LITFL Review 154

Welcome to the 154th 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’s the best approach to blunt traumatic cardiac arrest? Learn from Weingart and Hinds in this week’s EMCrit podcast. [MG]
If you watch only one lecture on EKGs this year, it has to be Steve Smith’s SMACC talk on “Subtle ECG Signs of Ischemia.”[MG]

The Best of #FOAMed Emergency Medicine

• How much does the urine dip affect your pretest probability? Boring EM offers a nice review of the (+) and (-) likelihood ratios for urine dipstick testing. [AS]
• All antibiotics have the potential to worsen symptoms of myasthenia gravis but some more than others. Bryan Hayes reviews the topic on ALiEM focusing on the fact that we should ensure to use the best antibiotic for the infection that’s affecting the patient. [AS]
• While there’s been lots written and said on Ebola, ERCast looks at something a bit different in Ebola, Quarantine and the Law. [AS]
• How necessary is it for patients to be “Warm and Dead?” Justin Hensley reviews a recent publication from Resuscitation. [AS]
• The Annals of Emergency Medicine Audio Summary for October is out. This month includes articles about ultrasound for appendicitis, FOAM. [MG]
• Rashes often give EM docs headaches. emDocs.net offers a great review of the ED management of patients presenting with undifferentiated rashes focusing on those who need immediate resusciation and how to do it.
• What is anaphylaxis? Michael Rose examines changing paradigms in how we approach the ‘allergic’ patien in this SMACC Gold talk. [MG]
• Left Bundle Branch Block and MI – is Sgarbossa all there is? What is the level of evidence for this and other decision aids? emDocs gives us an update. [MG]

The Best of #FOAMcc Critical Care

• Is adrenaline truly beneficial in cardiac arrest? Should it remain part of ACLS protocols? Our very own Anand “Swami” Swaminathan Rages Back at this exact topic. [SO]
• emDocs has a great overview of ventillator management in COPD. [MG]
• Ryan Radecki discusses one more reason why we should think twice about using mechanical CPR devices; device associated thoracic trauma. [AS]
• Are high filling pressures always beneficial in our critical care patients? Possibly not, as Phillipe Rola discusses in his post on venous hypertension and kidney injury (with a great trackback from Jon-Emile Kenny) [SO]
• The importance of, and how to assess, diastolic function in ICU patients is brilliantly explained by Sara Murthi from Maryland. [SO]
• Fluids can both heal and harm the critically ill patient. Justin Mandeville discusses some of the finer points around fluid administration in a blog post for the Oxford Intensive Care Medicine page. [SO]
• TEG and ROTEM will probably be available in your hospital soon if they aren’t already. Check emDocs.net for a nice review of viscoelastic hemostatic assays. Also see the Maryland CC Project vidcast by Mark Walsh. [AS]

The Best of #FOAMus Ultrasound

• The University of Utah department of anaesthesiology has a rather excellent website devoted to perioperative echocardiography. It’s got video lectures, video quizzes, and is regularly updated with interesting posts. Covering both TEE/TOE and TTE, it’s a superb learning resource. Get stuck in! [SO]

The Best of #FOAMped Pediatrics

• Button battery ingestions are dangerous and potentially catastrophic. St. Emlyn’s reviews the management of asymptomatic and symptomatic patients based on battery location. [AS]
• Great peds myth-busting from Don’t Forget the Bubbles – corneal abrasions may not be the source of crying in infants. [AS]

LITFL Weekly Review Team

Reference Sources and Reading List

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