LITFL Review 144
Welcome to the 144th 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
Ripper this week is taken out by Scott Weingart has produced Podcast 128 – Pulmonary Embolism Treatment Options and the PEAC Team with Oren Friedman. This is a cutting discussion of how to rationalise the treatment options for non-massive,submassive and massive PE. [CN]
The Best of #FOAMed Emergency Medicine
- Stephen Smith reposts on a Certain Pattern of PseudoSTEMI to remind us that WPW can cause STEMI-like findings on the 12-lead ECG. Patients with chest pain and this finding should be considered for cardiac catherization or thrombolytics but caution is advised. [AS]
- Audio from NYU/Bellevue Grand Rounds in June 2014 featuring Jerry Hoffman on Over-diagnosis and David Newman on Chest Pain posted this week to the All NYC EM Conference site. Great talks from a couple legends in Emergency Medicine on topics critical to us all. [AS]
- Richard Body at St Emlyns uses his own research to answer the question How accurate is clincal judgement for acute coronary syndromes? He highlights the relative uselessness of historical features and risk factors – but interestingly the combination of clinician gestalt, normal ECG and negative troponin looks very promising… more studies needed, but a must read all the same. [CN]
- TTL Podcast 1. Getting to CT in 30 mins is a St. Emlyns podcast examining what aspects of initial trauma managment are really needed before going for a scan, when you have to have the scan done within 30 minutes of arrival. This sparked
- Hippo EM present a videocast on pus and stones discussing how you can diagnoses UTI in patients with ureteric calculi. Or rather, how you can’t. [CN]
- Are topical anesthetics dangerous in the treatment of corneal abrasions or is withholding them simply evil? Ken Milne and Salim Rezaie discuss on The Skeptics Guide to Emergency Medicine. Ken even brings in an opthalmologist who says it’s “okay” to give topical anesthetics! [AS]
The Best of #FOAMcc Critical Care
- Speak up! on INTENSIVE focusses on speaking up, an obligation of all healthcare professionals to ensure that patients are not harmed. It can be difficult, requires skill, and requires courage – but is essential. [CN]
- Cliff Reid has looked into the options for rewarming when you are faced with profound hypothermia and no ECMO. [CN]
- PulmCCM highlight a recent meta-analysis showing that Prone positioning reduces ARDS mortality by 26%. Is your ICU proning yet? [CN]
The Best of #FOAMtox Toxicology
- Leon provides insightful commentary on article that demonstrates how not to use intralipid in Acute respiratory distress syndrome following intralipid emulsion therapy. He also highlights an interesting case series in Mussel Beach: PAralytic Shellfish Poisoning [CN]
The Best of #FOAMped Pediatrics
- In yet another superb smaccGOLD talk, Paediatric INtensivist and Palliative Care physician Greg Kelly tells us what to do when children die. [CN]
LITFL Weekly Review Team
LITFL RV brought to you by:
- Anand Swaminathan [AS] (EM:RAP, Core EM,REBEL EM and The Teaching Institute)
- Andrew J. Bowman [AJB]
- Bruno Tomazini [BT] (ICURevisited)
- Chris Connolly [CC] (RCEMFOAMed, FOAMShED)
- Chris Nickson [CN] (RAGE, INTENSIVE and SMACC)
- Cian McDermott [CMD] (POCUS Geelong, SMACC)
- Craig Wylie [CW] (BadEM)
- Jeffrey Shih [JSh](ALiEM)
- Luke Phillips [LP] (POCUS Geelong)
- Manpreet ‘Manny’ Singh [MMS] (emDOCs.net)
- Marjorie Lazoff [ML] (TandemHealth)
- Mat Goebel [MG]
- Matt Siuba [MS]
- Philippe Rola [PR] (Thinkingcriticalcare)
- Rick Pescatore [RP] (EM News UC:RAP)
- Sarah Newman [SN]
- Salim Rezaie [SR] (REBEL EM, The Teaching Institute)
- Segun Olusanya [SO] (JICSCast, The Bottom Line)
- Thomas C. Neal [TCN] (PulmCCM)
Reference Sources and Reading List
LITFL Review
#FOAMed Updates
Marjorie Lazoff, MD FACP. Board certified internist with clinical background in academic emergency medicine, currently the founder of The Healing Red Pen, an editorial consulting company. Dr Lazoff is a full-time editor and strong supporter of FOAMed.