The LITFL Review 024

Welcome to the sensational 24th 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!


Top spot this week heads over to Gareth Hardy with his controversial post on NIV in asthma, and his excellent review on nerve blocks in patients with fractured neck of femurs.

  • Ok so its time to get all controversial with NIV in asthma? No point right? Although many questions are still unanswered I think Scott Weingart’s comment at the bottom of the post sums up what we should be doing with our sick and dying asthmatics; “all I ask folks to do is when they get an asthmatic who they are going to intubate, while they are getting everything set, put them on NPPV with continuous nebs. If they still look like crap, they don’t have a perfect sat, or their mental status is not where you like, then go ahead an intubate. If they look a little better, hold off a few minutes and give NIV a chance.”
  • The fractured NOF is bread and butter for the Doc’s were i work, but is it were you work. This post on Fascia Iliaca Block for fractured neck of femur. Do you? You should! gives you an awesome review on providing effective analgesia to your patients with fractured NOF’s.

The Usual Suspects

Free Emergency Medicine Talks

  • This week talks comes from one of the premier educators in emergency medicine Stuart Swadron on Bleeding from the Trach.

Emergency Physicians Monthly


Dr. Smiths ECG Blog

Academic Life in Emergency Medicine

The Poison Review

The Rest Of The Best

  • Colin and Kate give us the lowdown on approaching and managing Neonatal Jaundice.

Emergency Medicine Ireland

UMEM Educational Pearls

Rob Rogers brings us this week pearl on the Complications of Acute Aortic Dissection

There are several complications of acute aortic dissection that emergency physicians must be familiar with.

These include:

  • Cardiac tamponade (most common cause of death)
  • Acute aortic regurgitation
  • Stroke
  • Free intrathoracic rupture
  • Malperfusion syndrome (kidney, spinal cord, bowel, extremity, etc.)

*Key Pearl: If a patient with suspected or confirmed acute aortic dissection suddenly arrests consider cardiac tamponade.

The Trauma Professionals Blog

  • Early Coagulopathy After Severe Traumatic Brain Injury Equals Poor Outcome. Bottom Line:
    • Prehospital: Coagulopathy should be suspected if the patient is bleeding profusely from multiple sites, including your IV needle sticks. This indicates severe brain injury and demands triage to a trauma center with immediate neurosurgical support.
    • In-hospital: Coagulopathy that is noted in the ED portends severe injury and poor prognosis. Rapid access to CT scan and your neurosurgical consultant is critical.
  • A review on the study by the man behind emcrit Scott Weingart looking at Extubation in the Emergency Department for trauma patients.

Broome Docs


  • Bias in nursing practice. Ian provides a nice review to help us identify and prevent our cognitive errors that are caused by these bias’s.

Better in Emergency Medicine

  • Food for thought……Stick with the Herd? Or  lets change it.  Let’s take the time to venture outward, leading the herd.  Let’s generate knowledge and take time to test it, apply it, and teach it.

Emergency In The Shed

  • David takes a look at some Interesting facts about the ETT, you will be surprised by what he and his staff came up with in this months podcast.

Dr. John M

  • The mysterious athletic heart can sometimes challenge us, is that bradycardia normal? Was that syncope just from dehydration or is it something sinister? Dr John answers these questions and many more.

Doctors Unplugged

  • Ever wonder how the dude from ABBA died? Why all these rock stars keep dying of asphyxiation? Can you die of food poisoning? The crazy dudes at Doctors unplugged have a look at Famous Deaths.


  • ZDogg throws a few punches at celebrity MDs and puts the rap on them with Sucker MDs

Twee-D and Twitcal Care

Some of the interesting encounters you get being an emergency physicians by @peteralley

Peter alley JPEG

News from the Fastlane

  • The LITFL team apologiser’s for anyone that had difficulty accessing the site over the last week, as we updated to a new host.
  • We also make welcome to our newest author on the Fast Lane, Dr Bishan Rajapakse check out his post here and follow him on Twitter @trainthetrainer

The Final Words

  • The true sign of intelligence is not knowledge but imagination

-Albert Einstein

  • Knowing is not enough.  We must apply.
    -Johann Wolfgang von Goethe

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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