Welcome to the awesome 93rd 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 is taken out by boringem with a great review on Palliative Care in the ED and how to use a 4 step approach to managing the terminally ill patient. Critical care resuscitation is something we all love to do every shift, however when that level of care isn’t appropriate, do you know how to provide excellent end of life care? This post is a must read then!
The LITFL Review Top Picks
- Mr EmCrit & his Amazing Airway checklist – Scott and Minh discuss the ins and outs of using and developing an airway checklist!
- Delayed Sequence Intubation or DCI…Deadly Critical Intubation? Nope that doesnt sound better.. Another great short vodcast from Minh, highlight some tips and tricks for intubating the critically hypoxia patient -and coins the new term of damage control intubation!
- Graded assertiveness is a learned skill. It is a process of communicating, advocating and directing with hardcore clarity that is useful in stressful or crisis scenarios.Want to know more? Check out – Graded assertiveness: PACE.
- Ian puts his hand on his heart and writes An open post to my community. Great piece Ian on getting the community involved and confronting the issue of access block.
- Using social media to enhance our profession. Ian shares his workflow for accessing and using social media…We just need to get more EDCC nurses on board!
- The American review of the2012 Surviving Sepsis Campaign Guidelines – Scott goes to town and shares his opinion on the new sepsis guidelines.
- This months podcast is on theTreatment of Aortic Dissection from managing the BP, through to tubing the dissecting patients, Scott covers it all!
- Dr Newman takes on SMART Pseudoaxioms 1: The Digital Axiom. This one looks at adrenaline into the digit! Remember this Excellent one-liner: “doctors don’t unlearn”!
Rick and Jerry hammer out a review of the January literature. Check out how the masters do journal club and get your entry ready for SMACC Club.
- High Frequency Oscillation Trial Results – In summary, the Oscillation for Acute Respiratory Distress Syndrome Treated Early (OSCILLATE) and the Oscillation in ARDS (OSCAR) trials showed no improvement in in-hospital death or 30 day mortality, respectively.
- Great TED Talk by Jamshed Bharucha Learning’s Dirty Little Secret- Learn the 3 key things on ever lasting long learning:
- The Magic of Spaced Repetition and Cognitive Science – yes, repetition is the mother of all learning!
- Does your COPD patient need in-flight oxygen? New algorithm may help – Clinical Take-Away: This algorithm for the pre-flight evaluation of COPD patients that utilizes resting room air (sea level) oxygen saturation and six-minute walk test desaturation may effectively discriminate who needs in-flight supplemental oxygen, and reduce the number of patients requiring more sophisticated testing with HAST.
- Continuing beta blockers safe during acute COPD exacerbations- Thats reassuring!
- Relative Bradycardia- aka Faget’s sign – a Relative bradycardia compared to what would be expected with fever.
- Thiamine Before Glucose will not cause Wernicke’s Encephalopathy. Bottom line: Giving glucose prior to thiamine will not precipitate an acute Wernicke’s encephalopathy. Prolonged administration (at least > 24 hours) of glucose only diets may worsen symptoms, but can then be reversed by giving thiamine.
- YOU SAY GURNEY, THEY SAY TROLLEY, I SAY BÅRHELVETE. Take-home message: CPR can´t be performed effectively while moving a patient.
Dr. Gary Joubert gives us an update in Acute infant respiratory problems:
Dr. Joel Krause talks on managing radiation exposure in the Emergency Department:
- The English review of the New Surviving Sepsis Guidelines – What’s new?
- Milk for refractory migraines?- Interesting study, but certainly has some limitations. Be interested to see if this is repeated in a larger cohort of patients.
- Robbo is back with another podcast on Shoulder Injuries, and also provides us with a great FOAMed link on applying common splints in the ED.
- a twisting tale… – 11 year continually vomiting and developing abdo pain- see what the abdo x-ray shows!
- When you think you see a dog but maybe it’s just spots. – A great case on CHRONIC Aortic Dissection, not too often we find and pick up ones of these!
- Learning to Read (Efficiently)- Its simple as using a feed aggregators, and Lauren shows you how!
- What Are “Trustworthy” Clinical Guidelines? – This is a problem – because most aren’t.
- New ACEP tPA Clinical Policy – Makes it difficult not to give tPA if policy that govern ED Doc’s are supporting it!
- Website Review: What to dominate your emergency board in-training exam? Check out this awesome FOAMed website to help you- Emergency Board Review.
- Paucis Verbis Card: Diagnosis of DVT (ACCP guidelines)
- One-dose vancomycin for SSTIs: Just don’t do it – No evidence of benefit, either seen em home on orals, or bring em in for IV if toxic looking!
- Trick of the Trade: Incision and loop drainage using tourniquet
Amal’s ECG case of week:
- Interview with Dean Richard Hoppmann: SUS WHO? SUSME!
- The Three Strikes And You’re Out Airway Rule. Bottom line: We should never allow more than 3 airway attempts, and sometimes clinical conditions will dictate fewer tries. Examples that come to mind are severe brain injury patients (hypoxia is bad) and patients who do not recover from oxygen desaturation when they are bagged. Don’t lose track of time and the number of attempts!
- Ice, Ice, Baby – Pre-hospital therapeutic hypothermia… Benefit? Or just cool em in the ED?
- Does smoking marijuana cause stroke? – Possible but not probable!
- Bit of research from down-under on mushroom poisoning…..Treating Amanita phalloides poisoning: is silibinin superior to chicken dung?
- Empty the Dishwasher - Great piece on ED overcrowding. Yes Seth agree we do move patients to ward corridors to free up ED beds, and magic does happen and beds do appear when you start doing this!
- ECG of the Week – 28th January 2013 – can you decipher whats going on here?
- Turn the Oxygen DOWN! Brilliant post on why we need to use target specific oxygen, not just the time honoured tradition of applying a non-rebreather mask, to very half sick looking patient! A must read!
- Eye Complaints – nice podcast review on managing the common eye complaints- brilliant for med students and a nice refresher for the rest of us.
- Excellent trick of trade on making sure you dont get your O2 lines mixed up during NODESAT – Make It Happen! Check it out and try it!
- This is a great, short and high value talk Elbow effusions from Radiopaedia.org.
The LITFL Review Shout Out of the Week
- This week’s shout out is taken out by Aaron over at IVLine with his great viewpoint on Capturing the Great FOAM. Worth a read, were do you think FOAMed should be heading?
The GMEP Plug of the week
Twee Dee and Twitical Care
News from the Fastlane
- TechTool Thursday 014 – Great app review by Tessa this week on LactMed which provides information about the side effects of medicines when breastfeeding.
The Final Words
LITFL Review EM/CC Educational Social Media Round Up
Emergency Medicine and Critical Care BlogrollEmergency Medicine and Critical Care Podcasts123Sonography.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 — emimdoc — 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 — IVLine — 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 — Resus Room Management — 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