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Research and Reviews in the Fastlane 047
In this study, the research team collected pooled urine (read many people used the urinal they collected from) from a popular nightclub area in London and analyzed the specimens for the presence of illicit drug compounds. The goal was to determine whether this method could be used to track patterns and monitor trends in recreational drug use.  Recommended by: Anand Swaminathan Emergency Medicine, Critical Care, Anaesthetics Hindman BJ et al. Intubation Biomechanics: Laryngoscope Force and Cervical Spine Motion during Intubation with Macintosh and Airtraq Laryngoscopes. Anesthesiology. 2014; 121(2):260-71. PMID...
Source: Life in the Fast Lane - September 9, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Clinical Research Education Emergency Medicine R&R in the FASTLANE critical care Intensive Care literature recommendations Research and Review Source Type: blogs

EMA Journal August 2014
Issue 4 (Vol. 26) of EMA Journal for 2014 was published online on 4th August. Editorial overview by Andrew Gosbell & Geoff Hughes Lifers – the loneliest doctors   (#FOAMed) In the latest dispatch from the FOAM Frontier, Spiegel (@EMNerd_), Johnston (@Eleytherius), Ercleve (@Ercleve) and Nickson (@precordialthump) takes us on board the deep space transporter Odysseus where the deep space medics, jovially known as ‘Lifers’, deal with the perils of the induced mental and physiological stasis of passengers who make the centuries long voyages through deep space. The goal of appropriate sedation and ‘quenc...
Source: Life in the Fast Lane - August 15, 2014 Category: Emergency Medicine Authors: Mike Cadogan Tags: Education EMA Journal Emergency Medicine dental emergencies esop tool kit Lifers pediatric fractures Source Type: blogs

CCC Update 007
Hopefully you are well aware of LITFL’s Critical Care Compendium. It started out as a resource for the FCICM exam — which it is — but has grown into a 1500+ page mega-paedia of critical care. If something isn’t there and you think it should be, let me know and I’ll make it happen. If you are having trouble accessing some pages it is because LITFL has undergone a bit of spring cleaning. The “education/” part of the URL for CCC pages has been removed. For example: http://lifeinthefastlane.com/education/ccc/burnout/ is now http://lifeinthefastlane.com/ccc/burnout/ The links in the searchable...
Source: Life in the Fast Lane - August 12, 2014 Category: Emergency Medicine Authors: Chris Nickson Tags: Critical Care Compendium Emergency Medicine FCICM Fellowship Intensive Care CCC FCICM exam update Source Type: blogs

Synthetic Cannabis Can Cause Cyclic Vomiting
Another reason to skip "Spice."Cannabinoid hyperemesis,  as it is known, was not documented in the medical literature until 2004. Case studies of more than 100 patients have been reported since then. The biomedical researcher who blogs as Drugmonkey has documented cases of hyperemesis that had been reported in Australia and New Zealand, as well as Omaha and Boston in the U.S.As Drugmonkey reported, patients who are heavy marijuana smokers, and who experience cyclic nausea and vomiting, “discovered on their own that taking a hot bath or shower alleviated their symptoms. So afflicted individuals were taking multiple h...
Source: Addiction Inbox - August 12, 2014 Category: Addiction Authors: Dirk Hanson Source Type: blogs

Better ways to meet the needs of people with chronic pain
In this study, participants were randomised into two groups – one group received usual care, while the other received automated symptom monitoring via voice-recorded phone calls or the internet, along with one face-to-face meeting with a nurse care management, who discussed medications with a pain physician, followed by a phone call to discuss the care plan, and two other calls, one at one month and one at three months. Additional calls were provided on the basis of symptom records.  Patients in the intervention group benefited, with reduced scores on pain severity and interference as recorded by the Brief Pain Inve...
Source: HealthSkills Weblog - July 20, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: Chronic pain Groupwork Pain conditions Research function healthcare Occupational therapy pain management physiotherapy self management Source Type: blogs

The LITFL Review 143
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. Welcome to the 143rd edition, brought to you by: Kane Guthrie [KG] from LITFL Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles Brent Thoma [BT] from BoringEM, and ALiEM Chris Ni...
Source: Life in the Fast Lane - July 9, 2014 Category: Emergency Medicine Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs

The LITFL Review 142
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. Welcome to the 142nd edition, brought to you by: Kane Guthrie [KG] from LITFL Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles Brent Thoma [BT] from BoringEM, and ALiEM Chris Ni...
Source: Life in the Fast Lane - July 1, 2014 Category: Emergency Medicine Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs

We need to talk about TTM…. Again
This study has brought about widespread (although not universal) practice change in Australia.Whilst the conclusions of the trial were well received, there have been concerns from those involved in the trial that the study has been misinterpreted as evidence against actively cooling patients following out of hospital cardiac arrest. It is worth noting that many international bodies that set guidelines for the management of cardiac arrest have not endorsed the recommendations of the TTM trial. Currently this includes the Australian Resuscitation Council (ARC). As has been well documented, social media played a large role in...
Source: Life in the Fast Lane - March 8, 2014 Category: Emergency Medicine Doctors Authors: David Denman Tags: Emergency Medicine Evidence Based Medicine Featured Intensive Care Resuscitation post-cardiac arrest care Targeted Temperature Management Therapeutic Hypothermia TTM trial Source Type: blogs

First Do No Harm
As I’ve become balder and more grey, I have come to think about the health system as much as the delivery of acute care.  This is another advantage of FOAMed.  It allows you to broaden your horizons and still stay in touch with the latest in your chosen specialty.  I would like to share a story that has brought me out of the blogging wilderness. Last week, I looked over the fence and noticed my neighbour had her arm in a cast.  She told me she had fallen over playing tennis and fractured her wrist.  She had been seen by her GP first, then sent up to a local private emergency department.  This would have cost he...
Source: Life in the Fast Lane - February 26, 2014 Category: Emergency Medicine Doctors Authors: Sean Rothwell Tags: Administration Emergency Medicine Featured Health expenses First Do No Harm out of pocket private insurance public health Source Type: blogs

The LITFL Review 127
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. Welcome to the 127th edition, brought to you by: Kane Guthrie [KG] from LITFL Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles Brent Thoma [BT] from BoringEM, and ALiEM Chris Ni...
Source: Life in the Fast Lane - February 25, 2014 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Education eLearning Emergency Medicine Featured Health Intensive Care Source Type: blogs

Change Day Australia
Change Day is coming and it’s time to make your pledges. What is Change Day? Change Day is running in Australia for the first time this year (http://changeday.com.au). Following the hugely successful NHS Change Day in the UK, the UK team have supported Australians in getting our own one up and running. It’s being run by a group of people who work in health and want to make patient care and our working lives better. The aim being for EACH and EVERY one of us to make a pledge to do something to improve healthcare. Join in the conversation, and share your stories on Twitter, Facebook and YouTube Why should I bother? Al...
Source: Life in the Fast Lane - February 20, 2014 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Emergency Medicine Featured Health #ChangeDayAus Australia change day pledge Source Type: blogs

EMA Journal December 2013
This report, from the Emergency Care Improvement & Innovation Clinical Network, describes a project that used a multimodal approach, grounded in quality and safety theory, to improve consistency in clinical practice, minimise risks and strengthen clinical governance arrangements for paediatric sedation across a number of Victorian EDs. Key activities addressed clinical governance, risk assessment and procedure documentation, training and credentialing of clinicians, and clinical audit of key quality and safety measures. This multi-modal implementation strategy supported by an evidence-based programme and resources ena...
Source: Life in the Fast Lane - December 23, 2013 Category: Emergency Medicine Doctors Authors: Mike Cadogan Tags: Education eLearning EMA Emergency Medicine Featured Journal burden of GP patients Burnout chest pain EMA Journal emergency medicine australasia NOACs oral anticoagulants paediatric procedural sedation Saline therapy Source Type: blogs

Anaesthetic Crisis Manual
Book Review: The Anaesthetic Crisis Manual, David C Borshoff The Anaesthetic Crisis Manual (The ACM), was first published in 2011 and is a collection of 22 life threatening crises that anaesthetists manage in everyday practice. Based on the cockpit QRH (quick reference handbook) used in the airline industry, and using CRM (crew resource management) principles developed for aviation safety, the ACM brings tried and tested checklist instruction to the field of Patient Safety. LITFL reviewed the book as a potential resource in the setting of the emergency resuscitation area and at the ICU bedside. The ACM utilises accepted...
Source: Life in the Fast Lane - December 20, 2013 Category: Emergency Medicine Doctors Authors: Mike Cadogan Tags: Book Review Education eLearning Emergency Medicine Featured Reviews ACM Anaesthetic Crisis Manual Anesthetic Manual CRM David C Borshoff Dr Borshoff QRH Source Type: blogs

Australian College of Rural And Remote Medicine Comments On The PCEHR. Very Interesting Indeed.
This submission was released a few days ago. Here is the link: https://www.acrrm.org.au/files/uploads/PCEHR%20Submission%2022.11.13.pdf Here is the summary:Summary of ACRRM position on eHealthACRRM supports the introduction of Shared Electronic Health Records as a strategy to address the current fragmentation of medical information spread across different locations and providers. This is especially important for rural and remote patients, who are often required to travel to access specialist services, and who are most likely to be transferred away from their local community in the event of a medical emergency or serious i...
Source: Australian Health Information Technology - December 3, 2013 Category: Technology Consultants Authors: Dr David More MB PhD FACHI Source Type: blogs

Reports of therapeutic hypothermia’s death are greatly exaggerated
I expect you’re completely #FOAMed out by the post-publication frenzy stirred up by the TTM Trial. If not, you’ve come to the right place! Mike collated the explosion of initial FOAM responses in All in a lather over TTM and there have since been notable additions such as Scott Aberegg’s Chill Out: Homeopathic Hypothermia after Cardiac Arrest… and ICN’s interview with TTM investigators Niklas Nielsen and Anders Aneman one week after TTM. Soon after, Charles Bruen came with his fascinating blogpost/podcast putting the latest studies in historical perspective: Therapeutic hypothermia: The h...
Source: Life in the Fast Lane - December 1, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Emergency Medicine Evidence Based Medicine Featured Health Intensive Care Resuscitation Bernard critical appraisal HACA Nielsen Targeted Temperature Management Therapeutic Hypothermia TTM Source Type: blogs