The LITFL Review 023

Welcome to the bumper 23rd 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!


  • Well it has been a huge week in the emergency medicine/ intensive care blogging-podcast world and made the task of selecting the top dog for the top spot the most difficult to date. However there can be only one and this week its Scott Weingart post on Haemostatic Resuscitation by Richard Dutton was the stand-out post. Richard Dutton was one of the primary formulators behind the concept of 1.1.1. in massive transfusion resuscitation, his talk covers the history of haemostatic resuscitation from the early days through to the current concepts that are being employed today.
  • It’s been a busy week for Scott not only taking out top spot he also put out a second podcast on The Mind of a Resus Doc: Logistics over Strategy. This podcast which looks to be part 1 in a series that delve’s into the philosophies that make a good resuscitationist.

The Usual Suspects


  • What do you get when you combine an Internal Medicine Rock Doc with a Emergency “Budgie Smuggling” Medicine guru? A podcast on  Hypertension Rocks! Zdoggmd returns to ERCAST to discuss the ins and outs of HTN, personally it was more like listening to a comedy show. Caution: this podcast should be watched with caution as has the potential to induce laughter associated stress incontinence!!!

Emergency Physicians Monthly

  • Tap That Belly a nice summary of the pearls and pitfalls on spontaneous bacterial peritonitis. 
  • Dr. Perfect. Take home point be careful you don’t dislocate your shoulder when patting yourself on the back!!
  • Nasal Intubation no its not in retirement according to Rick Levitan in his featured article looking at a technique that has suffered an overall general demise in recent years, but still remains a valuable technique for securing the airway when the mouth is off limits.


Dr. Smiths ECG Blog

Academic Life in Emergency Medicine

  • Trick of the Trade: Fingertip Injuries this is pure awesomeness for killing two-birds with one stone, analgesia and haemostasis of the bleeding digit.
  • How great would it be if you could give patients concrete numbers when you are talking about cancer risk and CT? Well now you can in a nifty little table created by Dr. Hans Rosenberg Lifetime attributable risk of cancer from CT in this weeks Paucis Verbis.
  • Social media in academia: Why do it? Because the cool kids are doing it… Also you learn, share and disseminate information amongst some brilliant minds in medicine!!!

The Poison Review

Emergency Medicine News


  • The explosive growth of ultrasound imaging, and increasingly limited access to specialty care have combined to make first trimester bleeding a disease for emergency and primary care docs. This months podcast see’s David and Ashley take a deep dive look at Threatened Ab: Knowledge is Power.

Intensive Care Network


  • Mel apart from wearing another stupid hat, gives us a quick review on the utility of New LBBB and MI.

The Rest Of The Best

ICU Rounds

Emergency Medicine Ireland

UMEM Educational Pearls

Pearl of the week is from Mike Winters with a brief look at the cardiovascular complications of End-Stage Liver Disease.

  • Patients with end-stage liver disease (ESLD) can develop a number of complications that lead to, or complicate, critical illness.
  • Regarding the cardiovascular system, ESLD patients can develop:
    • Hyperdynamic vasodilated cardiovasculature: low baseline blood pressure and high cardiac output
    • “Cirrhotic cardiomyopathy”: impaired systolic response to stress or altered diastolic relaxation
    • Autonomic dysfunction: reduced responsiveness to vasoconstrictors
  • ESLD patients also tend to have a normal or near-normal lactate at baseline, despite lactate being cleared more slowly.
  • When managing the critically ill patient with ESLD, look for signs of heart failure, expect an abnormal response to vasopressors, think about steroids for persistent shock, and don’t ascribe an elevated lactate simply to impaired hepatic clearance.

The Trauma Professionals Blog

Broome Docs

  • Big in Japan not so big here, but a case that will rock you to your core!!!
  • “That’s not a knife….” Brilliant case highlighting the importance of getting an accurate history and mechanism of injury  in trauma patients, and having a high index of suspicion helps as well!!!
  • Excited delirium – a new syndrome? It’s not new, been around for a while but poorly researched and highlighted…Have you seen a case? Do you know which patients are at risk of succumbing to it? Well worth learning about it on Broome Docs rather than being educated on it in the coroners court!!!
  • Can’t Intubate, Can’t Ventilate! The low down on code brown Casey provides us with a sensational algorithmic look at managing the “Can’t Intubated, Can’t Ventilated scenario”.




Better in Emergency Medicine


  • Tim provides us with a fascinating post on the management of Crocodile bites.

Priceless Electrical Activity

Twee-D and Twitical Care

Thanks to @precordialthump for highlighting the following tweets this week:

Nature Tweet JPEG


Intussusception JPEG

News from the Fastlane

  • The LITFL team apologises in advance as the site will be updating its host this week, and some of you may find viewing content on the site difficult over the next few days.
  • Mike been busy again behind the scenes getting the FACEM SAQ And SCE Remix questions up-to-date.

The Final Words

  • “You only see what you look for, you only look for what you know.”

-Friedrich Nitzsche

  • “Amateurs discuss strategy; experts discuss logistics.”


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


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