LITFL Review 150

Welcome to the 150th 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 ripper this week is taken out by EMRAP crew offers up a mini episode on ebola via their free Hippo EM blog and podcast. It gives us the nuts and bolts about what we need to know about ebola! [MG] [KG]

The Best of #FOAMed Emergency Medicine

• The induction to EM training continues on St. Emlyn’s with a great introductory podcast on syncope from Simon Carley and Iian Beardsell. [AS]
• Core content review of anaphylaxis from FOAMCast touching on biphasic reactions, penicillin-cephalsporin “cross-reactivity” and the treatment of streptococcal phayrngitis. [AS]
• We have accepted that ultrasound is excellent for detecting pneumothorax, but how good is it and what is the evidence base? Boring EM tackles this question in “Boring Question: How does the sensitivity/specificity of lung ultrasound compare to plain films in diagnosing pneumothorax?” [MG]
• Students will appreciate a review of the rapid neuro hand exam from EM in 5.  [MG]
• Beta-blockers early in STEMI: they’re in, they’re out, are they back in? Amal Mattu reviews the latest literature in episode 8 of his Updates in Resuscitation Podcast. Amal also presents a case of syncope with a subtly diagnostic EKG. [MG]
• emDocs answers the question, “Does End Tidal CO2 correlate with PaCO2 in Traumatic Brain Injury?” [MG]
• What do extremely fast narrow tachycardias, asthma, and wide complex tachycardia have in common? Find out this week from Dr Steve Smith. [MG]

The Best of #FOAMcc Critical Care

• EMLyceum tackles 4 debatable areas in the management of diabetic ketoacidosisincluding the role for bicarbonate infusions in severely acidotic patients and whether insulin boluses are necessary. [AS]
• Josh Farkas from Pulmcrit challenges the myth of large volume resuscitation in pancreatitis– and almost simultaneously Phillipe Rola from Thinking Critical care puts up a podcast discussing fluid resuscitation. Great minds…[SO]
• Critical care resources will always be scarce and it’s important for us to recognize that putting one patient in the ICU may prevent another from benefiting from that care. Ryan Radecki discusses the Opportunity Cost of ICU utilization for patients without hope for recovery. [AS]
• Steve Bernard from the Alfred Hospital discusses state-of-the art post-arrest care in this great talk from SMACC Gold. [SO]
• The ED ECMO project bring us a journal club analysing two game-changing papers in the world of extracorporeal CPR. [SO]

The Best of #FOAMtox Toxicology

• Leon Gussow from the Poison Review reviews a recent article examining nine patients, who developed acute kidney injury after smoking a synthetic cannebinoid [JAR]
• An interesting case where ketamine may not be the answer- is lamotrigine ketamine’s black swan? [JAR]
• On the topic of synthetics, Leon also looks at a structural analogue of ketamine- methoextamine, the bladder friendly ketamine analogue… [JAR]
• Mary A. Wittler from ALiEM has put together a nice review of iron toxicity [JAR]

The Best of #FOAMped Pediatrics

• Croup season is just a couple months away (at least in the US). Great review of the diagnosis and management of croup from Don’t Forget the Bubbles. [AS]
• A succinct summary of the evidence on clearing c-spines in children at Clinical Monster. [TRD]
• Sean Fox at Pediatric EM Morsels covers a difficult topic for paediatric doctors – eating disorders. [TRD]
• All things pediatric asthma in one place. Andy Sloas finishes up his asthma series reviewing EtCO2, BiLevel, Intubation and Vent Strategies in sick asthmatics. [AS]

LITFL Weekly Review Team

Reference Sources and Reading List

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