LITFL Review 330

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Welcome to the 330th 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

Last week, our own Salim Razaie’s tweeted summaries of his strategy of shock dose RSI (sedatives low and paralytics high). The tweets inspired varying reactions in the Twitter community. In the true spirit of FOAM, his new R.E.B.E.L. EM post offers us further evidence to draw our own conclusions and encourages us to think critically when it comes to using FOAM in our practice. [SN]

The Best of #FOAMed Emergency Medicine

Very nice and simple explanation of differentiating TTP vs DIC from Tom DeLoughery. [SR, AS]

The team at FOAMcast provide several valuable pearls regarding the emergency management of lactating patients. Included are medication considerations, a chart on mastitis, and a review of general emergency care for nursing mothers. [TCN]

Pearls for the emergency management of obese patients are discussed in this emDOCs post. Pathophysiologic alterations of obesity are discussed and their influence on intubation, ventilation, and pharmacokinetics of common emergency medications. [TCN, MG]

Dr. Smith has great ECG case this week that will make you question “what’s in a T wave”? Like me, you may end up adjusting your ECG frame of reference. [MG]

From the latest EM Cases Best Case Ever series, recent entries on necrotizing fasciitis and ectopic pregnancy. [MMS]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

Josh Farkas et al challenges the latest iteration of the Surviving Sepsis Guidelines with a plea to petition against the current guidelines and a call for return to common sense and clinical medicine. [AJB]

Great reminder from the Pharm ER Tox Guy blog that massive transfusion results in hypocalcemiaand that hypocalcemia is strongly associated with mortality. [AS, SR]

Interested in learning about dual lumen bicaval ECMO cannulae? Well, the INTENSIVE team have just the post for you. [SO]

David Lyness recently summarized Day one of AESICM’s forum on Acute Respiratory Failure forum. Check out all the pearls of wisdom he’s acquired. [SO]

The Best of #FOAMus Ultrasound

This week @5minsono does vascular phantoms [CMD]

The International Fluid Academy (IFA) releases a free comprehensive book on Critical and Acute Care Ultrasound (CACU) featuring chapters from key opinion leaders in POCUS. Download is free to IFA members, whose membership is free. [MMS]

Here’s a lovely little primer on renovascular POCUS from our own Phil Rola and Korbin Haycock, looking at the renal resistive index and venous flow. Awesome! [SO]

ACEP Now describes the 3 step CASA POCUS protocol to prevent prolonged CPR pauses in cardiac arrest [CMD]

The Best of #FOAMtox Toxicology

Is naloxone-resistant opioids really a thing? Great post by Andrew Stolbach discussing the unlikeliness of naloxone resistant opioids. There may be other factors such as hypercapnia and/or hypothermia as the causes of unconsciousness. [SR]

The Best of #FOAMpeds Pediatrics

Don’t Forget the Bubbles presents the The 17th Bubble Wrap: a roundup of new and noteworthy publications in pediatric critical care. [SN]

The Best of #FOAMim Internal Medicine

The Curbsiders dive into the diagnosis and management of pulmonary embolism with Dr. Oren Friedman. Pathophysiology is discussed as well as medical and interventional management, including modern approaches to thrombolysis. [TCN]

The Best of #MedEd FOAM and #FOAMsim

The ALiEM Wellness think tank sits down with Jason Brooks to discuss dealing with stress before and after high acuity shifts. [SR]

Gettings things done in a hyperdistracted world – Learn some amazing pearls from one of the most productive and organized individuals in FOAM. [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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