LITFL Update 059
Sending you free open-access medical (FOAM) content from around the globe. We keep an eye on all the trends and best articles and share them with you so that you stay on top of your field.
Can you crack the case of ‘Metabolic Mayhem’? One patient’s ECG hints at a rare syndrome, another’s screams of a common crisis. Both have life-threatening electrolyte imbalances. What’s your diagnosis? Peek at the ECGs and guess the conditions.
Pharmacology of metaraminol (Critical Care Compendium): Sympathomimetic amine (direct and indirect), synthetic phenylethylamine derivative, vasopressor. Review the mechanism of action, pharmaceutics, dosing, controversies, and practical tips.
Fernand Léon Cathelin (1873-1960) was a French urologist, best remembered for helping to establish caudal (sacral) epidural injection at the dawn of regional anaesthesia. In 1901 he described a “new spinal route” via puncture of the sacral canal.
Latest updates from the #FOAMed world
ICU boarding isn’t just a bed-flow problem – it’s a secondary-injury problem, and this post lays out a practical “ICU-in-the-ED” bundle you can run while you wait. It reframes the goal as stabilise + prevent the second hit, then walks through a tight, shift-ready checklist. If you regularly babysit ventilated/pressor patients in ED, this is the playbook
Ovarian pathology isn’t a common ED presentation – but when it’s bad, it’s fertility- and sepsis-level bad. This post is a rapid, clinician-friendly run-through of the three “can’t miss” adnexal emergencies: cyst rupture/hemorrhage, ovarian torsion, and tubo-ovarian abscess.
Migraine care in the ED is about to get a lot less “whatever works” and a lot more standardised. This SGEM Xtra unpacks the new 2025 American Headache Society ED migraine guideline with two of the neurologists who wrote it – then translates it into what you should actually do on shift.
DAS 2025 has finally stopped treating obesity as a throwaway “risk factor” and reframed it as a distinct, high-risk airway phenotype – with planning that starts before the first attempt. This post breaks down why physiology makes these airways so unforgiving (rapid desaturation, reduced FRC, aspiration risk, tricky hemodynamics/drug dosing) and distils the guideline into 5 practical moves: head-up preoxygenation, HFNO, early 2nd-gen SGA, consider OR environment, and a stronger push toward awake techniques. Worth a read if you intubate real humans.
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Emergency nurse with ultra-keen interest in the realms of toxicology, sepsis, eLearning and the management of critical care in the Emergency Department | LinkedIn |
BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |