LITFL Review 316

Welcome to the 316th 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

Ercast’s Rob Orman from sits down with performance coach Jason Brooks to discuss performance, reflection, burnout, stress inoculation, humility, fear of ignorance, and so many other great topics. Always gratified, never satisfied. [SR, AS]

The Best of #FOAMed Emergency Medicine

In this month’s Emergency Physician Monthly magazine (free registration to any ER staff), the brilliant Al Sacchetti succinctly discusses the upside of ED cardioversion in recent-onset atrial fibrillation. [AS]

Pendell Meyers touches on two contrasting cases on Dr. Smith’s ECG blog to show why our patients deserve better than the “STEMI criteria”. [MMS]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

More on sepsis: Dan Horner does a great review of the ADRENAL Trial (Steroids in Septic Shock). In his analysis he states that hydrocortisone should be reserved for the sickest of the sick septic shock patients as there is really no mortality benefit. As for the secondary outcomes…well we should always be skeptical of secondary outcomes. [SR]

Scott Weingart walks listeners through the hemodynamically neutral intubation. Don’t give meds and higher doses of meds that would drop the BP, take away sympathetic drive, and maintain spontaneous respirations (i.e. Awake Intubation, DSI, or combo of two). [SR]

Ryan Radecki reviews another interventional open label ischemic stroke trial: DEFUSE 3. This trial was stopped early and evaluated linterventional therapy out to 24 hours post stroke. Like the DAWN trial, the key here is tissue viability, not time metrics. [SR]

Rory Spiegel (EMNerd) and Duncan Chambler (The Bottom Line) both review a recent article on the use of APRV for ARDS. The results of this trial were pretty astonishing—however given this was a small, single center trial, the results should be taken with a grain of salt. [SR]

Listen to the awesome Julia Wendon discuss the future of hepatic failure management in a podcast from the Intensive Care Network. [SO]

More updates from Deranged Physiology come in the form of excellent articles on arterial lines- start with this one on the transducer set up. [SO]

PHEMcast and Ian Roberts discuss a recently published meta-analysis on Tranexamic Acid. [CW]

The Best of #FOAMtox Toxicology

This is a fantastic and information-packed infographic on calcium channel blocker overdose by Dr. Joshua Feblowitz at Academic Life in EM! [RP]

The Best of #FOAMus Ultrasound

The International Fluid Academy Day 2017 continues to upload videos as #foamed to their Vimeo channel. Here is Martin Balik discussing pericardial diseases and ultrasound. [SO]

The Best of #FOAMpeds Pediatrics

Does your preschool wheezer need steroids? The team at Don’t Forget the Bubbles has a thorough discussion of a recent RCT from The Lancet asking that same question. [RP]

The Best of #FOAMim Internal Medicine

Screening for Depression video from the University of Louisville has a very interesting final section on using computer technology for treatment of depression. [ML]

The Best of #MedEd FOAM and #FOAMsim

Capitalize on the processes and outcomes in cases that are excellent with Amazing & Awesome (A&A) rounds at your institution. [MMS]

Simmers! Learn some strategies to stay up to date on the diverse sources available to simulation educators and share what you use to do so. [MMS]

LITFL Weekly Review Team

Reference Sources and Reading List