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LITFL Review 153

Welcome to the 153rd 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

What do we do when our diagnostic capabilities outstrip our abilities to understand the disease and it’s necessary treatment? Rory Spiegel gives turns a critical eye onto the practice of cardiac catheterization for all cardiac diseases that aren’t STEMI. [AS]


The Best of #FOAMed Emergency Medicine

  • Looking for a way to reduce a mandibular dislocation without procedural sedation? Ryan Radecki reviews the syringe technique this week. [AS]
  •  More pearls from Amal Mattu’s EKG series. This week he covers the prolonged QT interval, the general causes and a great trick to narrow the differential without further testing. [AS]
  •  FOAMCast covers a rarely mentioned topic in FOAM; the spleen. Great pearls about asplenic patients, traumatic splenic injuries and more. [AS]
  • Although the recommendations seem to be rapidly changing, EM Basic gives a sensical, non-alarmist update on Ebola screening and treatment as of October 16th 2014. [AS]
  • emDocs.net offers a concise review of the literature surrounding outpatient treatment of low risk patients with pulmonary embolism. [AS]

The Best of #FOAMcc Critical Care

  • When should trauma patients get TXA? What is the ideal initial access in trauma patients? IO or CVL? FFP or PCC for coagulopathy of trauma and more questions via EM Lyceum. [AS]
  •  Trying to reduce advanced chest imaging in trauma? Check out a review from ALiEM on the NEXUS Chest rule. High sensitivity but low specificity. Many questions left unanswered but it’s a start. [AS]
  •  The Maryland CC Project features a great video cast reviewing Thromboelastometry (TEM) Guided Transfusion for Perioperative Coagulopathywith Klaus Gorlinger. [AS]
  •  The NICE guidelines for managing acute heart failure are out and it appears that no Emergency Physician is happy with its recommendations. St. Emlyn’s gives a nice critique of the key pieces. [AS]
  •  The VITdAL-ICU study looking at the effects of vitamin D supplementation in ICU was another fab study from ESICM in Barcelona. Oli Flower interviews the lead author here. [SO]
  •  THe Maryland CC Project (again!) has a wonderful lecture by Sanjay Desai on Ventilator Waveform analysis. [SO]
  •  Looking to make yourself more ECMO than EC-NO? The Alfred Hospital recently completed an ECMO course. Lots of handy tips were tweeted out, and have been wonderfully compiled by the INTENSIVE blog here. [SO]
  •  The Australia and New Zealand Intensive Care Society have a youtube pagewhere lots of talks from their Annual Meetings have been recorded. Lots of wonderful #Foamcc to be imbibed- including a great talk by Chris Nickson on rapid response teams. [SO]
  •  More “great physiology in 1000 words” by Jon-Emile Kenny for Pulmccm: This time he tackles Stroke Volume Variation. [SO]
  •  CTA has replaced angiography as the standard diagnostic modality for a large number of indications but The Skeptics Guide to Emergency Medicine points out that CTA sensitivity for blunt cerebrovascular injury detection is suboptimal. A negative CTA for this indication should not end the diagnostic workup. [AS]

The Best of #FOAMtox Toxicology


The Best of #FOAMus Ultrasound

  • Handsonecho is an amazing FOAMus resource featuring links to courses and lots of video tips- including a large selection of tips on US from Daniel Lichtenstein himself! [SO]

The Best of #FOAMped Pediatrics

  • The PEMED podcast discusses a physically and mentally challenging clinical entity that is all too common – child abuse. Andy sits down with Marci Donaruma-Kowh to discuss cornerstone exam findings and red flags that will help you identify these patients and get them the protection and care they need. [AS]

LITFL Weekly Review Team

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Reference Sources and Reading List

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#FOAMed Updates

New Jersey Emergency Physician with academic focus on resident education and critical care in the ED. Strong supporter of FOAMed and its role in cutting down knowledge translation | @EMSwami |

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