LITFL Update 061
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.
CT Case 103: 35-year-old male with recurrent spontaneous bleeding from his right ear, a pulsatile cystic lesion on the right antitragus, and a blood-filled external auditory canal that haemorrhages persistently post-examination. A CT angiogram of his head and neck is arranged.
Education Theory Made Practical: ALiEM has released a FOAM downloadable 8-volume library for clinician-educators covering 77 high-yield education theories and frameworks – full of usable tools for feedback, assessment, curriculum design, debriefing, and faculty development.
Achille Mario Dogliotti (1897-1966) was a versatile surgeon-scientist who was a pioneer of pain therapy and a leader in Italian cardiac surgery. He approached anaesthesia and analgesia as integral components of operative care rather than separate disciplines.
Latest updates from the #FOAMed world
A recent PulmCrit commentary challenges the standard practice of giving beta-blockers for sinus tachycardia in thyroid storm, noting it’s not supported by solid evidence. Emerging data suggest beta-blockade may even precipitate cardiovascular collapse in these patients. Instead, clinicians should focus on treating underlying causes of tachycardia and reserve beta-blockers for conventional indications after careful hemodynamic assessment.
A recent Life on the Frontline article reviews updated PE guidance, moving from “massive/submassive” labels to a physiology-based classification focused on right ventricular function and clinical severity. The key message: outcomes are driven more by RV strain than clot size, helping ED clinicians better risk-stratify and guide imaging and management decisions.
A recent post from REBEL EM reviews a pilot RCT examining continuous suctioning during rapid sequence intubation. The study found no increase in oxygen desaturation compared with as-needed suctioning. Although limited by small size and variable technique, the findings suggest continuous suctioning — including SALAD-style airway management — appears safe and unlikely to worsen hypoxemia during emergency intubation.
A Taming the SRU review outlines key emergency management of traumatic shoulder injuries, including fractures, dislocations, and soft-tissue damage. It emphasises careful neurovascular assessment, appropriate imaging, prompt reduction when indicated, and clear disposition planning, with urgent referral for open injuries, irreducible dislocations, or neurovascular compromise.
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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 |