LITFL Review 142

Welcome to the 142nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest, and deliver a bite-sized chunk of Global FOAM.

The Most Fair Dinkum Ripper Beauts of the Week

The hits keep coming from SMACC Gold. Simon Carley again discusses metacognition on when to change and the dangers of being early and late adopters to new medical interventions. His talk inspired Scott Weingart to record a SMACC back and Simon to follow that up with his rebuttal. Wonderful back and forth on this topic. [AS]

The Best of #FOAMed Emergency Medicine

• Do you need all of that infusion to run in? Tips from ALiEM  and Bryan Hayes, PharmD on how to get every last drop of your med into the patient. [AS]
• Do you know the EKG signs of arrhythmogenic right ventricular dysplasia? Learn them this week from Amal Mattu. [MG]
• Is it myo-pericarditis or STEMI? Diagnose this difficult ECG with Dr Smith. [MG]
• A recent Ebola outbreak in West Africa has made an otherwise obscure diagnosis worth reviewing. Learn them signs from Mayo’s EM Blog. [MG]
• Takotsubo cardiomyopathy is known to mimic anterior STEMI, but can it also mimic posterior infarct? Find out this week from Dr Smith. [MG]
• Ming Le Cong continues his overview of challenges in retrieval medicine, this week focusing on obstetric retrievals. [MG]
• Sydney HEMS features a case of strange readings on a pre-hospital monitor. Can you solve the mystery (answer in the comments). [MG]
• Luke Regan talks about stacking the deck to improve outcome. Sometimes it’s not about a magic bullet when we’re getting it right the first time. (direct / iTunes / RSS)  [MG]

The Best of #FOAMcc Critical Care

• Believe that patients with OHCA who are intubated in the field have worse outcomes? Not so fast. Ryan Radecki offers a commentary on the significant weaknesses of these studies. [AS]
• The Bottom Line is a great new resource for critical care literature summaries. The culmination of a week of reviewing the literature was last’ weeks ‘Hall of Famer’ from the R&R in the Fastlane: Chatterjee: Thrombolysis for Pulmonary Embolism and Risk of All-Cause Mortality, Major Bleeding, and Intracranial Hemorrhage – A Meta-analysis [CN]
• Here’s what new from the always great Maryland CC Project: Chyle- coming to a paracentesis near you! (which speaks for itself), Jeff Zilberstein – Community ICU Admin is Freaking Hard, But You Can Make a World of Difference (an insight into being a community ICU director in the USA aka ‘hell is an open unit’) and Giora Netzer – Blood Transfusion Strategies in the Modern Era (that old chestnut). [CN]
• Priya Rao asks What does this monitor screen tell you about TBI? Tackle this one to see if you’re a NeuroICU Sherlock Holmes. [CN]
• On Early Adoption: I started this discussion thread on the FOAMcc G+ Community to tie together the FOAM debate between Simon Carley and Scott Weingart on the virtues and vices of early adoption. Have your say! [CN]
• Remember to keep an eye on links being shared on Twitter tagged with the #FOAMcc hashtag – there’s lots of great stuff waiting to be found! [CN]

The Best of #FOAMtox Toxicology

• Mushroom poisoning with a difference, Leon Gussow from the Poison Review looks at a recent article from France on shiitake dermatitis [JAR]
• Does cannabis cause acute coronary syndrome? This paper tries to say yes but Leon says no and with good cause [JAR]
• A nice piece from The Dose makes the Poison on the period of time a drug is detectable in urine [JAR]
• Leon looks at a nice review on overdose and death from chloral hydrate sedation, recommended read [JAR]
• An interesting case of paraffin oil use gone wrong from the Poison Review [JAR]
• Justin Hensley from EBM Gone Wild has posted his talk on Centipedes, Caterpillars and Creepy Crawlers…great pictures! [JAR]

The Best of #FOAMped Pediatrics

• Andrew Tagg at Don’t Forget the Bubbles reminds us that it’s Red Nose Day in Australia – we should be remembering those who’ve lost children to SIDS and raising awareness for others. [TRD]
• Sean Fox at Pediatric EM Morsels reminds us never to trust a neonate. Watch out for ALTEs. [TRD]

The Best of #MedEd FOAM and #FOAMsim

• Social media and Emergency Medicine Learning is a great discussion of FOAM on Anton Helman’s Emergency Medicine Cases featuring Rob Rogers, Brent Thoma and Ken Milne. [CN]
• Are You a Good Educator? – Rob Rogers (him again) introduces LITFL Reviewer (and ridiculously promiscuous FOAMer) Anand Swaminathan’s interview with Simon Carley and Nat May from StEmlyns on this topic. [CN]
• Quantam Quandries – The title may be esoteric and nerdy but Casey does a great job commenting on Simon Carley’s talk on risk stratification and making clinical decisions in the absence of absolutes [AS]
• Question everything! Louise cullen examines the minefield of published research and importance of reading around topics, not articles. (direct / iTunes / RSS)  [MG]
• Tony Brown’s emotive expose on the bias of medical research and publication. The flaws in our current paradigms. (direct / iTunes / RSS)  [MG]
• What to do when you make a ‘big’ clinical mistake? A must read from The Nurse Path. [CN]

LITFL Weekly Review Team

Reference Sources and Reading List

• #FOAMed – #FOAMcc – #FOAMres
• #FOAMped – #FOAMtox – #FOAMus
• #FOAMim – #FOANed