The LITFL Review 066

Welcome to the awe-inspiring 66th 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

The Poison Review

  • Atypical antipsychotic overdoses are a frequent presentation in emergency departments as the prescribing of these drugs skyrocket. Leon has a great review on a recently published review article about atypical antipsychotic overdose, and sums the article up nicely in true “TPR fashion”. Although Leon does not agree with everything in this article (like whole bowel irrigation!), he still recommends it as a must read article for all toxicology enthusiasts.

The LITFL Review Top 20 of the Week

  • Ian shares with us the ultimate guide for dominating the role of Airway Nurse – hey docs worth a read too you might pick ups some tips and tricks from the nursing perspective.

Emergency Medicine Ireland

  • Tips For Surgeons: Seat Belt Sign – Michael shares some of his observations and approaches he takes to towards the patient with a seat belt sign. He does make this interesting point – “Seat belt sign on physical exam requires abdominal CT for evaluation, regardless of age. The high incidence of significant injury mandates this test.”
  • Is CRP correlated to CT result in the evaluation of abdominal pain? The bottom line: CRP is often used to evaluate abdominal pain.
    The utility of this test alone is  limited. Normal CRP does not exclude a positive CT study. On the other hand a high level CRP does not mean a positive result, CRP became increasingly more specific as levels increased.
  • Meet the New ARDS: Highlights the recent release of an expert consensus panel on a new definition and severity classification system for patients succumbing to ARDS.

  • Radiation Risks of CT Scans: What Now?– Some logical rational advice on doing repeat CT scans in patients with renal colic, and a brief look at and some advice on scanning the pregnant patient to rule-out PE.



  • Cephalosporins Can Be Used in Penicillin Allergy – In summary – 3rd-generation and greater cephalosporins with disimilar R1 side chains can probably be used in appropriate clinical situations despite a PCN allergy without incidence of allergy greater than in those patients who do not have a documented PCN allergy.


  • Minh interviews Dr Rob Bryant on his hospitals policy and protocol for delayed sequence intubation or as they like to call it  Damn Sexy Intubation, he walks you through the approach he takes and the experience and expertise he has gained from using this approach to emergency airway management.
  • Lauren shares some of her thoughts, and those of others, in Clinical Training Wheels from ‘what is clinical gestalt?’ through to ‘what are clinical decision rules and how do we use them effectively to guide our practice?’
  • Feeding the NGT through the nasopharynx on the intubated patient can often present as the impossible challenge. Well now we have  The ScanCrit Manoeuver – to help us dominate this procedure – my only recommendation is make sure there paralyzed well first!!

The LITFL Review Shout Out of the Week


  • Well there is another EM blog on the scene, by someone I used to work with and hold in high regard. That’s right TJdogma is a blog by emergency physician and fanatical cyclist Trevor Jackson. In his own words he describes the blog as: A corner of the interweb devoted to emergency medicine education, with occasional digressions into my other passions. Dogmata are omnipresent in medicine and life, but I’m not actually dogmatic in my approach to either. Having known him and his approach to medicine I can guarantee his writing will be methodical, structured and straight to the point, packed full of educational pearls and pitfalls that he has gained over the years.

Don’t believe me…Read for yourself.

 Twee-D and Twitical Care

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News from the Fastlane

The Final Words

  • “We do not remember days, we remember moments.”

Cesare Pavese

  • “And what greater might do we possess as human beings than our capacity to question and to learn?”
– Ann Druyan

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

LITFL Review EM/CC Educational Social Media Roll Call

Academic Life in Emergency Medicine — A Life at Risk — All LA Conference — Broome DocsCLIC-EM — Critical Care Perspectives in EM — CritIQ Podcast — DrGDH — Dr Smith’s ECG Blog — ED ExamEDTCC — EM Basic — EM Core ContentEMCrit – EM Literature of Note —  Emergency in the Shed — Emergency Medicine CasesEmergency Medicine EducationEmergency Medicine News – Emergency Medicine IrelandEmergency Medicine Updatesempem.orgEMpills — Emergency Physicians MonthlyEM Lyceum —  EMRAP: Educators’ Edition — EMRAP.TV —  ER CASTFree Emergency Medicine TalksGmergency! —  Greater Sydney Area  — ICU RoundsImpactednurse Intensive Care Network —  Keeping Up With Emergency Medicine — LipheLongLurnERdok  — MD Aware — MD+ CALC  — MedEDMasters  — Medical Education VideosMedicina d’urgenzaMedicine for the OutdoorsMicrognome — Movin’ MeatPediatric EM Morsels — PEM ED — PHARM — Priceless Electrical —  Rahul’s EM Blog — —  RESUS RoomRichard Winters’ Physician LeadershipSCANCRITSCCM Blogs —  SCCM Podcast — SinaiEMSinaiEM Ultrasound —  SMART EM  — Takeokun —  The Central LineThe NNT  — The Poison Review —The Short Coat–  The Trauma Professional’s Blog — The underneaths of EMToxTalk — TJdogma  Twin Cities Toxicology — Ultrasound PodcastUMEM Educational Pearls  — Ultrasound Village

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