LITFL Review 338

Welcome to the 338th 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

Josh Farkas reviews the controversial topic of bicarbonate therapy in the setting of metabolic acidosis and then dives into the recent BICAR-ICU Trial. Not all acidosis needs bicarb. [SR]

The Best of #FOAMed Emergency Medicine

Nice review by Justin Morgenstern on the use of TXA in Non-Traumatic ICH (TICH-2). Best evidence is that TXA does not help in non-traumatic ICH and should not be using it. [SR]

Excellent and to the point review of Tumor Lysis Syndrome from ALiEM. [AS]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

Justin Morgenstern gives his take on Bougie 1st intubation as he reviews the recent BEAM trial by Driver and colleagues. [SR]

Is transfusion for anaemia in ICU really such a good thing? Patrick Almeida discusses this on ICU Revisited. [SO]

In light of recent trials, Deranged physiology have updated their page on lung recruitment manoeuvres– they can no longer be routinely recommended… [SO]

The ATRIUM Cardiology Collaborative shares some insights regarding the appropriate dosing of amiodarone. Different guideline recommendations for AFib and ventricular arrhythmias are represented and special consideration is given to the importance of loading doses. (Spoiler alert: steady state levels can take around a year to achieve without loading doses!) [TCN]

The Best of #FOAMus Ultrasound

The Bottom Line critiques the SHoC-ED trial on POCUS in undifferentiated shock noting that the study changes little. [AS,CMD]

When does a pericardial effusion turn into a pericardial tamponade? POCUS will help guide the way. See an in-depth review of pericardial effusion and tamponade at emDOCs.net. [LP]

“Think high or think low” – Twits on a printable badge card by Alan Cheim for EM interns to refer to when evaluating sick patients along the shock spectrum. [MMS]

The Best of #MedEd FOAM and #FOAMsim

How can we improve education in resuscitation to raise the quality of care? CanadiEM has released 8 fantastic infographics on 8 topic areas covered in the latest AHA Scientific Statement on Resuscitation Education Science. [MMS]

For all trainees starting a new position, besides following #TipsForNewDocs on Twitter to learn valuable nuggets from seasoned providers, check out this gem with list of pointers from Edwin Leap. [MMS]

Are you okay? Fantastic interview with Chris Doty from Medutopia podcast on burnout, depression and suicide with many helpful take home pearls. With this in mind, it is helpful to revisit the top 10 things you can do to be happier in life with Rob Rogers from Medutopia. [MMS]

News from the Fast Lane

A topic close to our hearts: Andrew Davies discusses the tragic death of Richard Harding, a UK trained intensivist, with his widow Kate. This is a powerful discussion on wellbeing, the pain of mental illness, and the need for us to look after each other. Be warned, some of the material may be triggering. [SO]

LITFL Weekly Review Team

Reference Sources and Reading List