwell (part 2)… with Critical Hyperkalaemia, nice approach Chris however I’m not convinced resonium still has a role!
The LITFL Review Shout Out of the Week
Shout out of the week goes to our very own Rick Abbott showing you’re never to old to join Twitter! Check out and follow ricks Tweets @Rabbott47
Twee Dee and Twitical Care
News from the Fastlane
- Michelle puts out the calling for All Fabulous Females Of #FOAMed.
- Rick Abbott been doing some roving reporting and provides us with The News From #ACEP12 Day 1 and The News From #ACEP12 Days 2 And 3.
- EMA October 2012 is out, check it out!
- Chris spoke at the Bedside Critical Care 2012 conference recently, as featured on ICN’s Podcast 31: Chris Nickson on Erectile Dysfunction and #FOAMed.
The Final Words
- “Criticism is something you can easily avoid by saying nothing, doing nothing, and being nothing.”
~Aristotle
- It is not length of life, but depth of life.
~ Ralph Waldo Emerson
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
Emergency Medicine and Critical Care Blogroll
Emergency Medicine and Critical Care Podcasts
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

























