LITFL Review 177
Welcome to the 177th 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 chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the WeekMichelle Johnston manages to capture, in her superbly eloquent style, the heartbreak of the Wrong type of Swiss Cheese. Errors must be prevented, yes. But not at the cost of our humanity. [SO] The Best of #FOAMed Emergency MedicineThe April issu...
Source: Life in the Fast Lane - April 12, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
My experience with an emergency airway management CME
Physicians need to complete about 50 hours of some kind of continuing medical education (CME) every year. The ideal kind of class is one that we actually attend in person, with teachers who are expert in the field being taught and are somewhere near the cutting edge. CME classes are especially nice when they include something hands-on rather than just a lecture format because much of medicine is hands on and because that wakes us up and keeps us focused.
There are other ways to get education, such as studying written materials or attending classes taught via video presentation, and they are an important way for physicians ...
Source: Kevin, M.D. - Medical Weblog - April 4, 2015 Category: Journals (General) Authors: Janice Boughton, MD Tags: Physician Emergency Source Type: blogs
LITFL Review 175
Welcome to the 175th 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 chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the Week If you are trained in transcutaneously pacing then you absolutely must read part 1 and part 2 of Transcutaneous Pacing Success, over at the EMS 12-Lead Blog. [MG] The Best of #FOAMed Emergency MedicineEM Didactic offers a great primer to the c...
Source: Life in the Fast Lane - March 29, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
In Defense of the Hyperangulated Blade
Let me begin, as is my wont, with a story. Let's say, for the sake of discussion, that I was moonlighting at Janus General Hospital. I had a patient signed out to me by my partner: a young patient with COPD, influenza, and pneumonia. He was on BiPAP and supposedly stable waiting for an ICU bed. Murphy's law being what it is, immediately after my partner left, the patient deteriorated and clearly was going to require intubation. He had all the predictors of being a tough tube, so I made sure to have my back-up plans articulated and ready to go.My go-to technique for quite a few years is video laryngoscopy (VL) with the hype...
Source: Movin' Meat - February 4, 2015 Category: Emergency Medicine Source Type: blogs
LITFL Review 166
Welcome to the 166th 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 chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the WeekIt’s Junior Doc changeover time in sunny blighty. Point your new Juniors to this fantastic series from the team in Virchester. This podcast talks over the basics of Problems in Early Pregnancy. [CC] Helping to get around the difficulty of ...
Source: Life in the Fast Lane - January 25, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
CCC Update 009
Here is a quick overview of the major updates and revisions to the LITFL Critical Care Compendium since CCC Update 008.Check these out:Airway and cervical spine injuriesPeople can get pretty twitchy about intubating patients with suspected cervical spine injuries. Apply MILS, use a bougie and perform rapid sequence intubation. What’s so hard about that?… Airway management in Major TraumaAn overview of the issues affecting airway management in major trauma, including the indications for intubation the possible causes of airway compromise in this setting.Antimicrobial stewardshipUpdated with a recent systematic rev...
Source: Life in the Fast Lane - December 15, 2014 Category: Emergency Medicine Authors: Chris Nickson Tags: Critical Care Compendium Emergency Medicine FCICM Fellowship Intensive Care CCC update FCICM exam Source Type: blogs
Research and Reviews in the Fastlane 061
Welcome to the 61st edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the...
Source: Life in the Fast Lane - December 10, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: R&R in the FASTLANE airway critical care emergency Emergency Medicine Intensive Care recommendations Review Trauma Source Type: blogs
Research and Reviews in the Fastlane 058
This study (n=60) randomized patients in the ED getting IV opioids to morphine (0.1 mg/kg) + placebo or morphine (0.1 mg/kg) + ketamine (group 1 0.15 or group 2 0.30 mg/kg). Patients in the ketamine arm had significantly decreased pain without significant adverse effects, although the group with the higher dose of ketamine had a seeming increase in side effects without added analgesic benefit. The literature is mounting that low dose ketamine has utility in the acute analgesia armamentarium but selecting the right population will likely be key (and more is not better).
Recommended by: Lauren Westafer
Further Listening: Cli...
Source: Life in the Fast Lane - November 20, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Education R&R in the FASTLANE Review Source Type: blogs
LITFL Review 152
The LITFL Review is 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 chuck of FOAM.
Welcome to the 152nd edition, brought to you by:
Anand Swaminathan [AS] (EM Lyceum, iTeachEM)
Brent Thoma [BT] (BoringEM and Academic Life in EM)
Chris Connolly [CC]
Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC)
Joe-Anthony Rotella [JAR]
Kane Guthrie [KG]
Mat Goebel [MG]
Segun Olusany...
Source: Life in the Fast Lane - October 14, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Review LITFL R/V Source Type: blogs
Help African Emergency Medicine Now!
aka Postcards from the Edge 010
This ‘postcard from the edge’ is by Swedish Emergency Physician Dr Katrin Hruska (@akutdoktorn), who writes a Swedish/ English language language blog called akutdoktorn.
Immaculate Nagaddya is a registered nurse, working in Lugada Hospital in Uganda. It is a small hospital with about 10 000 visits per year, where she receives critically ill patients, presenting with conditions like status asthmatics, status epilepticus and severe dehydration from watery diarrhoea. Together with seven other nurses and between one and three doctors she keeps this emergency department open day and night, a...
Source: Life in the Fast Lane - October 7, 2014 Category: Emergency Medicine Authors: Chris Nickson Tags: Emergency Medicine International Emergency Medicine AFCEM AFEM africa immaculate naggadya jeremiah njenga postcards from the edge Source Type: blogs
My Difficult Airway
Looks can be deceiving. I was not supposed to have a difficult airway, but we found out the hard way that wasn’t true. I was about to undergo an exploratory laparotomy for suspected appendicitis in 1989, and my wife was adamant that an attending anesthesiologist perform my intubation. The anesthesiology resident at a large Midwest teaching hospital made a claim that I suspect many of us did as we advanced through training and began to feel procedurally invincible. He claimed that the attending anesthesiologist rarely did intubations, and that the residents who performed them daily were more prepared. Unaware of any uniqu...
Source: M2E Too! Mellick's Multimedia EduBlog - July 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
My Difficult Airway
Looks can be deceiving. I was not supposed to have a difficult airway, but we found out the hard way that wasn’t true. I was about to undergo an exploratory laparotomy for suspected appendicitis in 1989, and my wife was adamant that an attending anesthesiologist perform my intubation. The anesthesiology resident at a large Midwest teaching hospital made a claim that I suspect many of us did as we advanced through training and began to feel procedurally invincible. He claimed that the attending anesthesiologist rarely did intubations, and that the residents who performed them daily were more prepared. Unaware of any uniqu...
Source: M2E Too! Mellick's Multimedia EduBlog - July 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Research and Reviews in the Fastlane 034
This study was hoping to show that NAC will keep all those contrast CTs from giving our patients contrast induced nephropathy (CIN). It did not. It looks like the real answer is fluids (and that maybe we are not killing off so many kidneys anyway).
Recommended by: Zack Repanshek
Pediatrics
9. Wang J, Xu E, Xiao Y. Isotonic versus hypotonic maintenance IV fluids in hospitalized children: a meta-analysis. Pediatrics. 2014 Jan;133(1):105-13 PubMed PMID: 24379232
Meta-analysis of 10 RCTs looking at maintenance IV fluids in hospitalized pediatric patients. The study found a RR = 2.24 for hyponatremia in comparing hypo...
Source: Life in the Fast Lane - June 12, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Featured Health Intensive Care Pediatrics Pre-hospital / Retrieval Renal Resuscitation Trauma critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
FDA Draft Guidance Analgesic Indications: Developing Drug and Biological Products
The FDA recently released a new draft guidance with recommendations on how sponsors of analgesic painkillers should develop products in preparation for future marketing authorization. The draft, "Analgesic Indications: Developing Drug and Biological Products", is intended for sponsors of analgesic products intended to treat acute, chronic and breakthrough pain.
All three types of pain—acute, chronic and breakthrough—are characterized by the need for long-term, regular treatment with analgesics. FDA notes that while it is important to understand how a single dose of the drug works, it's even more interested in underst...
Source: Policy and Medicine - February 27, 2014 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
The LITFL Review 105
Welcome to the 105th edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
Emergency Medicine Ireland
Andy Neil smashes out the top spot this week with his awesome review of the evidence sur...
Source: Life in the Fast Lane - June 10, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs
