The LITFL Review 047

Well back from a relaxing honeymoon, thanks to Chris for filling in last week. Well it’s that time of the week again for another epic 47th edition of the LITFL R/V!

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 heads over to our local emergency paediatric gurus  Colin, Kate and Chris at This fortnight’s podcast on Meningococcal Disease: Pearls and Pitfalls is absolute gold and will have you dominating this problematic disease in no time.

Pic of the week:

waiting room

The Usual Suspects



  • Scott also shares with us a nifty video on using the Tonopen properly!

How to use the tonopen from Scott from EMCrit on Vimeo.

Free Emergency Medicine Talks

The Poison Review


Academic Life of Emergency Medicine

Emergency Physicians Monthly

Dr Smith’s ECG Blog


The Rest Of The Best

ICU Rounds

Emergency Medicine Literature of Note

UMEM Educational Pearls

This weeks pearl highlights managing the adult patient with first time seizure.

  • Seizures occur commonly and it is estimated that 1 of 26 people will develop epilepsy at some point in their life.
  • A first seizure provoked by an acute brain insult is less likely to recur (3-10%) than a first-time unprovoked seizure (30-50% over the next 2 years).
  • As an emergency provider managing an adult who presents with their first-ever seizure, there are four primary questions that require answering:
  1. Was it in fact a true seizure? (often associated with tongue biting, urinary/bowel incontinence, preceding aura, post-ictal phase; examples of seizure mimics include syncope (i.e. cardiogenic, neurogenic, vasovagal), vertigo, myoclonic jerking, psychogenic convulsions, movement disorders.)
  2. Does the patient have epilepsy? (defined a having at least 2 unprovoked epileptic seizures by any immediately identifiable cause.)
  3. What type of epilepsy? (cryptogenic (i.e. of unknown etiology) or symptomatic (i.e. caused by prior central nervous system insult such as brain injury.)
  4. What is the cause? (metabolic panels to assess for uremia, electrolyte and glucose abnormalities, and drug intoxications should be performed, as well brain imaging to determine the presence of focal intracranial lesions.)
  • Many patients do not require anticonvulsant medication following a single, first time seizure; A general consensus is that such therapy should be strongly considered for initiation after a second episode of seizure activity.

Pediatric EM Morsels

 Broome Docs

  • To frolic with renal colic — Casey provides an excellent short ‘to-the-point’ review on renal colic from how to find the stone, to what works and what doesn’t!!

 Emergency Ultrasound Podcast

  • The lads are dedicating the month of December to teaching us all about scanning the scrotum, check out part 1 of Testicular Ultrasound.

The Trauma Professional’s Blog

A Life at Risk: The Emergency Physician

Twin Cities Toxicology

  • An oral pressor for a patient with a MAP of 46 mmHg? — Agree… this report did leave me a little unsatisfied with its conclusion.
  • IV Contrast — Bottom line always check the kidneys before giving the contrast juice. Remember…. always think about the global needs of your patient and plan accordingly (and safely).
  • ZDogg goes where no blogger or podcaster has gone before and introduces us to Mrs ZDogg – you’re a brave man Zubin!!!

Twee-D and Twitcal Care

[blackbirdpie id=”141610750723620865″]

News from the Fastlane

  • Want to know how to dominate the FFFF?  Now you can even contribute. Chris show’s you how in How To Kick FFFF Ar$E!.
  • Mike is battling with a(nother) mid-life crisis and wearing sandals to work in the Sanuk Barefoot Challenge.
  • Congratulation to emergency education extraordinaire Dr Trevor Jackson for receiving the UCEM diploma of HTFU —  well deserved!

The Final Words

  • “There is nothing in this world quite so dangerous as sincere ignorance or conscientious stupidity”.

— Scott Weingart

  • “If you call an organic process psychiatric, we have another name for you — the defendant”.

— Greg Henry

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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