LITFL Review 319

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

LITFL review

Welcome to the 319th 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 Cummins

A “proper” set of posts: Rory Spiegel investigates whether we have achieved diagnostic absurdity in the pursuit of pulmonary embolism. [AS, SR]. The same trial as Rory discusses above–the PROPER trial of PERC vs gestalt for excluding pulmonary embolism in the ED–is extensively discussed by Scott Aberegg in his blog. [SO] 

The Best of #FOAMed Emergency Medicine

  • Fantastic infographic summarizing the 2018 changes to the ATLS 10th Edition text. Finally starting to catch up to the times. [SR]
  • Another fantastic review on the use of intravenous lidocaine in renal colic by the ALiEM team.  Evidence in the ED is not that strong, but can still be an opioid-sparing option. [SR, AS]
  • PHEMcast this week is all about checklists, and features an outstanding interview with the famed Martin Bromley. [MG]
  • Wanting to know how to manage a patient on chronic opioids with acute pain?  Well its not more opioids.  Consider IM or IV Haldol. [SR]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

  • Does the day or time of admission to the ICU affect morbidity and mortality in critically ill adult patients? Great review of a recent trial. [SR]
  • Nice post by Justin Morgenstern on post-intubation care.  Have a checklist so things don’t get missed.  Titrate O2, ventilation, look at ventilator waveforms and keep track of your peak and plateau pressures. [SR]
  • Another gem from Josh Farkas on how to use BiPAP and HFNC in respiratory failure.  It’s more of an art than a science. [SR, RP]
  • Celia Bradford evaluates the long-term clinical outcomes after early initiation of RRT in Critically Ill Patients with AKI. There may be some mortality benefit with early RRT, but stay tuned for the STAART-AKI trial which will hopefully answer the optimal timing of RRT in critically ill patients. [SR]
  • Is peripheral vasopressors safe or dangerous? Read a great piece from R.E.B.E.L. EM on the latest evidence. [MMS]

The Best of #FOAMus Ultrasound

  • Great tips on performing an ultrasound-guided pericardiocentesis from 5minsono. [LP]
  • E-point Septal separation (EPSS) to estimate ejection fraction: what does the evidence say? [CMD]
  • Found an occult pneumothorax on lung ultrasound? @thepocusatlas asks what should you do next? [CMD]

The Best of #FOAMim Internal Medicine

  • Review Cardiac Arrest on Louisville Lectures. [ML]

The Best of #MedEdFOAM and #FOAMsim

  • How would you describe #YourWorstDay? Listen to this podcast from EM over Easy that inspires us all to be better physicians, providers and better people. Know that you are not alone. [MMS]
  • The REAL CRIC Trainer: Great how-to YouTube video on creating a realistic cricothyrotomy simulator based on the 3D Cric Trainer. [MMS]
  • Managing Chaos in the Emergency Department is a great piece on the skill of managing the multiplicity of patients in a single ED. [MMS]

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: Feb 20, 2018 @ 1:00 am

LITFL Review 319
Marjorie Lazoff, MD

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Author: Marjorie Lazoff, MD

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