LITFL Review 146

Welcome to the 146th 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

Brilliant new series from Academic Life in Emergency Medicine highlights how successful people in EM work smarter. Posts from Michelle Lin, Victoria Brazil and Esther Choo. [AS] Want a simple, awesome and comprehensive guideline?…Check out these Guidelines for Paediatric Concussion [KG]

The Best of #FOAMed Emergency Medicine

• Computers can’t be trusted to do simple calculations . . . at least not when it comes to the QTc duration. Stephen Smith discusses in a case of syncope and bradycardia. [AS]
• With changeover of junior doctor’s looming in the UK, the EmergencyPedia team set out 10 fundamentals of how to impress in the Emergency Department. [SL]
• Wonder how accurate your respiratory diagnoses are in the ED? The St.Emlyns team discuss potential to improve our practice following a recent publication on point of care ultrasound for the breathless patient. [SL]
• A pharmaceutical company (Boehringer Ingelheim) suppressed data? Inconceivable! If you’ve fallen behind on the dabigitran controversy, Ryan Radecki gives a short commentary on the situation. [AS]
• New LBBB = STEMI? Not always. New LBBB with > 5 mm discordant ST elevation = STEMI? Nope. Great case from Stephen Smith highlighting the fact that ST segment elevation increases with tachycardia and the importance of STE-S wave ratio. [AS]

The Best of #FOAMcc Critical Care

• How should we care for the sick and trying to die pregnant patient? Haney Mallemat discusses the Critical Pregnant Patient on the All NYC EM Podcast. [AS]
• More greatness from SMACC Gold: Scott Weingart weighs talks on Sepsis in New York:  Our first 15,000 patients, while Mark Wilson talks on Monroe Kellie 2.0. [SO]
• Interested in ICU physiology, particularly heart-lung interactions? Jon-Emile Kenny from Vancouver has an excellent set of animated lectures at www.heart-lung.org. Check them out! [SO]
• Trans-oesophageal echo. It’s complicated, bulky, and outside the remit of point-of-care use for resuscitationists. Or is it? Matt and Mike from the Ultrasound Podcastpresent a lecture on POC TEE/TOE by Rob Arntfeld: Part 1 & Part 2 [SO]

The Best of #FOAMtox Toxicology

• Poisoned patients…….the next group of ED patients to benefit from the bedside US?  Dr Leon Gussow discusses the use of POCUS for the poisoned.  [CC]

The Best of #FOAMped Pediatrics

• Sean Fox at PED EM Morsels reviews delayed diagnosis of foreign bodies. It might be just a cough, but consider asking about that peanut they choked on six months ago…. [TRD]
• Don’t Forget the Bubbles reviews a recent paper on ketamine dosing in obese adolescents – are we giving them too much? [TRD]
• Is loss of consciousness useful in determining which kids with minor head trauma need a head CT? Rory Spiegel delves into the PECARN data and discusses its limitations. [AS]
• Kids are just little adults. At least when it comes to the first hour of sepsis management, Simon Carley argues to think of kids as little adults to prevent the paralysis induced fear that EM physicians who rarely treat kids can feel. [AS]

LITFL Weekly Review Team

Reference Sources and Reading List

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