LITFL Review 311

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LITFL • Life in the Fast Lane Medical Blog – Emergency medicine and critical care medical education blog

LITFL review

Welcome to the 311th 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 chunk of FOAM.

The Most Fair Dinkum Ripper Beauts of the Week

Nick CumminsDo you have an ED spa at your shop? Invest in yourself and see the results as you flourish. On a related topic, an article from this month’s Today’s Hospitalist: Don’t drink your coffee alone. Take some time to interact with your non-EM colleagues when they are in the ED. [MMS]


The Best of #FOAMed Emergency Medicine

  • Intravenous medication shortages have reached a critical point in the U.S. following Hurricane Maria’s impact on Puerto Rico. The team at ALIEM discusses best strategies for maximizing use of enteral antibiotics. [RP]
  • In few situations have clinicians noticed the IV medication shortage more than with benzodiazepines. Josh Farkas reminds us of the efficacy and simplicity of phenobarbital monotherapy for alcohol withdrawal. [RP]
  • Rory Spiegel dives deep into the “time-to-antibiotics” paradigm this week on the EM Nerd blog. [AS]
  • Do you know what life-threatening bleeding is? Me neither. Seems like no one can agree. The Trauma Pro blog discusses the definitional morass and promises a simplified approach in a future post…A second conundrum is tackled in When does the Performance Improvement Clock Start Ticking? [CPN]
  • How do you diagnose STEMI in the presence of RBBB? Check out emDocs for the answer. [MG]
  • RoshCast this week covers cardiac and Ortho topics. [MG]
  • EMClerkship is all about OBGyn this week. [MG]
  • What’s the evidence for slow push vs short infusion of ketamine? Listen to the SGEM to find out. [MG]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

  • Tranexamic acid nebulization for hemoptysis may be a cheap and effective intervention, but the data are limited. Chad Simpkins and the EM Daily team bring us the latest. [RP]
  • We missed highlighting this one a few weeks ago, but Rob Hackett of the Patient Safety Network has created quite a stir with the theatre cap challenge in the “name” of patient safety. Is he as mad as a Hatter? [CPN]
  • The ART trial recently published in JAMA examined an open-lung versus a lung protective strategy in patients with moderate to severe ARDS. The team at The Bottom Line delivers a clear and comprehensive review of this important study. [RP]
  • The RAGE podcast is back from hiatus and better than ever, with a new episode on open lung ventilation strategy, sat targets, and more. [MG]
  • SydneyHEMS podcast has Everything ECMO – part 2. [MG]
  • The Handover is one of the most critical components of patient care, and is the subject of this week’s Resus Room podcast, [ML]
  • The recent Australian College of Intensive Care Medicine Annual Scientific Meeting has some excellent podcasts. Have a listen to Ian Seppelt’s talk on traumatic brain injury. [SO]

The Best of #FOAMtox Toxicology

  • Is there a better way to administer IV N-acetylcysteine? Leon reviews a “3-skull” rated article that may herald the beginning of the end for the complex 3-bag approach to IV NAC administration for paracetamol overdose. [CPN]
  • What’s the role of ultrasound in the tox patient? Check out the ToxNow podcast to find out. [MG] 

The Best of #FOAMus Ultrasound

  • Weingart, Spiegel, and Rola discuss the hot topic of assessing volume status using advanced ultrasound techniques. [JSh]
  • A great case from 5minSono with a ruptured ectopic pregnancy and easy to miss POCUS pitfall  of clotted blood in the pelvis. [LP]
  • More evidence that using POCUS may lead to longer interruptions in chest compressions during cardiac arrest. Is it time to change to intra arrest TEE? [CMD]

The Best of #FOAMim Internal Medicine

  • The CORE IM Podcast is back this week with 5 pearls on hepatic encephalopathy. [RP]
  • Video presentation on a timely topic: Opiates, from Louisville Lectures [ML]

The Best of #MedEdFOAM and #FOAMsim

  • As always, there is some interesting stuff on ICE Blog. First, Rob Cooney has a book review of The First 90 days: proven strategies for getting up to speed faster — this book is on my reading list as a number of people have recommended it to me as a guide for starting out in a new role. Secondly, Victoria Brazil brings a hot topic into focus in Simulation and Patient Safety  — A Complex Relationship? This is a ‘must read’ for simulation educators.  [CPN]
  • Ross Fisher posits that the Take Home Message for any talk is that there can only be one take home message. [CPN]
  • Ben and Vic from Simulcast talks to us regarding the lessons learned during the November journal club of articles on simulation. Highlighted is the seminal paper,  “Establishing a Safe Container for Learning in Simulation” with its important points regarding the narrow line of creating a safe environment in simulation while still challenging the learner. Links to other journal articles this month round out the “wrap.” This is another ‘must read’ for any educator or clinician that uses simulation as a teaching tool. [CW]

Reference Sources and Reading List

  • Emergency Medicine and Critical Care blog/podcast list
  • LITFL Global Blogroll
  • FOAMEM RSS feed syndication for global FOAM
  • #FOAMed – #FOAMcc – #FOAMres #FOAMped – #FOAMtox – #FOAMus – #FOAMim – #FOANed

Brought to you by:

  • Anand Swaminathan [AS] (EM:RAP, Core EM,REBEL EM and The Teaching Institute)
  • Chris Connolly [CC] (RCEMFOAMed, FOAMShED)
  • Chris Nickson [CN] (RAGE, INTENSIVE and SMACC)
  • Cian McDermott [CMD] (POCUS Geelong, SMACC)
  • Craig Wylie [CW] (BadEM)
  • Jeffrey Shih [JSh](ALiEM)
  • Luke Phillips [LP] (POCUS Geelong)
  • Manpreet ‘Manny’ Singh [MMS] (
  • Marjorie Lazoff [ML] (TandemHealth)
  • Mat Goebel [MG]
  • Matt Siuba [MS]
  • Philippe Rola [PR] (Thinkingcriticalcare)
  • Rick Pescatore [RP] (EM News UC:RAP)
  • Salim Rezaie [SR] (REBEL EM, The Teaching Institute)
  • Segun Olusanya [SO] (JICSCast, The Bottom Line)

Last update: Dec 18, 2017 @ 8:39 pm

LITFL Review 311
Marjorie Lazoff, MD

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Author: Marjorie Lazoff, MD

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