LITFL Review 227

Welcome to the 227th 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 old and new titans of critical care Paul Marik and Rob MacSweeney throw down over the futility of predicting fluid responsiveness in resuscitation. [JS]

Natalie May provides a thought-provoking post looking at our polarised perspectives in the emergency department (although really applies to hospital as a whole). Can we be each be a little kinder, less judgemental, and inclusive this week? [SO]

The Best of #FOAMed Emergency Medicine

• Amal Mattu and Rick Body talk low-risk chest pain evaluation in the ED. This post via St. Emlyn’s contains full video of their talks from last week. [AS]
• The usual subscription-based EM:RAP has relaunched its free TV as EM:RAP HD on YouTube. This week, the team highlights tubes for stopping GI bleeds. [AS]
• PHEMCAST joins in with the sepsis debate but with an interesting prehospital slant and also an insider’s view from Tim Nutbeam who is heavily involved in the UK Sepsis Trust. [SL]
• A great case discussion from SMACC on a prehospital trauma case led by Brian Burns, great to a hear more than one way to skin a cat from these experts and highlighting the difficulties in critical decision making. [SL]
• Here is a superb bunch of tips on managing cognitive load as an emergency physician– useful for all physicians really. [SO]

The Best of #FOAMcc Critical Care

• Is it finally time to put medications to rest in cardiac arrest? The recent NEJM article puts another nail in the coffin. ScanCrit offers an excellent review of the evidence. [AS]
• Another excellent review of the ALPs paper from Rory Spiegel delving into nihilism in medicine and where our attention and efforts should be placed in cardiac arrest patients. [AS]
• Celia Bradford also weighs in on the ALPS trial in OHCA. [SR]
• Incredible talk (despite AV issues) from Scott Weingart on the resequencing of the emergent airway. [AS]
• A rationale call to provide appropriate documentation of airway difficulties–anatomy, physiology or otherwise–to ensure proper care later on. [AS]
• Our own Anand Swaminathan reviews the incidence of immediate and delayed traumatic ICH in patients on warfarin and clopidogrel. [SR]
• Lovely journal club from the Neurocritical Care Unit in Cambridge on steroids in severe community acquired pneumonia. [SO]
• The Maryland CC Project have a wonderful talk by Roy Brower on driving pressure in ARDS. [SO]
• Justin Morgenstern delves into the management of delirium tremens. [SR]
• Josh Farkas discusses why we fail at hemodynamics: The Flaw of Averages & the Swan’s Curse. [SR]
• Blake Bailey and Michael Nguyen show us how to set up for Percutaneous Translaryngeal Ventilation. [SR]

The Best of #FOAMus Ultrasound

• Here’s some more on ultrasound guided central lines from Matt and Mike- in part 3, they show you what to do with your hands (oops….) [SO]
• Phillipe Rola shares a great video showing ultrasound guided periocardiocentesis. [SO]

The Best of #FOAMped Pediatrics

• Here’s a great and challenging post from the chaps at St Emlyn’s- why don’t we use dexamethasone for children’s asthma? [SO]
• Anton Helman goes through an evidence based approach to management of asthma exacerbations in children. [SR]

The Best of #FOANed Nursing

• Two great offerings from new kid on the block, ICU Nurse Educator Joanne Reading, making the clotting cascade easier to understand, and discussing the nuances of oxygen flow rate and FiO2. [JS]
• A neat beginners guide to sepsis from Tom of the Critical Care Practitioner team. Great for the student or novice health care practitioner. [JS]

The Best of #FOAMim Internal Medicine

• The Louisville Lecture series has added a talk by Dr Jan Basile on Hypertension and Resistant Hypertension. [SO]

The Best of #MedEd FOAM and #FOAMsim

• A case study of ALIEM in how to build effective communication networks: Home bases, embassies and outposts. [JS]
• Scott delivers a great talk (minus the technical gremlins that plagued his SMACC keynote) on thinking about thinking: OODA Loops. [JS]
• ALIEM’s “Case of the Pimping Physician” is now complete, with expert commentary and community feedback. Definitely worth a look. [SO]

LITFL Weekly Review Team

Reference Sources and Reading List

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