Welcome to the rocking 19th edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peeks 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 Most Fair Dinkum Ripper Beaut of the Week!
Its was a tough ask to determine the best of the best this week, however the ZDoggMD and his posse have come out Top Dog their blockbuster parody…It’s Call Day!!!!. It even includes Dr Harry’s immaculate rendition of an emergency physician (which reminded me of working with @sandnsurf, AKA DrMCDoganMD.
The Usual Suspects
- Predicting neurological outcome after cardiac arrest is not an easy task, and the waters have been further muddied by the implementation of therapeutic hypothermia.
- Cliff reviews the Intubation checklist a simple, easy to follow guide for optimising your intubation attempts and chances of success — Cliff actually recommends and uses this himself. Also worth checking out the link to SaferIntubation.com, another excellent airway management resources, and its free!!!!
- Scott becomes a fly on the wall as Cliff Reid interviews Jonathan Benger one of the authors on the NAP4 Guidelines and discusses the finer points of the review in a podcast on Failure to Plan for Failure: A Discussion of Airway Disasters.
Points that came out from the show:
- Mortality is higher in the ED and ICU compared to the operating room. Our patients are sicker, so we must be more diligent in planning
- Quantitative wave-form ETCO2 should be the standard of care for EVERY ED and ICU intubation
- Needle cricothyrotomy seems to fail more often than surgical cricothyrotomy
- Awake intubation was not used when it was indicated
- Junior resident anaesthesiologists were often responding to the ED and ICU
- There was a failure to plan for failure
- Obesity figured into a large percentage of the airway disasters
- Managing the Elderly with Abdominal Pain — Did the Dr deliver the standard of care in this case? Worth reading as its packed full of pearls to help guide you through these challenging presentations.
- Inhalant Abuse covers everything from “bagging” refrigerants to sniffing glue as it surveys the toxicities and treatments for inhalant overdoses.
- Wide complex tachycardias: 2 cases. What is the diagnosis and management? Don’t be fooled by what the textbooks teach you about this, go to ECG guru for the truth.
- Is it MI or pericarditis? Nice summary on how to tease these near twins apart.
- Trick of the Trade: Ultrasound workshop setup — Michelle gives you the tips and tricks she learned from setting up an ultrasound workshop.
- Paucis Verbis: Head CT clinical decision rules in trauma provides a nice comparison of the 3 different clinical decision rules available to use.
- App of the week: Takes a peek at Webicina your incredible one-stop shopping site for medical professionals and patients to join the Web 2.0 world.
- Video of the week is a collection put together looking at the ins and outs of the The EM Eye Exam based for medical students these videos are short, informative, with high resolution = worth watching.
Check out video 1 in the series:
Leon gets all “RENAL” on us this week with 3 superb posts looking at the kidneys versus the poisons:
- Haemodialysis and other extracorporeal modalities in toxicology cases
- Another must-read article on hemodialysis and other enhanced-elimination techniques
- Management of poisonings from a nephrologist’s point of view
- Joe’s right on the money this week when it comes to controversial topics, listen to Jacob Ufberg talk on Imaging the Pregnant Patient with Suspected Appendicitis or PE.
- Best Case Ever #3: Headache Pearls & Pitfalls, short podcast highlighting some of the red flags you need to know in the patient presenting with a chief complaint of headache. Is CT and LP always enough to rule out serious headache causes?
- USC Essentials 2011 is just around the corner, and guarantees to be bigger and better this year (is that possible?). Check out these awesome promo videos from the master of Emergency Medicine education @Mel Herbert … ‘Tis a shame i can’t postpone my wedding to go… I did ask 🙁
The Rest Of The Best
- Vitamin D for Fracture Prevention in Elderly and Nursing Home Patients. The numbers (below) speak for themselves!
- Highlights an excellent resource for the teaching and learning of bedside Echocardiography.
- Whats wrong here??? Here’s a hint, its one of the most common causes of sudden cardiac death.
- Reuben shares his ED Procedural Sedation and Analgesia Checklist.
Check out this week’s pearl from EM/ECG guru Amal Mattu:
- Beck’s triad is well known to many physicians, but here’s some simple things you may not have know.
- Beck actually describes two triads, one for acute and on for chronic tamponade
- The triad for chronic tamponade consists of increased CVP (JVD), ascites, and a small quiet heart (muffled heart sounds).
- The triad for acute tamponade consists of JVD, hypotension, and muffled heart sounds.
- Almost 90% of patients have at least 1 of the signs, but only one-third have all 3. Furthermore, it appears that the simultaneous occurrence of all 3 signs is a very late manifestation of tamponade, usually preceding cardiac arrest.
- Nurses have you got your priorities in order?
- Aaron provides us with an in-depth, pictorial and animated look Pathology 101 -focusing on Pulmonary Tumours with a nice summary by @Eleytherius.
- Pneumothorax in Children. This condition is far more mysterious than in adults
- DPL: A Dying Art? DPL is occasionally brought out of retirement, but i doubt it will add much to your decision-making process with the imaging modalities that are currently available.
- Yes they’re back with even more pointless medical information…To keep us entertained, this episode covers everything from Neck Tattoos, Baby Farts, and Vaccinations!
Twee-D and Twitical Care
- Like the UMEM Educational Pearl each week? Well, now you can follow them on Twitter @UMEmergencyMed
- Sounds like a challenge by @MedicalReg…Who’s up for it?
News from the Fastlane
- LITFL cracks a mention/plug on Oddee.com.
- Mike’s been busy sorting out and revamping FACEM VAQ Remix.
The Final Words
- Do more for the high risk and less for the low risk.
— Ron Lee Nichols
- A fashionable surgeon, like a pelican, can be recognized by the size of his bill.
— J. Chalmers Da Costa
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 our roving reporter:
kane AT lifeinthefastlane.com