LITFL Review 321

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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 321st 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 CumminsAre you an average doctor? Sounds harsh, but most of us are. Ross Fisher tells us why that’s not so bad. [AS]
Rusty Carroll shares a powerful personal story of PTSD. A must read for anyone working in medicine and hopefully one that will help others recognize symptoms in themselves. [AS]

The Best of #FOAMed Emergency Medicine

  • Nice piece from ER Cast focusing on ACS and minimizing our misses. Forget about the med-mal stuff and focus on the non-traditional risk factors, presentations and where patients fall through the cracks. [AS]
  • What does ST-elevation in aVR means?  It’s not always STEMI–there are other causes of this pattern, and the cath lab is not where these patients should be. [SR]

The Best of #FOAMcc Critical Care and #FOAMres Resuscitation

  • Another great post from Josh Farkas reviewing the recently published SALT-ED (Non-Critically Ill) and SMART (Critically Ill) Trials.  Both single center, randomized trials evaluating normal saline vs balanced crystalloids (i.e. LR or Plasma-Lyte A). Bottom Line: There is nothing Normal about Normal Saline.  [SR, AS]
  • More thoughtful FOAMs discussing balanced vs unbalanced fluids in the SALT-ED (Non-Critically Ill) and SMART (Critically Ill Trials):
    • Rory Spiegel at EMNerd (EMCrit): The Case of the Unbalanced Solution [SR]
    • Fraser Magee at The Bottom Line: SALT-EM [SR]
    • Celia Bradford at The Bottom Line: SMART [SR]
    • Simon Carley at St. Emlyn’s Blog: JC – Balanced Fluids vs Saline on the ICU. The SMART Trial [SR]
  • The latest REBELCast will change how you think about non-invasive ventilation and respiratory failure. [MG, MMS]
  • Airway Jedi’s Intubation During Cardiac Resuscitation is a step-by-step breakdown of the different ways you can intubate during CPR. [CN]
  • ED ECMO 43: The Cutdown features an interview with ALice Hutton from SAMU Paris discussing the cutdown procedure the Paris team use for ECMO cannula insertion. [CN]

The Best of #FOAMtox Toxicology

  • Open access repository of 30 peer-reviewed toxicology simulation cases from ACEP. [MMS]
  • TPR highlights: (1) there are designer benzodiazepines on the streets such as flubromazolam and (2) that NEJM has a review of a diagnosis you can’t afford to miss: Anti-NMDA receptor encephalitis [CN]

The Best of #FOAMus Ultrasound

  • More about fascia iliaca nerve blocks from @5minsono [CMD, AS]
  • Just 3 for a DVT? Listen to what the ultrasoundgel team have to say about this? [CMD]
  • A different approach to draining a PTA at the bedside using ultrasound. [MMS]

The Best of #FOAMpeds Pediatrics

  • Andy Tagg discusses some important topics in the management of kids.  Assess their pain, ask about stressors, tell jokes, and remember…observation is an intervention. [SR]
  • The Fussy Infant: A social visit or your most dangerous presentation tonight? [MMS]

The Best of #FOAMim Internal Medicine

  • Learn 5 pearls on albuminuria on this episode of Core IM. [MMS]

The Best of #MedEdFOAM and #FOAMsim

  • Top 10 tips for peace and happiness in 2018 on the latest Medutopia podcast. [MMS]
  • Although uncommon, difficult interactions are a part of life in healthcare settings. Great read on cultivating extra communicating skills to help in managing them. [MMS]
  • Sandra Lussier provides a perspective on the recent FRACP exam debacle in Specialist exams – time for change? An important read describing what many test-taking physicians throughout the world face. [CN/ML]
  • Ross Fisher discusses the marginal gains that can help improve your presentation. He also has detailed, useful advice on the dreaded interview presentation and what to do after the call of any questions? rings out. [CN]
  • Participant Observation to Enhance Learning is an interesting ICE blogpost by Eve Purdy on how medical learners can benefit from channeling their inner anthropologist. [CN}
  • More ICE: The KeyLIME Podcast #159: Does WBA ‘work’? How would we know? delves into the murky waters of workplace-based assessment: “There is a need to re-conceptualize WBA as a continuous practice, in which assessment, feedback and deliberate practice become normalized”. [CN]

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: Mar 5, 2018 @ 8:43 am

LITFL Review 321
Marjorie Lazoff, MD

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Author: Marjorie Lazoff, MD

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