This week the LITFL Review turns 50!!
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 Queensland and is taken out by David Corkhill from Emergency in the Shed. David teams up with Aussie ED doc Jeff Hooper to have a chat about Avoiding the Pitfalls of Trauma Part 1 — they highlight the top 10 common mistakes that they see repeatedly missed in trauma patients, and provide some nice pearls on managing the trauma patient.
The Usual Suspects
- Joe’s pick this week is by Scott Melanson with a look at Which Neck Injuries require Vascular Imaging?
- Case report: seizures after smoking a synthetic cannabinoid product — a rare occurrence, but something to be familiar with when patients present after using these synthetic cannabinoids.
- Review of ricin toxicity. Nice point by Leon: the fact that ricin as never been used as a mass terror weapon — despite its abundance — is a measure of how difficult this process really is.
- It’s a bird, it’s a plane . . . OMG, it’s a snake! — Snakes don’t fly….or do they?
- Case report: fatality after ingestion of methylone and butylone sold as “ecstasy” — be careful what you pay for.
- Leon highlights some Aussies literature reviewing 4 toxic Spider bites!
- Circulatory support in cardiogenic shock — is it time for ‘out with the old, and in with the new’ inotropes, and maybe throw in some mechanical devices on the side.
- Treating sepsis – have we got it the wrong way round? — some food for thought on sepsis from Cliff. What do you think about this?
- Trick of the Trade: Tie-over dressing for scalp lacerations — holds the dressing in place, and has your patient looking like they’re from a spiderman movie. Win-win!
- Handling Serious Bacterial Illness in Children — highlights some new articles and concepts for tackling this sometimes deadly disease.
- Airway expert Richard Levitan provides us with some tips and tricks for using Video + Direct Laryngoscopy.
- Ventricular fibrillation on a 12-lead ECG — Dr Smith explains how this looks like torsdades, but its not – shock it anyway.
- Avoiding the death stare. — “Our own emotional response to these situations is not a switch. It is a tide.”
- Managing the patient with an intellectual disability. — this post is gold, a must read for every ED nurse and Dr — so we can deliver the care these patient desperately require.
The Rest Of The Best
- Andy bounces-back from top spot last week with another excellent vodcast with Anatomy for Emergency Medicine – #2 the Vertebral Artery.
- This week the team released part 2 of their podcast on Fever of Unknown Source.
- Another Review on Ketamine Use in ED — the most unappreciated drug in emergency medicine shines brightly in another excellent review of the literature.
- Did Hell Just Freeze Over? — It looks like orthopods are stronger and smarter than anaesthetist — it’s true then that “long term propofol use leads to muscular atrophy and now long term cognitive impairment.”
- Amit shares some of his experience on EMRAP regarding Aussie EM Training vs US EM Training — You American docs have got it easy… 😉
- Cardiac arrest and prognosis — some tips on when we should stop.
- Dexmedetomidine Is Not For ED Sedation in behavioural emergencies — but may have a role in procedural sedation and sedation for NIV in the ED.
- Under/Overtesting in Fever Without a Source — where is the middle ground.
- Nitroprusside Saves Pigs – How About Humans? — They could be onto something— only time will tell.
This week’s pearl is by Rose Chasm on Pyloric Stenosis:
- Causes gastric outlet obstruction and vomiting.
- 1 in every 500 infants; with a 4:1 male-to-female ratio and a family history in another sibling.
- Symptoms begin 2-4 weeks after birth, with projectile NON-bilious vomiting.
- Firm, mobile, nontender, olive-shaped mass in right hypochondrium or epigastric area.
- Diagnosis confirmed with US or upper GI series.
- Treatment is a pyloromyotomy, but fluid and electrolyte replacement is vital in ED.
- Pierre Robin Sequence — one of the most difficult airway situations an emergency doc can come across — guaranteed sphincter tightening!!!
- Michael highlights some new amazing technology for Real Time Cerebral Blood Flow Monitoring For TBI.
- Cricothyroidotomy Using The Scalpel-Bougie Technique — a cool video — demonstrating a simple approach to the surgical airway.
- Trauma in Pregnancy — some excellent short pearls on managing the pregnant trauma patient — worth reading.
- The ins and outs of managing Hypertension in Pregnancy.
- An update on managing bartholin gland cysts.
- A short, sharp simple guide pack with key-points for Postpartum Hemorrhage.
- You have to know about this for your next cyanide exposure… worth knowing about if your going to dialyse your sick cyanide poisoned patients.
- A special Christmas message from ZDogg and Dr Harry in Feed The Wards (Do They Know It’s Christmas Time?)
Twee-D and Twitcal Care
News from the Fastlane
- The LITFL team would like to wish all our readers a Merry Christmas, and wish you all the best for 2012. We look forward to providing you more online educational goodness next year, and we love you all.
The Final Words
- “There was never a genius without a tincture of madness”
- “Destiny is not a matter of chance, but of choice; it is not a thing to be waited for, it is a thing to be achieved.”
— Winston Churchill
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