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LITFL Review 331

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Welcome to the 331st 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

One of the most challenging blog posts I have ever read is this one on codependency and the (emergency) physician from St Emlyn’s. Food for thought. [SO]



The Best of #FOAMed Emergency Medicine

Fantastic review of the literature on the absence of evidence to support our insistence on fasting prior to procedural sedation from First10EM. [AS, SR]

Our own Salim Rezaie reminds us that alcohol may blind us to potential badness in our ER patients. Having served as an expert witness I have seen how costly a missed critical diagnosis in the intoxicated patient can be costly to our patient…and to us [AJB]

Don’t get fooled by chest trauma: Pulmonary pearls & pitfalls, from the emDocs crew. [BT]


The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

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Josh Farkas discusses a simple airway algorithm to deal with intubating a patient who is actively vomiting: The Drowned Airway Algorithm. [SR, MG]

David Carr recently presented at dasSMACC with the attention-getting title, “Endocarditis will also f&*k you up.” Easy to remember “fever plus…” criteria for identifying suspected endocarditis and current management practices are presented as a means to avoid missing this critical diagnosis. [TCN]

The EDECMO podcast hosts Dr. Heidi Dalton to discuss her approach to ECMO for sepsis. An important discussion, as sepsis was once considered a contraindication for ECMO. Dr. Dalton describes which septic patients to consider ECMO for and when to initiate extra-corporeal support. [TCN]

The classic teaching for LVAD patients in cardiac arrest is to withhold chest compression, but the NAEMSP blog has an important literature update. [MG]

The Bottom Line review a recent NEJM paper on Thrombectomy 6-24 hours after stroke. Nice work Anthony! [SO]

ICU is all about “sweating the small stuff”- routine things like VTE prophylaxis and feeding are incredibly important. Deranged Physiology discusses the merits of routine ICU care mnemonics(such as FAST HUGS) in a really detailed post. Not to be missed. [SO]


The Best of #FOAMus Ultrasound

Is the RV useful during cardiac arrest? Andy Neill on RCEMLearning explores what you can and cannot tell. Republished from 2017. [CMD]

The guys at UltrasoundPodcast put the ”fun” back into the eFAST! [JSh]


The Best of #FOAMtox Toxicology

David Juurlink makes a case for why we should not be prescribing Tramadol. It should be called Tramdont as it can cause seizures, serotonin syndrome, drug-drug interactions, hypoglycemia, dependence, addiction, and death. [SR]


The Best of #MedEd FOAM and #FOAMsim

A nice piece by Eve Purdy on the importance of owning our mistakes and behaviors in day-to-day interactions. [SR]

Eric Levi writes a beautiful piece summarising much of the latest evidence on burnout from the doctor and institutional perspective, with ideas on how to change things. Bravo. [SO]


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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