LITFL Review 248
Welcome to the 248th 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
Susan Wilcox drops some serious knowledge on pulmonary hypertension and clapped-out right ventricles on EMCrit Podcast. Brilliant guest with excellent clinical applications. [JS]
Anatomy is back, Andy Neill returns with more of the superb Emergen...
Source: Life in the Fast Lane - September 11, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Research and Reviews in the Fastlane 149
Welcome to the 149th 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, Justin Morgenstern 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 o...
Source: Life in the Fast Lane - August 31, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Emergency Medicine Infectious Disease Intensive Care Neurology Palliative care Pre-hospital / Retrieval R&R in the FASTLANE Radiology Respiratory critical care recommendations research and reviews Resuscitation Source Type: blogs
LITFL Review 243
Welcome to the 243rd 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
EM Nerd Rory Spiegel gives us statistical non-nerds an excellent and important education in descriptive statistic in a case of central tendencies. [SO]
The Best of #FOAMed Emergency Medicine
Ketofol or Propofol for procedural sedation i...
Source: Life in the Fast Lane - August 7, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs
Research and Reviews in the Fastlane 145
Welcome to the 145th 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 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern, 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 ...
Source: Life in the Fast Lane - August 4, 2016 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Education Emergency Medicine Pediatrics R&R in the FASTLANE Resuscitation EBM literature recommendations research and reviews Source Type: blogs
The widespread use of fentanyl escalates the risk of overdose
A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009.
For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling to see it become the cause of rising numbers of deaths from overdose. Fentanyl is a potent medication, useful in the operating room to cover the intense but short-lived stimulation of surgery. The onset of a...
Source: Kevin, M.D. - Medical Weblog - June 30, 2016 Category: Journals (General) Authors: Karen S. Sibert, MD Tags: Physician Medications Pain management Source Type: blogs
Demystifying General Anesthetics
When Margaret Sedensky, now of Seattle Children’s Research Institute, started as an anesthesiology resident, she wasn’t entirely clear on how anesthetics worked. “I didn’t know, but I figured someone did,” she says. “I asked the senior resident. I asked the attending. I asked the chair. Nobody knew.”
For many years, doctors called general anesthetics a “modern mystery.” Even though they safely administered anesthetics to millions of Americans every year, they didn’t know exactly how the drugs produced the different states of general anesthesia. These states include unconsciousness, immobility, analgesia...
Source: Biomedical Beat Blog - National Institute of General Medical Sciences - June 22, 2016 Category: Research Authors: Carolyn Beans Tags: Pharmacology Anesthesiology Big Questions Source Type: blogs
Fame and Fetanyl
By KAREN SIBERT, MD
A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009.
For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling to see it become the cause of rising numbers of deaths from overdose. Fentanyl is a potent medication, useful in the operating room to cover the intense but short-lived stimulation of sur...
Source: The Health Care Blog - June 7, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Fetanyl Source Type: blogs
Fame and Fentanyl
By KAREN SIBERT, MD
A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009.
For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling to see it become the cause of rising numbers of deaths from overdose. Fentanyl is a potent medication, useful in the operating room to cover the intense but short-lived stimulation of sur...
Source: The Health Care Blog - June 7, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Fetanyl Source Type: blogs
An unusual wrist injury
A 30 year old man attends the Emergency Department after injuring his right wrist. He was playing rugby and landed awkwardly during a tackle with his hand trapped underneath another player. On arrival he is complaining of significant pain in his right wrist with reduced movement in all directions.
Clinical Case Report
Examination:
Examination of the wrist reveals reduced movement in flexion and extension and significant pain on pronation and supination.
You notice a hollow where his ulna styloid normally sits on the dorsum of his wrist.
+ Show Clinical Image of wrist on arrival
expand(document.getElementB...
Source: Life in the Fast Lane - May 6, 2016 Category: Emergency Medicine Authors: Dan Stevens Tags: Clinical Case Education Orthopedics dislocation DRUJ relocation Trauma Volar Distal Ulnar Dislocation wrist injury Source Type: blogs
LITFL Review 222
Welcome to the 222nd 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
Josh Farkas explains his top 10 issues/problems with the new Sepsis-3 definitions. [SR]
The Best of #FOAMed Emergency Medicine
First 10 EM drops their articles of the month as February comes to a close. [AS]
Cameron Berg discusses another way ...
Source: Life in the Fast Lane - March 6, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Briefly without pulse, has pulmonary edema and LBBB with 10 mm of ST Elevation
A middle-aged male was found down. EMS was able to get the patient to climb onto the ambulance by himself, then during transport he became less responsive. They briefly could not find pulses, and gave a short period of CPR with ROSC, but he did not require a shock. They gave Narcan without improvement. An oral airway was placed and BVM oxygenation provided. The patient arrived unable to provide any further history.BP was 180/100, HR 130, Oxygen saturations 84%.He was intubated. A bedside ultrasound showed poor global function and B-lines of pulmonary edema.Here was the first ECG:There is sinus...
Source: Dr. Smith's ECG Blog - December 13, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Funtabulously Frivolous Friday Five 127
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 127
Question 1
Which two life threatening diseases can bats transmit?
+ Reveal the Funtabulous Answer
expand(document.getElementById('ddet1031217351'));expand(document.getElementById('ddetlink1031217351'))
Histoplasmosis and rabies (technically bat lyssavirus)
Question 2
What parenteral drug commonly used in Emergency Medicine practice is known to generate green urine?
+ Reveal the Funtabulous Answer
expand(document...
Source: Life in the Fast Lane - November 27, 2015 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five asparagus asparagusic acid bat lyssavirus Green urine Histoplasmosis Malaria normal saline propofol rabies Source Type: blogs
Rise of the Machines
By SHIRIE LENG, MD
“We are convinced the machine can do better than human anesthesiologists.”
This statement was made by a doctor. Not only a doctor but an anesthesiologist. Not just an anesthesiologist but a pediatric anesthesiologist. Not just any old pediatric anesthesiologist but one in charge of pediatric anesthesia research at the University of British Columbia medical school in Vancouver.
One can only assume that this guy has a pretty low estimation of what his colleagues can do. Must make for great break room conversation.
The doctor making this statement, one JM Ansermino, is co-creator of a new automated ...
Source: The Health Care Blog - July 31, 2015 Category: Consumer Health News Authors: suchandan roy Tags: THCB Shirie Leng Source Type: blogs
Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management
A young woman presented with intermittent shocks from her implantable defibrillator. She was intermittently unconscious and unable to give history. The monitor showed intermittent polymorphic ventricular tachycardia. The physician was presented with this ECG at the same moment he was observing the repeated syncope:Time zeroIt is a bigeminal rhythm with a very bizarre PVC. The PVC has an incredibly long QT, but the intervening native rhythms do not. However, when I saw this (it was texted to me), it immediately reminded me of this case, so I knew by sheer recognition that it was lo...
Source: Dr. Smith's ECG Blog - July 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
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
