LITFL Review 343

Welcome to the 343rd 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 FOAM.

The Most Fair Dinkum Ripper Beauts of the Week

The Australian College of Intensive Care Medicine Annual Scientific Meeting just ended–and the Intensive Care Network has a bunch of podcasts from it. Titled “In the Heart of the Matter”, it focuses on all things cardiovascular. Start with this talk on the management of acute heart failure.  [SO] 

The Best of #FOAMed Emergency Medicine

The latest ALIEM Approved Instructional Resource is a module on peripheral vascular disease, with an honorable mention to our own Anand Swaminathan for his post on superficial venous thrombosis. [RP]

emDOC’s Brit Long, MD, builds on his earlier Part I post about the evaluation of ADHF with more myths in Part II: the ED management of ADHF exacerbations. Acute pulmonary edema may be managed more effectively with early NIPPV, and nitroglycerine before diuretics and morphine may do more harm than good in these patients. Judging disposition remains a challenge; clinical judgment, risk stratification tools, and patient factors should be considered together. [TCN]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

There has been a flurry of FOAM recently on acute decompensated heart failure. Another great blog post from the Atrium Cardiology Collaborative: a PharmD’s discussion on the potential harms of discontinuing beta-blockers during ADHF exacerbations. In the absence of cardiogenic shock, the dogma surrounding this practice may lead to poorer short- and long-term outcomes. [TCN]

The Best of #FOAMus Ultrasound

TEE is so hot right now! All is explained in this fantastic piece from @emdocsdotnet [CMD]

The POCUS Atlas has a great piece on how to scan for appendicitis using bedside ultrasound. Rule in appy, not rule out! [LP]

One step closer to an opioid-free ED:  start incorporating ultrasound-guided nerve blocks into your practice today. A great review of the topic by EMDOCS [LP]

The Best of #FOAMtox Toxicology

A great review of acetaminophen toxicity at Core EM reviewing current known science and potential population differences and confounders. [AJB]

Great dive into pediatric overdose and how to manage small poisoned humans in the latest podcast from the Dantastic Mr. Tox and Howard. [MMS]

The Best of #FOAMim Internal Medicine

The title says it all:  Door to tPA under 20 minutes — Impressive or Dangerous? More on stroke and tPA, this time from JournalFeed. [ML]

The Best of #FOAMped Pediatrics

A study in the journal Pediatrics suggested that drinking alcohol while breastfeeding could lead to bad cognitive outcomes in children. Perry Wilson, the Methods Man, dives into the data and thinks it’s still OK to have that glass of wine with dinner. [RP]

The Best of #MedEd FOAM and #FOAMsim

Scott Weingart has a fascinating reflective post on checklists, resuscitation, and the problems with Twitter as a medium for medical discourse. Definitely worth a read. A powerful reminder to think before judging someone’s comments. [SO]

The latest Medutopia podcast discusses Amal Mattu’s Top 10 Pearls for Interns on how to be an excellent provider and human being. Recommended read & listen for non-interns as well. [MMS]

David Slessor reviews the now famous Riskin paper on rudeness for the Bottom Line. It remains a behaviour that has no place in our practice. [SO]

“Women in Medicine, Be Bold” Check out this latest podcast from the Curbsiders, which discusses the gender disparities that exist in medicine and some of the work we can do to address them. [MMS]

Reference Sources and Reading List

• FOAMEM RSS feed syndication for global FOAM

• #FOAMed  – #FOAMcc – #FOAMres – #FOAMped

• #FOAMtox – #FOAMus – #FOAMim – #FOANed