Welcome to the post-SMACC 98th 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
There’s lots of debate and discussion about what FOAMed is and offers, and is it all about airway management, going around the Twitter lately? This weeks top spot goes to what i think is one of the best FOAMed blogs going around. Each week Chris over at thebluntdissection continues to bust out simple, easy to read cases that are packed full of pearls and pitfalls, controversies and conflicts to challenge and change the way we practice, and improve the outcomes for our patients. Check out these last two latest post from Chris if you don’t believe this is FOAM gold:
- no place like home…. an insightful look at managing a critically ill patient in an environment he’s not use to, and highlights the challenges and lessons he learn’t from this.
- All you need to know about pacemaker dysfunction all wrapped up in a nice easy to read post check out…off the pace…
The LITFL Review Top Picks
- Casey tries something different with Lessons Hard Learned: Dr Tor Ercleve – Great first up case by Tor (he who designed the UCEM logo!), as he shares his experience and lessons learnt when he was a young junior doctor, trying to make a one in a million diagnosis.
- Put your tox hats on and step up to the challenge in 5 Quick Tox Cases.
- SMACC 2013 Summary and Learning Points – Scott shares his SMACC experience, and turns this into a clinical podcast with some great pearls from the SMACC Simwars competition for you to take back to the real bedside.
- The Holy Grail of Fluid Resuscitation is just a Tin Cup – Where are we at? Chad Meyers drowns out some of the dogma, and lets us know were we should be heading when giving fluids to our sickest patients.
- Cuffed Endotracheal Tubes in Children – are they in or out? This post gives you the pros and cons of both!
- Is it time to trash the stethoscope? The age of ultrasound – Yay the wobbly guessing stick is on its way out!
- Lytics for sub-massive PE: Ready for primetime? – Maybe not ready for prime time but worth giving strong consideration to using these.
- Be a great speaker: 10 practical pearls (part 2 of 5) – 10 great tips to improve your next talk!
- Ketofol: Is this the “Game Changer” of Procedural Sedation & Analgesia? – Is this the ultimate sedation agent? It is good but sedation needs to be tailored to each individual patient.
- Bath Salts and Synthetic Marijuana – Leon Gussow from TPR teams up with Rob O to tell us the latest on managing bath salts and synthetic canabinoids – worth a listen!
- Code Brown: Central Line goes Wrong very very wrong! Great teaching case though.
- The GCS still does not belong in Emergency Medicine – Interesting study highlights the strengths and weakness of using the GCS in the ED.
- Vascular Access Training Phantom – James shows us how all you need is a balloon, some dye, and a chicken breast and you’ve got yourself one sophisticated vascular training device.
- SOCMOB How To: Make Your Own End-Tidal CO2 Detector – The MacGyver approach to making sure you have ETCO2 for all your procedural sedations.
- Gastrointestinal Side Effects and Toxicity. Bottom line: Different NSAIDs all produce similar levels of analgesia, but some are much worse than others when it comes to side effects.
- SMACC2013′s roving reporter delivers some brilliant interviews from the delegates and speakers. MORE Jelly Beans from SMACC 2013 with Dr Doug Lynch
- Cricoid pressure – what do you do? Minh wants to know. And the results may surprise some of you! Cricoid pressure survey results are IN!
- THE CRUX by Dr Harold Shim – A look at the vortex concept all the way from the middle east!
- SMACC 2013 in 6 minutes- A pictorial review by Minh.
- What is the optimal target temperature following out of hospital cardiac arrest? Find out in NIELSEN on Therapeutic Hypothermia after Cardiac Arrest.
- Hot Case #13 – To bust or not to bust? – In a case of submassive PE!
- More cases of pediatric IV acetaminophen overdose. – Bottom line: Oral is best when its come to paracetamol, but be very careful with IV dosing in paediatric patients.
- Bleeding complications of “bath salt” exposure: is it DIC? – Tip look for hyperthermia in these patients, and you may also find DIC!
- Long ago and far away: the best toxicology literature of 2011 – If want to know whats new in 2013 in toxicology? Well, then get FOAMed!
- TALKING SMACC – A NURSE EYE VIEW – One of the best reviews from SMACC. Basically says it all!
- Great collection of FOAM resources for Nurses…Check out – FOAM Injection for Nursing Graduates
- Making a referral with Iain Beardsell – Not as easy as we think it is, great informative post for our juniors to learn the art of this tricky process we do daily in emergency medicine!
- The Thunderbox Papers: Basic Drug Calculations – Not the most harding hitting FOAM around this week, but something we all should know or use to educate our juniors.
- High Energy Defibrillation for Incessant Ventricular Fibrillation – Refractory VF -> give them some more joules – the outcome may actually change some of the time!
- Pitfalls and Pearls of Temporary Transvenous Cardiac Pacing – A simple yet very informative post on this often daunting topic!
- Andre shares us his Thoughts on Poker and Medicine – and how we wrestle with risk on daily basis!
- SMACC2013 – critical illness does not respect geography – Though provoking and inspiring we can and should do better for our patients in the bush!
- Bad to the Bone – When the diabetic patient has an ulcer, this podcast looks at when it is osteomyelitis and when its not!
- How to write a medical blog/podcast disclaimer – Some handy informative advice for those thinking of getting into the world of FOAM.
- Full Capacity Protocols – This actually works… I’ve seen that when there no beds and you start sending patients to wait in ward corridors, beds somehow appear!
- Altered Mental Status: The Forgotten Four – Before racing your next altered patient to the scanner, check and treat in case they have one of the forgotten four!
- Ondansetron Is Safe In Pregnancy – Large study showing no adverse fetal outcome – that’s reassuring!
- Early Repolarization Increases Risk of Arrhythmia Death – So its not as benign as we think it is!
- Massive Precordial ST Elevation. What is it? Oh and the patient is hypotensive and bradycardic as well!
- Wide Complex Tachycardia – This challenging tachycardia that want go away with adenosine – so what is it!
- High frequency oscillation ventilation fails as 1st-line treatment for ARDS . Clinical Takeaway: Stick with low-tidal volume mechanical ventilation as first-line treatment for ARDS. High-frequency oscillatory ventilation remains a defensible option as a rescue mode for those who cannot be oxygenated or ventilated using conventional mechanical ventilation.
- An ECG saves the life of a patient with knee pain…huh??!! Check it out in 9 minutes.
The LITFL Review Shout Out of the Week
Finally the LITFL Review has some competition… That’s right! But it only covers the Canadian FOAMed. Brent is now doing a weekly review off all the Canadian FOAM over at boringem, Check out the first two issues!
The GMEP Cases of the week
GMEP Video of the week:
GMEP Image of the week:
Its a nasty neck laceration, kindly submitted by Dan Crompton
Twee Dee and Twitical Care
News from the Fastlane
- Chris shares his thoughts on SMACC, Down But Not Out, also checkout the support materials to his keynote presentation at SMACC All Doctors Are Jackasses.
- Tessa shares us with the basics of Twitter in TechTuts Tuesday Twitter Basics.
- We welcome Doug Lynch and his JellyBean 001 to the LITFL team.
The Final Words
crackophrenia (noun): “the state or condition of being crazy from smoking crack cocaine.”
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 — EM CapeTown — 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 —Injectable Orange — 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 Review — 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