Welcome to the stimulated 84th 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 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
Top spot this week is taken out by Academic Life in Emergency Medicine headed up by Michelle Lin and her team of EM blogging guru’s, each week they provide us with high quality and hard hitting posts on a wide arrange of topics to help guide our daily practice, and this week is no exception.
- New video series for med students: The “Patwari Academy” - Michelle shares with another awesome collection of educational videos by @rahulpatwari on teaching emergency medicine using the fliped classroom approach. Check out the video to see for yourself.
- Take the Quiz: Do you know your antihypertensive agents? - Cool concept by Javier!
- Trick of the Trade: Searching for Comments to a Published Article - Bryan shows us how.
- Paucis Verbis: PE Severity Index (PESI) score - all wrapped into a nifty little reference card.
The LITFL Review Top Picks
- Joe’s pick of the week is from Mel Herbert talking on: Unstable Shock-Resistant Patients with Rapid Atrial Fibrillation. Great talk Mel and best of all its free…Love FOAM!
- Well last week was a big week for iTeachEM, with the inaugural International Emergency Medicine Teaching Course in Baltimore, Maryland. See the wrap up from the conference on storify and you can even watch some of the talks recorded here on livestream.
- Getting Chilly Quickly - A change in evidence maybe! Should we be delaying the induction of therapeutic hypothermia to our cardiac arrest victims? Simon certainly does give us food for thought!
- Harris on Interview Technique Part 2 - how to be prepared and answer those tricky interview questions.
- How good are you at saying sorry and providing open disclosure to your patients, and their families? Most of us aren’t that great,however spend 20mins listening to Stuart Lane on Saying Sorry, could be some of the most rewarding and informative 20minutes any podcast can give you!
- Gatward on ALS Update 2102- Absolutely brilliant talk on we’re we are at when it come to ALS in 2012:
- Simulation as an assessment tool. - Bedside teaching is a fantastic form of education for both doctors and nurses, however its not always easy to find the right patients….Well it is easy with aid of simulation and manikins.
- IVC Ultrasound for Fluid Tolerance in Spontaneously Breathing Patients – EAT IT STONE - Scott serves it up to Stone and Mallemat, and advocates that IVC ultrasound does have a role in assessing fluid status! I’m sure this is only the start of the debate on this topic!
- Diagnostic Peritoneal Lavage: A Procedure Worth Resuscitating - Maybe the DPL isn’t dead after all…But i doubt it will be resuscitated back into many resus rooms!
- Medical education challenge: teaching small groups of diverse learners - TJ provides us with some pearls and pitfalls on what works for him in teaching small groups.
- Prehospital ketamine analgesia- Conclusion: Intravenous morphine plus ketamine for out-of-hospital adult trauma patients provides analgesia superior to that of intravenous morphine alone but was associated with an increase in the rate of minor adverse effects.
- The Hazards of Love - “Sexual activity is mechanically dangerous, potentially infectious and stressful for the cardiovascular system.” We will be keeping this study a secret!
- Don’t ß-Blockade Cocaine Chest Pain - this study is a perfect example of inappropriately extending a conclusion from retrospective data. Bottom line: Best to avoid beta-blockers in cocaine associated chest pain.
- This week’s ECG- What’s going on?
- Tachycardia and altered mental status after smoking “K2″; but what is “K2″? The spice of life for the emergency departments
- Suboxone (buprenorphine): one pill can kill. Take home point: The duration of buprenorphine toxicity in children ca be prolonged or the onset can be delayed up to 6 hours. Thus, it may be prudent to admit children for 24 hours of observation after buprenorphine exposure.
- Holy Cardiomegally Batman…It is crucial that you rule out pericardial tamponade with this patient.
- Calcium and cardiac arrest. May be beneficial in the cardiac arrest patient caused by either hyperkalemic or CCB overdose!
- Rocuronium leads to delays in post RSI sedation initiation compared with Suxamethonium - Just because Roc Rocks….Don’t forget to be quick in providing your post intubation sedation package!!
- The problem with PRN opioids. Who’s using a sedation scales to guide the delivery of opioid to their patients in the emergency department.
- iatrogenic acceleration… Can you find the cause of the persistent tachycardia in this tricky trauma case.
- Hip Ultrasound, Aspiration and Injection The ultimate guide with aid of a probe and some gel!
- The 10 commandments of presenting - Great post John, tips there for us all to learn from.
- Stop putting IV cannulae in the 2nd ICS for tension PTX - if you going to use a needle use a long one – if not just use your finger!
- Do you rely on Google to dig up information to help you with your professional development or find information around a particular clinical topic on the fly? There’s now an alternative: take the trip: an evidence based search engine.
- Pediatric Cholelithiasis - it is becoming increasingly apparent that we must consider adult diseases in the kids in our EDs.
- Explosions can cause a complex series of injuries, which may include subtle or delayed findings. Repeated evaluations, such as serial abdominal exams, may be required.
- Blast injuries are divided into 4 categories:
- Primary blast injuries: Injury from blast wave over-pressure. Found in gas filled structures (ear, lung, hollow organs)
- Secondary blast injuries: Injury from thrown objects (primarily penetrating trauma, but may blunt)
- Tertiary blast injuries: Injuries from patient being thrown by blast wave (blunt trauma)
- Miscellaneous (quaternary) blast injuries: Injuries from other causes, such as burns, crush injuries, rhabdomyolysis, and toxic chemicals.
- The most common primary blast injury is tympanic membrane rupture.
- Can we treat that PE as an outpatient?- The literature say’s yes, but how many of us actually are? Is is a case of treating to the potential tort!
- Brilliant case CODE BROWN: PERICARDIOCENTHESIS- demonstrating the role of ultrasound in detecting pericardial tamponade, and highlights that CPR is going to be useless in this patient unless the tamponade is drained. Great picture also!
The LITFL Review Shout Out of the Week
This weeks shout-out goes to the new EM blog/podcast The Skeptics Guide to Emergency Medicine. The Skeptics Guide to Emergency Medicine (SGEM) is a knowledge translation (KT) project. Its goal is to shorten the KT window from about ten years down to one year. To do this it will turn traditional medical education on its head.
Have a listen and check out the latest podcast:
- Podcast #12: Oh Dance-a-tron- dominating the dehydrated child!
- Podcast #11: All Seizures Stop…Eventually - and she’s pregnant eek!
Twee Dee and Twitical Care
News from the Fastlane
- Justin Bowra joins the team and starts of with a cracking piece on The Most Expensive Medical Equipment In The World - Such a massive issue put in words…..Looking forwards to more post and discussion from Justin.
- LITFL Takes A Leap Of Faith - and we give out our first PHD to Peter Wyllie – you are awesome!
- TechTool Thursday 006 - Tessa provides us with a cool review of an emergency medicine ultrasound app.
The Final Words
- “The pursuit of normality is the ultimate sacrifice of potential.”
- Faith Jegede
- Believe those who are seeking the truth. Doubt those who find it.
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 — — 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