LITFL Review 320

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Welcome to the 320th 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

Deep dive into flu controversies on this episode of FOAMcast, including a review of the CDC recommendations and evidence from a 2014 Cochrane Review. [MMS, SR]



The Best of #FOAMed Emergency Medicine

Dr. Smith’s ECG blog features a fantastic post on a patient with shoulder pain. The specifics, while important, aren’t the big takeaway. Rather it is the focus on being an advocate for your patient and not succumbing to believing that the specialist knows all. [AS, SR]

This great review from CanadiEM is a timely reminder on the assessment and management ofsuspected DVT in ED. [CC]

In case you missed last week’s 2018 changes to the ATLS 10th Edition text, here’s a second pictorial summary of a review of the updates you need to know about. [MG/ML


The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

You won’t want to miss “The Great Lactate Debate” Part 1 and Part 2, where Jon-Emile Kenny explains the incredibly complex interplay of acid-base physiology and finds fault with the Stewart approach. [RP]

Paul Marik reports on a recent meta-analysis comparing SIRS vs qSOFA in screening patients for mortality. Bottom Line: SIRS was better. [SR]

Are you all ‘Sepsis-ed’ out? Not me!! From pre-hospital antibiotics to paracetamol for fever. A stonking topic review from roadside to resus with the Resus Room team. [CC]

Rory Spiegel and Ken Milne cover the ADRENAL trial. This is a great critical appraisal and for those interested in how to critically appraise a research study, be sure to read and listen to this post. No difference in 90d mortality, and secondary outcomes are hypothesis generating. [SR]

The READS trial assessed the ability of critical care physicians to identify ARDS on CXR- and is reviewed by the Bottom Line this week. [SO]

Jonny Wilkinson has a great collection of clips, infographics and links in the Critical Care Northampton review of February. [SO]


The Best of #FOAMus Ultrasound

Read the latest updates on FAST exam in ectopic pregnancy.from the UCSD ultrasound team [CMD]

Ultrasound to aid in the diagnosis of a young patient with May-Thurner Syndrome via EMdocs [JSh]

Are measures of venous excess such as portal vein pulsatility the new “stop points” of fluid resuscitation? Read the latest on this debate on Phil Rola’s Blog. [SO]


The Best of #FOAMtox Toxicology

Scott Weingart and Bryan Hayes discuss the use of physostigmine in anticholinergic overdose. Ensure you have cardiac monitoring and atropine at the bedside. [SR]


The Best of #FOAMpeds Pediatrics

Sean Fox reviews Ludwig’s Angina in Children at the Pediatric EM Morsels blog. [RP]


The Best of #MedEd FOAM and #FOAMsim

St Emlyn’s has an amazing discussion with Liz Crowe on debriefing in critical care. [MG]

Great post by Mike Lauria on the psychology of FOAM, and how it is related to game playing. Challenging ourselves, inter-connectedness, and it just feels good. [SR]

Discovering how we learn: A conversation Dr. Geoff Norman (PhD nuclear physicist) on how the brain processes information so we can apply it in our educational practice. [MMS]


LITFL Weekly Review Team

LITFL RV brought to you by:

Anand Swaminathan [AS] (EM:RAP, Core EM,REBEL EM and The Teaching Institute)
Andrew J. Bowman [AJB]
Bruno Tomazini [BT] (ICURevisited)
Chris Connolly [CC] (RCEMFOAMed, FOAMShED)
Chris Nickson [CN] (RAGE, INTENSIVE and SMACC)
Cian McDermott [CMD] (POCUS Geelong, SMACC)
Craig Wylie [CW] (BadEM)
Jeffrey Shih [JSh](ALiEM)
Luke Phillips [LP] (POCUS Geelong)
Manpreet ‘Manny’ Singh [MMS] (emDOCs.net)
Marjorie Lazoff [ML] (TandemHealth)
Mat Goebel [MG]
Matt Siuba [MS]
Philippe Rola [PR] (Thinkingcriticalcare)
Rick Pescatore [RP] (EM News UC:RAP)
Sarah Newman [SN]
Salim Rezaie [SR] (REBEL EM, The Teaching Institute)
Segun Olusanya [SO] (JICSCast, The Bottom Line)
Thomas C. Neal [TCN]


Reference Sources and Reading List


LITFL Review

#FOAMed Updates

Marjorie Lazoff, MD FACP. Board certified internist with clinical background in academic emergency medicine, currently the founder of The Healing Red Pen, an editorial consulting company. Dr Lazoff is a full-time editor and strong supporter of FOAMed.

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