Welcome to the awesome 21st 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 Most Fair Dinkum Ripper Beaut of the Week!
- Reuben Strayer has come out on top this week with his brilliant screen-cast paediatric airway for emergency physicians who are not also paediatrician. Reuben gives you all the pearls and pitfalls you need to dominate the paediatric airway and have you ruling the paeds resus room in no time, best of all he does it in a short 12 minute screen-cast (about the maximum attention spam you can get out of a emergency physician).
The Usual Suspects
- Scott teams back up with Stephen Smith to discuss when Left Bundle Branch Block doesn’t = STEMI! also worth checking out Stephen’s blog post on this topic here.
- Thrombolysis in submassive PE – still equipoise? Nice review Cliff on a topic that still doesn’t provide us with a definitive management option.
- American airway management in the field. Food for thought for those involved in pre-hospital airway management.
- Posterior Leads Fail to Diagnose Posterior STEMI Great case! Why were posterior leads negative? One must remember that it is a long way from the heart to the back, with a lot of air (lung) interposed. So the voltage is far less.
Academic Life in Emergency Medicine
- Paucis Vebis:Interesting literature review Outpatient treatment for diverticulitis,…Take home point not all patient need an admit these days with an acute episode of diverticulitis.
- Trick of the Trade: Ring removal from a finger. Looks easier than using the bolt cutters.
- Superb review of high-dose insulin therapy in treating calcium channel-blocker overdose. Not quite a 5 skull review, but close enough =worth reading.
- Hepatotoxicity from abuse of kratom: first reported case. Ingesting the kratom leaf has been associated with a variety of effects, including sedation, analgesia, increased energy, a sense of well being, and improved mood…Will have to start growing this in the waiting room.
- Are you using capnography for confirming ETT placement, what about during procedural sedation? Find out all its use’s in this week talk by Ernie Yeh on Capnography.
Intensive Care Network
- Presents a talk by Simon Finfer discussing the role of decompressive craniectomy for diffuse traumatic brain injury in the post DECRA era. Check out part 1 of his talk below:
The Rest Of The Best
- Nice case by James Rippey. Describes a patient with penetrating chest trauma that presents with hypotension and tachycardia. Can you tell what the ultrasound showed?
- Awesome tips and trips from Andy on using ultrasound for foreign body removal.
- No Entry! Is it time for a new approach to who gets into ICU?
- Decompressive Craniectomy in Diffuse Traumatic Brain Injury, a nice look at the pros and cons of the DECRA study.
Amal Mattu’s pearl of the week looks at starting cooling during the resuscitation phase, instead or post ROSC.
- It is now well-accepted that induction of hypothermia should be initiated in victims of cardiac arrest who regain spontaneous circulation and remain unresponsive.
- Studies are now being performed and published that suggest that the earlier that hypothermia is induced, the better the neurological outcome. With this in mind, some experts are now recommending that cool IVF be the initial resuscitation fluid that these patients receive when resuscitation is initiated.
- It appears that aggressive use of cool IVF right from the initiation of attempted resuscitation results in improvements in survival to hospital admission and discharge.
- The bottom line here is that when caring for victims of primary cardiac arrest, we should be certain to cool the patients fast and early!
Another busy week of vodcasting over at HQmed, check out these beauties:
- Bleeding in the Patient on Dabigatran. A must watch as this drug starts to invade our emergency departments.
- The ECG guru Dr Stephen Smith presents Pericarditis vs. MI
- 17 yo M chest pain nice video showing pneumothorax treatment.
- Is It Really Safe To Observe Occult Pneumothorax? Bottom line…Yes!
- Heartattack and Vine… Remember Casey “Absence of evidence is not evidence of absence “.
- Fluid therapy in shocked children is it time to change our approach and rewrite the guidelines? Or do more questions need to be answered? Only time will tell!!
- Nightmare-ECG…Do you vote for electricity?
- For the medical students amongst us Pathology 101 is back with a look at pneumonia.
Twee-D and Twitical Care
Having trouble learning pathophysiology @Eleytherius makes its as easy as a tweet:
News from the Fastlane
- Mikes been busy not only sorting out the Western Force in New Zealand, but also arranging the FACEM VAQ By Subject worth checking out before the big quiz.
The Final Words
- Do not follow where the path may lead. Go instead where there is no path and leave a trail.
–Harold R. McAlindon
- Great spirits have always encountered violent opposition from mediocre minds.
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