Welcome to the 3rd 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 will cast 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
The Usual Suspects
- The hyponatremic patient who is seizing like a squirrel can be a nerve wracking challenge for any ED doc… but not any more. Scott’s podcast gives you a powerful yet simple guide to managing the hyponatremic patient in the emergency department. Simply follow his 3 step approach, and the rule of sixes, and all the bases are covered.
- In Will Twitter replace peer review? Leon refers to an article on Nature.com that continues a theme among Web 2.0 doctor-bloggers that we touched on in last week’s edition of the The LITFL Review (002). Peer review is about to evolve… for the better!
Next up on TPR, though it may be cliche to say it, is a must read post on an important review in Hepatology: Acute liver failure of unknown etiology: how often is it really acetaminophen toxicity? Occult paracetamol toxicity seems more common that we realise. Another question, is whether N-acetyl cysteine should be given in acute liver failure regardless of the cause. Time will tell…
Leon also deals with body packers (aka ‘mules’), who can pose a thorny dilemma in the emergency department. One approach is discussed in Treatment protocol for asymptomatic body packers (mules).
- Tubing children tends to tighten the sphincters of those who don’t do it often. Rich Levitan, of AirwayCam.com fame, helps us relax by Demystifying pediatric laryngoscopy.
- The true emergency doctor needs to be ready for anything. Thought much about human stampedes? Thought not… Maybe you’d better read Edbert Hsu’s article on Human Stampede: An Unexamined Threat.
- The ‘top notch’ posts kept on coming thick and fast this week. Our favourite San Franciscans have given us plenty to mull over. First up is a blog post the LITFL team could learn a lot from: Article review: Academic professional bankruptcy. Equally illuminating is VIPER Video: how to give effective feedback — apparently there’s more too it that a slap on the back and saying ‘sweet as, bro!’. And finally, what is the best way to reduce a pulled elbow? Find out in Trick of the trade: Nursemaid elbow.
- Cliff’s post on Open Thoracoscopy for resuscitation the docs, IS A MUST READ POST! Nothing else need be said. Cliff also takes on the always bloody debate surrounding Sux vs Roc in ED RSI.
- Most, if not all, emergency physicians would agree that a talk by Amal Mattu should not be missed. Users of ‘Free Emergency Medicine Talks’ seem to agree — Amal Mattu: 2010 Cardiology Literature Updates is one of the most downloaded talks of the past week.
The Rest of the Best
- A 12 year old girl presenting with lower abdominal pain requires the consideration of a wide range of differential diagnoses. This case highlights another great use of ED ultrasound to hone in on the diagnosis.
- Delivering babies in the emergency department is something we don’t see all to often…. thankfully! Do you know what to do? David teams up with Liz Chappell, a neonatal nurse educator, in this two part podcast (episode 1 & episode 2) covering all the essentials of delivering the newborn in the emergency department.
- Are our attempts to find effective remedies, being hampered by the tendency to treat all organ failures equally? This is just one of the question asked in an excellent post, looking at The Pinocchio Effect.
- The first post of this new blog from Iain Beardsell is titled Top 10 tips for new ED SHOs, and it comes with with an accompanying audio version for people (like Scott Weingart) who’s cortical homunculus is all ears and mouth ;-).
- Jason Nomura, an ED ultrasound guru, makes his LITFL Review debut with some slick Tips and Tricks for Placement Confirmation of IJ CVCs.
- All airways are difficult airways in emergency medicine, however some are more difficult than others. Dr Teo Aik Howe gives you his approach to the difficult airway with a splash of LEMON, on the side to help you out.
Emergency Medicine Forum
- This case looks at an infant with a cough that has an episode of apnea. Is it an apparent life-threatening event (ALTE)? Find out here.
By: Amal Mattu
- Up to 30-40% of patients with infective endocarditis have neurological symptoms as a result of embolization. This is a good reminder of the frequency of embolization, and also that infective endocarditis should always be part of the differential when you are evaluating a patient with fever + neurological abnormalities.
- ZDoggMD teams up with with his general surgeon buddy Doc Quixote to give us this fly-on-your-face documentary footage of the making of their next stool-topping hit single.
Twitter Meducation News
- There’s nothing like having a colourful character like @bungeechump on Twitter to illustrate the farcical nature of what we do day-in and day-out:
News from the Fast Lane
- The past week at LITFL we’ve eradicated an annoying Trojan that may have got into our site through some rogue code in a comment to a blogpost. Mike has lost his last remaining hair in the process. But it looks like the site is completely clean again – apologies to anyone who was inconvenienced. If anyone experiences any further problems please let us know, so we can fix it ASAP!
- We apologise for neglecting some of the toxicological aspects in a few of our recent posts, Dangerous Love and Troubling Tachycardia, but thanks for the great comments!
- That bastion of science, the New York Times, seems to support our case-based Q&A approach in their article ‘To really learn, quit studying and take a test’. (Actually the research was recently published in Science).
A Word from our Sponsors
The Final Words
“The greatest lesson in life is to know that even fools are right sometimes.”
Winston C. Churchill
That’s it for now… Hopefully this roundup of the world of electronic emergency medicine and critical care education for everyone helps to you 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 our roving reporter: kane AT lifeinthefastlane.com