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!
- 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.
- 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
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