Welcome to the 117th edition, brought to you by:
The Most Fair Dinkum Ripper Beauts of the Week
- The Ripper award this week goes to ScanCrit and their blogpost Percutaneous trackies not so safe after all… — a Crit Care systematic review has has the hard numbers and identifies risk factors for trache badness: low tracheostomy site, not using fibrescope guidance, coagulopathy, previous surgery or radiotherapy to the neck, obesity or abnormal anatomy, malpositioned cannula and high cuff pressure. A great follow-up to their previous post on the Tracman RCT. BTW, how do you spell ‘trache / trachy/ trackie?’ [CN, BT]
The Best of #FOAMed Emergency Medicine
- Graded Assertiveness is a ‘to the point’ post by Ian Miller at The Nurse Path — everyone needs to know this. Communication is everything. [CN]
- When the Lex speaks, the wise emergency physician listens. Joe says listen to Sergey Motov talk about Ketamine for Pain Control in the ER [CN]
- You MUST recognize this pattern, even if it is not common… ‘nuff said, see what Dr Smith is on about (clue: it involves an ECG). [CN]
- Salim Rezaie has been busy over at REBEL EM with good posts on azithromycin and cardiac death, porcelain gallbladder’s (lack of) association with cancer, and distinguishing SVT and VT. [BT]
The Best of #FOAMcc Critical Care
- As promised Scott Weingart delivers his response to Paul Marik on the matter of fluids in sepsis. I personally expect most of what Marik says to become the norm in the coming years — especially with the impending demise of EGDT (yes, my gut tells me ARISE, etc will be ‘negative’). Scott has a few quibbles, but they’re mostly on the same page. [CN]
- Integrated ultrasound approach to Fluid Responsiveness……Canadian Style… Just when you thought there could be no more on ultrasound assessment of fluid responsiveness, there is this Guyton curves and all. Great for a graphical insight into the physiological underpinnings of fluid responsiveness… Also great for the accents! BTW, there’s a round up of all this IVC for fluid responsiveness stuff on EMCrit. [CN]
- Maryland CC Project gives the stage to Brian Bruns from the home of the Parkland formula to talk about Managing the Burns Patient in the ICU. [CN]
- Scott Aberegg has an interesting perspective on TTM titled Chill Out: Homeopathic Hypothermia after Cardiac Arrest… Has the age of homeopathic hypothermia begun? Oh, and Ryan Radecki weighs in too with giving hypothermia the cold shoulder [CN]
The Best of #FOAMPed Paediatrics
- Colin Parker and the empem.org crew released a podcast about constipation. It’s not the most exciting topic but those of us working in PEM need to know how to manage this well, and empem.org does another great job of discussing the topic. And there are many good poo-related puns in there too. [TRD]
- Sean Fox gives an overview of pyloric stenosis in Pediatric EM Morsels this week. Bilious vomiting does not exclude pyloric stenosis – read this Morsel to know what you’re looking for. [TRD]
- For all sorts of reasons, managing kids with ICU level asthma exacerbations is scary. Tessa Davis amalgamates the FOAM literature on ventilation strategies and provides her own take at Don’t Forget the Bubbles. [BT]
News from the Fastlane
- Some great tweets coming from ACEM conference in Adelaide follow the hashtag #ACEMasm13 or follow LITFL very own roving tweeters @peterallely or @Eleytherius.
- Chris been slaving away updating the CCC – see whats new in CCC Update 002.
- Yosef Leibman is back with another excellent edition of Emergency Medicine Updates for November!
LITFL Review EM/CC Educational Social Media Round Up