LITFL Review 328

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Welcome to the 328th 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

Nick Cummins Fair Dinkum Ripper Beauts of the Week

Simon Carley reviews the top 10 trauma papers from 2017 – 2018. He has limited this to studies that would affect our bedside care of trauma patients, though there was a real paucity of these. [SR]

Andy Neill and the RCEM team presents us with a gut wrenching review of aortic dissection–the Zebra of the chest pain family. He speaks with a family member of a missed dissection who unfortunately died and with a dissection survivor. Andy then interviews experts on the presentation and management of this uncommon but deadly condition. [LP, MG] 

The Best of #FOAMed Emergency Medicine

Don’t get sick to your stomach over the initial management of patients with undifferentiated GI bleeds! The strength and extent of the evidence behind using octreotide and somatostatin in these patients is reviewed by our own Salim Rezaie on R.E.B.E.L. EM’s latest podcast. [TCN]

Nice short journal club review 140  on idarucizumab for dabigitran reversal, and time to furosemide in CHF, among other current studies in the EM literature. The reviews, how to critically appraise research–all in 11 minutes. [SR]

Katie Selman at EMDaily has an excellent infographic explaining the controversy surrounding bicarbonate administration in severe acidosis. [RP]

Nice review by the folks over at Taming the SRU on the usefulness or uselessness of KUB xrays. There are some indications for KUB, but truly not that many. [SR]

Rob Orman discusses the new IDSA guidelines for C. Diff treatment.  Metronidazole is no longer recommended as a 1st line antibiotic. [SR, AS] (See too our recommended article 2 weeks ago on Metronidazole is out for C Diff, [ML])

Prehospital Emergency Care podcast addresses the concerns of patient fatigue in EMS–how fatigue may be measured, and how fatigue impacts patient care delivery. [AJB]

The team at the Bottom Line take a look at a trial comparing levetiracetam and phenytoin for status epilepticus. Great review of a challenging study. [SO]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

In this First10 EM post, Justin Morgenstern reviews the physiology of the right ventricle and its dysfunction brought about by pulmonary hypertension. Considerations during resuscitation of patients with pulmonary hypertension and right ventricular failure are detailed as well as ECG characteristics of pulmonary hypertension and the WHO groups based on pathogenesis. [TCN, SR]

Ever wondered about the specifics of pre and post-dilution in renal replacement therapy? Deranged Physiology have got you covered. [SO]

Todd Fraser interviews Manoj Saxena for the coolest TBI discussion about Temperature Control in Traumatic Brain Injury you’ll ever hear. [BT]

The Best of #FOAMus Ultrasound

Not so Fast!! Should we be doing Focused Assessment with Sonography for Trauma (FAST) exams on all pediatric trauma patients? EMPulse discusses the utility of the FAST exam in our smallest patients. [LP]

The Best of #FOAMtox Toxicology

Nice discussion from the Tox and Hound about Wellbutrin…or maybe should be better known as Illbutrin. Think of this medication like a sustained release bath salt.  [SR]

The Best of #FOAMpeds Pediatrics

The ICN has some lovely new podcasts on paediatric cardiac intensive care- have a look at part 1and part 2. [SO]

The United Kingdom has seen a recent spike in cases of scarlet fever, and Tessa Davis at Don’t Forget the Bubbles has an outstanding review of the symptoms, rash, and treatment of this common clinical challenge. It’s a must-read for anyone who takes care of kids, British or otherwise! [RP]

Failure to Thrive has a vast differential and list of possible causes. Sean Fox covers the basics of growth failure at Pediatric EM Morsels. [RP]

The Best of #FOAMim Internal Medicine

Organs from those who die of drug overdoses are transplanted at a lower rate. Should we be harvesting more from  overdosed patients? The Methods Man has a thought-provoking explanation of a recent Annals of Internal Medicine investigation. [RP]

This CORE IM podcast with 5 pearls on chronic adrenal insufficiency is anything but exhausting! [RP] (Skillful artwork, too. [ML])

The Best of #MedEd FOAM and #FOAMsim

Like social media and want to share your awesome clips? Ben Smith from Ultrasound of the Week has created Sono/Gif to de-identify, crop & convert your clips to a Gif. Another fantastic free resource that sits alongside his other great tools –sonoclipshare & clip deidentifier. [LP]

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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