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 casts 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 to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
Leon Gussow of The Poison Review fame takes out top spot this week with four great toxicology posts. Check them out and see if you agree!
- Is magnesium beneficial in treating Irukandji jellyfish stings? – We may never know for sure… But its not looking promising!
- Just when you thought it was safe to go back to the laundry room . . . Not the best study, but ingestion of these laundry detergents is not uncommon among our younger patients. Be on the look out for signs of respiratory distress and vomiting.
- Rapidly progressive, fatal sequelae of brown recluse spider bite: case report - Wow- tough case!
- Must-read article: everything you didn’t realize you wanted to know about narcotic bowel syndrome - Anything that gets 5 skulls by Leon is a MUST read!
The LITFL Review Top Picks
- One Way to Get a Fat Lip -Crickey! - Fantastic review of ACE-I angioedema, incidence are on the rise- and attention to airway is paramount in these cases!
- Don’t You Know That You’re Toxic? - Nice case highlighting chronic lithium toxicity- nice reminder to us all Lauren -worth checking out!
- Amal shares with us a case from Downunder:
- Scott takes us back to the old days, just him, the mic and us as he delivers a stellar podcast on The Post-Intubation Package, how to do things right once the tube is in. Pure gold!
- SMACC 2013 Preconference UK SIMWARS CHALLENGE with Professor S Carley and Dr N May -Minh puts the Poms through their paces in preparation for SMACC!
- Difficult airway intubation without paralytics - James DuCanto runs us through this challenging airway dilemma!
- #FOAMEd Online Airway training Program – Anatomy review lecture by Dr Seth Trueger - The course is up and running… Check out the first episode on anatomy!
- #FOAMEd Online Airway training Program – POSITIONING AND BLADE USE with Trueger and Faust – Part 2 how to position the airway and slide that blade in!
Pearl of the week is by Michael Winters on Delirium in the Critically Ill:
- Delirium has been shown to be an independent predictor of mortality and can occur in up to 75% of critically ill patients.
- Whether preventing or treating delirium in the critically ill patient, consider the following:
- Minimize the use of anticholinergic medications (i.e. diphenhydramine, chlorpromazine)
- Ensure pain is adequately controlled (avoid meperidine and tramadol)
- Be careful with sedative medications; consider bolus dosing and daily interruption of continuous infusions
- Additional measures to treat delirious patients include reducing sensory deprivation, promoting normal sleep-wake cycles, early physical rehabilitation, and treating psychosis.
- Upper extremity DVT – what is the current management? Find out in ICN Hot Case #10.
- Great two part podcast on managing respiratory failure and the ventilator by Anthony Tobin. Check out PART 1 on Managing Respiratory Failure and PART 2 on HFOV.
- Perimortem C-section: Can you cut it in Obstetric resus? – Brilliant approach to the sharp end of resuscitating the pregnant women, Excellent post Casey- a must read!
- The POP, the Chief, his risk assessment and her thromboprophylaxis - We probably should be giving VTE prophylaxis to these patients, we just need to work out who will benefit the most from it.
- Is this what we mean by critical care? – Rick puts it to us, how do we appraise, reflect, criticise in medicine, how often do we give criticism instead of praise? Maybe case conferences are the answer? Food for thought!
- Shrapnel to the Eye - An up-close look at how to care for a potentially-ruptured globe in the emergency department.
- ECG Case 001 - Is it sinus tachy, AF or A-flutt – you be the judge!
- Mnemonics for difficult airway predictors - a must print off and attach to your airway cart.
- Trick of the Trade: High volume irrigation of abscesses – simple just replace the syringe with a pressure bag and fluids – looking forward to using this approach!
- Tension Pneumothorax Decompression – Time to Change? - that’s the hard part Kent getting people to change!
- Clinical Case – “Diarrhoea and Abdominal Pain” – Kent provides us with a great approach to analysing the ABG/VBG!
- Acquired “Club Foot” - AKA the a medial subtalar dislocation!
- What’s with all the chloride? An assault on salt - Cliff makes valid point were al guilty of sticking with saline, by is it causing acidosis, AKI and putting our patients at risk for dialysis.
- Another nail gets hammered into the coffin of starch in: Hydroxyethyl Starch vs Saline
- Cliff finally get’s his head around ultrasound physics. See video for more:
- Looks like a Posterior STEMI. Is it? Remember this patient is old, check the med list first!
- A Man in his 20′s with Syncope. What is diagnosis? And what does the old ECG show?
- What is a MOOC? - A massive open online course (MOOC) is a type of online course aimed at large-scale participation and open access via the web. Sounds awesome check out the post for more!
- Normal Procalcitonin Rules-Out Line Sepsis - and hopefully help us achieve better antibiotic stewardship.
- New & Improved Glasgow Blatchford Score - to help you sort out those troubling GI bleeders!
- ΔK - Take home message: Think twice before using succinylcholine when intubating patients who have long ICU stays or who have developed critical care neuropathy.
- another ECG case… – complicated by the fact the patient has downed a heap of Amisulpride….Chris shares with us an approach to managing this tricky tablet.
- UTI and Duration of Fever - Vaccinations have prevented a lot of illnesses in our little ones, but when fever is ongoing, and viral illness doesn’t fit, check the pee!
- Give John a hand and crack this week’s ECG of the Week!
- The Impossible Job – we’re not always right in medicine, the job isn’t always easy – but would we do anything else really?
The LITFL Review Shout Out of the Week
- This week post on Situs Inversus - really got my attention. When normal isn’t normal aka the organs are the wrong way around!
Twee Dee and Twitical Care
News from the Fastlane
- Anyone that uses the Oxylog in there department, check out this awesome instructional video from Jo Deverill: Borrow The Oxylog 3000!
- Household Words Chapter 4 - Michelle wraps us this stunning series with a look at medical instincts.
The Final Words
- “To be a person is to have a story to tell.”
- Isak Dinesen
- Emergency Medicine is not the business of making diagnoses; it is the business of excluding them.
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 kane AT lifeinthefastlane.com
LITFL Review EM/CC Educational Social Media Round Up
123Sonography.com — Academic Life in Emergency Medicine — Adventure Medicine— A Life at Risk — All LA Conference — Al Sacchetti’s Youtube — Bedside Ultrasound — Better in Emergency Medicine — Broome Docs — CCM-L.org — CLIC-EM — Critical Care Perspectives in EM — Dave on Airways —DrGDH — Dr Smith’s ECG Blog — ECG Academy — ECG Guru — ECG of the Week—ED Exam — EDTCC — EKG Videos — EM Basic — EM Core Content — EMCrit — Emergency Medical Abstracts —EMERJENCYWEBB –EmergencyLondon — Emergency Medicine Cases — Emergency Medicine Education — Emergency Medicine News — Emergency Medicine Ireland — Emergency Medicine Tutorials—Emergency Medicine Updates —Emergucate —EM Literature of Note — empem.org — EMpills — Emergency Physicians Monthly — EM Lyceum — EMProcedures — EMRAP — EMRAP: Educators’ Edition — EMRAP.TV — EM REMS — ER CAST — Free Emergency Medicine Talks — GMEP — Gmergency! — Greater Sydney Area HEMS — HQmeded.com — ICU Rounds — Impactednurse — Intensive Care Network —iTeachEM - keepcaring — Keeping Up With Emergency Medicine — KeeWeeDoc — KI Docs — LipheLongLurnERdok — MDaware — MD+ CALC — MedEDMasters — Medical Education Videos — Medicina d’urgenza — Medicine for the Outdoors — Micrognome — Movin’ Meat — Neurointensive Care — Pediatric EM Morsels — PEM ED — PEMLit — PHARM — Practical Evidence — Priceless Electrical Activity — Procedurettes — PulmCCM.org — Radiology Signs — Radiopaedia — Resus.com.au — Resus.ME — RESUS Room — Richard Winters’ Physician Leadership —ruralflyingdoc — SCANCRIT — SCCM Blogs — SCCM Podcast — SEMEP — SinaiEM — SinaiEM Ultrasound — SMART EM — SonoSpot — StEmylns — Takeokun — thebluntdissection—The Central Line — The Ember Project —The Emergency Medicine Resident Blog — The NNT — The Poison Review — The Sharp End — The Short Coat —The Skeptics Guide to Emergency Medicine — The Sono Cave - The Trauma Professional’s Blog — underneathEM.com — ToxTalk — TJdogma — Twin Cities Toxicology — Ultrarounds — UMEM Educational Pearls — Ultrasound Village