Welcome to the mind-blowing 92nd 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 a ripper By Lauren looking at hypertension in the ED. Check our Mercury Rising – Severely Elevated Blood Pressure in the ED - sensational nuts and bolts review on what you need to know on managing hypertension in the ED- with great links embedded throughout the post that will have you being guru on managing or not managing the hypertensive patient in the ED!
The LITFL Review Top Picks
- Lactate – Is There Any Death It Doesn’t Predict? Patient with PE, and lactated above 2 = be worried!
- Come One, Come All – Low tidal volumes improve outcomes. Clinical Takeaway: Until a more definitive, large randomised trial is performed, this study provides an evidence-based rationale for instituting a low-tidal volume ventilation strategy in patients without ARDS who do not have a clear contraindication to low tidal volumes.
- Briefs: Acetaminophen vs Ibuprofen – who reigns supreme? - Bottom line, both of these drugs are safe and very effective- however ibuprofen may have the upper hand!
- Scott’s working on putting together a pre-intubation checklist, and wants your advice…check out Preview of the EMCrit Intubation Checklist for more.
- How much morphine should I do? - In obese patients, even those who are seriously obese, do not require a dose adjustment in the administration of morphine practiced for the onset of an acute pain.
- Can you get the doctors to work faster!!! Fascinating review Simon on a tricky topic. Agree from a nursing point speed doesn’t mean quality or that the patients is satisfied and sorted properly!
Academic Life in Emergency Medicine
- The Socratic Method - you ask? It is a learning tool used via dialogue in the form of questions and answers in various fields to impart knowledge.
- Diminishing Returns: The “MIC Creep” Dilemma with Vancomycin. Nice reminder here: Vancomycin is dosed based on total body weight.
- P-video: Remembering NEXUS criteria and clear that C-spine!
- Crashing Tox patient? Want to know if Intralipid is an option? Check out this nice sharp review by Tacon on Lipid Rescue Therapy.
- Matthew updates us on whats new in the way of Developments in heart failure treatment…. Be on the look out for Eplerenone!
- The Thunderbox Papers: Locating infarction on the 12-lead ECG - Great learning tool for getting up-to-date on picking out your infarcts.
- The Arrow of Time, as Trevor ages
he reflects back on time and see how things have changed. What will you be looking back on in 2025, and thinking I can’t believe we did that?
- Bath-salt constituent MDPV more like methamphetamine than ecstasy - Thats not good for us on the shop floor!
- A Journal of FOAM?? Is there a need? What will it add? I think the LITFL is a good starting point!
- Inferior MI with positive troponin: Acute STEMI or Old MI with new NonSTEMI?
What challenging ECG had Amal got for us this week:
- Emergency Cricothyrotomy for a partially swallowed Dental Plate - Wow amazing x-ray, great case report Minh- thanks for sharing!
- Cricothyrotomy case report : lessons learnt. This case describe a unique complication of successful Seldinger technique cricothyrotomy with an uncuffed Melker cricothyrotomy catheter. Their novel approach to managing the complication successfully is useful to know.
The Skeptics Guide to Emergency Medicine
- Hit Me with your BEST Shot. Nice review on how to educate your staff and patients on the flu and the benefits of having the flu shot.
- Bust-a-Move - Cast Vs Splint for the buckle fracture- which do you do? Find out what the literature says here!
- Leptospirosis in Aotearoa - The kiwi experience of managing of this infectious disease!
- Advanced airways and worse outcomes in cardiac arrest. Study found that CPR with advanced airway management (use of tracheal tubes and even supraglottic airways) was a significant predictor of poor neurological outcome compared with conventional bag-valve-mask ventila
- Necrotizing Fasciitis on CT scan, remember crepitus is bad on physical exam, use ultrasound and get early broad spectrum AB’s in early, and get the surgeons involved.
- Chris fills the gap and shows us How to make your own Cricothyrotomy Trainer- see the video for more:
- IS PROPOFOL REALLY THAT BAD? Davids doing a survey to find out what you are using to sedate your post intubate patients…So help him out!
- CRISIS. CHECK. - Great post David agree we need more checklist in medicine!
The LITFL Review Shout Out of the Week
This weeks shout-out go’s to all the amazingly awesome PK SMACC Talks. So far over 22 have been uploaded and theres not one that I haven’t liked or learn’t something from.
Check out this ripper on PEM for Dummies by Colin Parker:
The GMEP Plug of the week
Gerry Considine take out this weeks plug with a look at croup:
Twee Dee and Twitical Care
News from the Fastlane
- New Opthal reg David Baines joins the team and provides us with a great book review: Eye Essentials For Every Doctor.
- Can’t get the SMACC but still want to be part of the club? Check out So, You Wanna Know About SMACC CLUB?
The Final Words
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 —boringem—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 —ED-Nurse— EDTCC — EKG Videos — EM Basic — EM Core Content — EMCrit —EMDutch — Emergency Medical Abstracts —EMERJENCYWEBB –EmergencyLondon — Emergency Medicine Cases — Emergency Medicine Education — Emergency Medicine News — Emergency Medicine Ireland — Emergency Medicine Tutorials—Emergency Medicine Updates —Emergucate — emindoc — EM Literature of Note — empem.org — EMpills — Emergency Physicians Monthly — EM Lyceum — EMProcedures — EMRAP — EMRAP: Educators’ Edition — EMRAP.TV — EM REMS — ER CAST — EXPENSIVECARE — Free Emergency Medicine Talks — GMEP — Gmergency!—Got Resuscitation— 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 —PEMTweets Blog — PHARM — Practical Evidence — Priceless Electrical Activity — Procedurettes — PulmCCM.org — Radiology Signs — Radiopaedia — Resus.com.au — Resus.ME — RESUS Room — Resus Room Management — Richard Winters’ Physician Leadership —ruralflyingdoc — SCANCRIT — SCCM Blogs — SCCM Podcast — SEMEP — SinaiEM — SinaiEM Ultrasound — SMART EM — SOCMOB — 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 Podcast — Ultrasound Village
About Kane Guthrie
Thanks for the shout out -- I enjoy finding new topics to engage readers at the PEM Blog (www.pemcincinnati.com/blog) -- even ones as ‘simple’ as tylenol vs ibuprofen.
Great stuff
Have added the PEM blog feed to FOAMEM blog
Mike