Welcome to the global 90th 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 given to The Trauma Professional’s Blog, each week Michael provides us with fascinating reviews and insights into managing the trauma patient, and this week is no disappointment. Check out these two post:
- Trauma Mythbusters: Spinal Cord Injury From Airway Management - Bottom line: From a mechanical standpoint, even in unstable spine models, the maneuvers we use in preparation for intubation cause more movement of the spine than does the intubation procedure itself. The true number of spinal cord injuries actually (and provably) caused by intubation approaches zero.
- Don’t Ignore The Naughty Bits - Bottom line: The naughty bits are important because the occasional missed injury in this area can be catastrophic! Do your job and force yourself to overcome any reluctance to examine them.
The LITFL Review Top Picks
- How do you remember the timing of normal ossification centers? This weeks Trick of the Trade: Ossification centers of the elbow - Shows you how!
- In this inaugural P-video, Dr. Jeremy Faust gives us a quick way to remember how keep the maximum subscores of the Glasgow Coma Scale straight. -P-video: How to remember the GCS scoring
- Paucis Verbis: Composition of intravenous fluids - This PV card helps remind me what’s in each liter bag of fluids we order.
- Jeff Kline vs Corey Slovis: We Do More Harm Than Good Worrying about PE, These two guru’s of the EM/PE world shares there thoughts and controversies on how we should really be approaching PE patients in the ED – a must listen to!
- Superb review on Tranexamic Acid (TXA). By Ian, are you making sure your major trauma patients are getting it?
- Managing a ventilated patient: vent settings. - Ian reminds us of the brilliance of Weingart, by sharing his simple, easy to follow and understand vent lectures.
- Testing, Testing… Making Feedback More Than Just Noise. Are you good at giving feedback? But what about constructive feedback that can make a difference…Not sure? Natalie gives us some points on giving feedback the right way!
- Natural Seven for 2012 - Scott gives his best of the best shout-outs from 2012.
- Eye trauma with Dr Seb Rubinzstein-Dunlop - Casey catches with Dr Seb to discuss all things eye trauma with a focus on the true eye emergency and the performance of a lateral canthotomy.
- Blood ‘n Guts: hold the blood, save the patient? - Casey reviews a recent published study looking at transfusion in GI bleeders.
- Earache in kids with Dr Dave Forster - This is a super-common presentation and one that can be a bit confusing. In this podcast we talk about the differentiation of otitis externa from media, analgesia strategies and the often tricky question around antibiotics – do they help?
- ED vs ICU airway management all wrapped in a great podcast from Minh and Seth, and features a couple of ringins as well.
- Brilliant informative review on Ketamine for primary care providers in remote medicine.
- Minh gives a great in depth summary from this recent article - Complications and failure of airway management – update to NAP4
- From death we learn – Victorian coroners finding on failed intubation - Some of the most powerful lessons I find are from the coroners websites and inquest findings. Couldn’t agree with more in Minh with this, get access to coroners reprots and learn from the death of these patients, it guarantees to help and change your practice!
- Emergency Department I&D Checklist- Reuben shares with us his checklist approach to abscess!
- Holley on BURNS - Listen to Anthony Holley’s fantastic presentation on burns that he gave at the Bedside Critical Care Conference 2012. A must listen to if your interested or see burn patients in the ICU.
- Nguyen on Scary Obstetric Emergencies - There not so scary after listen to this brilliant podcast.
- Top 10 Ways to Rock EM Clerkship - I like number 2 the best!
- Brent shares a brilliant thought provoking post on is Normal Saline: The Coke of Crystalloid Fluids - so next time you’re ordering fluids for a patient in the ED consider: should they get IV Coca-cola? Or something healthier??
- Evidence Summary for Bell’s Palsy - steroids are in- antivirals are out!
- Angiography After Cardiac Arrest - not the most brilliantly designed study, however big survival difference was shown for patients in this group that did receive early angiography.
- Speeding things up through equipment design - making finding things easier during time critical situations.
- Swelling worse than bleeding for injured brains - Contusion and haemorrhage appeared to be less signiﬁcant predictors of outcome than the presence of brain swelling in this British dataset.
- Lifting the Fogg on ED Intubaton - an audit of ED intubations. As Cliff puts it -As a specialty we must continue to seek to do better, and I salute all these brave authors who are telling it like it is!
- Point of care analysis of intraosseous samples - you can do it, but discard the first 2mls of aspirate first!
- eh-vee-arrr - the importance of recognise AVR when in the context of coronary ischaemia.
- a diligent driver… in a nurse will altered visual acuity and a positive Marcus-Gun reflex- what is the diagnosis and what treatment does the ophthalmologist want you to start?
- Does Ibuprofen protect against Acute Mountain Sickness? - The answers are not yet fully clear but there is certainly promising signs to support the anti-inflammatory role of Ibuprofen in protecting against AMS by dampening down the inflammatory response to altitude induced hypoxia
- ECG sagas of subtlety 2 - Wow an challenge dynamic ECG case for you to learn from, by Australia’s own ECG geek!
- Check out The 3rd Annual Alexander Awards: Best Tox Reading of 2012- A must read!
- Low-dose abdominal CT is superior to plain film for imaging suspected body packers - nice review Leon, something to be aware of the neck time your packing it dealing with a body packer@
- PCI for stroke trials - a new concept in stroke care, but is the brain the same as the heart! Be very interesting to see where this concept is at in 10 years.
- Anatomy for Emergency Medicine 024 – Shoulder: Nerve compressions
- Eye of the Tiger a look at traumatic hypemas. Take home point: The ED management of traumatic hypemas would be to prescribe nothing and call ophthalmology.
- EPIPEN® in the finger… - Awesome X-ray!
- FLUID CHALLENGES AND ARTERIAL BLOOD PRESSURE - Take-home message: When giving fluid boluses, increases in blood pressure does not reliably track increases in cardiac output in sepsis patients.
- Comparison of Rectal, Axillary, Tympanic, and Temporal Artery Thermometry in the Pediatric ER - Which is best for finding the fever in our little adults?
- Emergency Medicine – Variations on a Theme - Lauren shares the top thing she has learned from rotations in emergency medicine…An awesome collection of pearls in this post from Lauren.
- Karel Habig shares with us an excellent vodcast on Rapid Sequence Intubation in Retrieval Medicine
The LITFL Review Shout Out of the Week
- TheNNT - has had a make over, check it out and find just how easy and user friendly it is now.
The GMEP Plug of the week
This week GMEP plug is a post on recognising and managing Brain Metastasis With Vasogenic Edema by Elisha Targonsky
…and welcome to the UltrasoundPodcast for joining the #GMEP revolution (high quality vodcast)
Twee Dee and Twitical Care
News from the Fastlane
- Mike gives us an update on GMEP and how to use the GMEP Media Library - time to check it out!
- Finally we get to here What Weingart Would Do is this challenging trauma case.
The Final Words
The real leader has no need to lead - he is content to point the way.
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 —boringem—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 —ED-Nurse— EDTCC — EKG Videos — EM Basic — EM Core Content — EMCrit —EMDutch — 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 — EXPENSIVECARE — Free Emergency Medicine Talks — GMEP — Gmergency!—Got Resuscitation— 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 —PEMTweets Blog — 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 — SOCMOB — 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 Podcast — Ultrasound Village