LITFL Review 171

Welcome to the 171th 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

Interested in Free Ultrasound Ebooks? Not sure where to find them? Kasia Hampton from Sonokids has an entire list for you right here! [SO]

The Best of #FOAMed Emergency Medicine

• Should we treat all sore throats with antibiotics in fear of Fusobacterium Necrophorum ? Not so fast says EM Lit of Note. [AS]


• EM Lyceum posts its “answers” to debatable topics surrounding infectious disease questions including home management of patients with neutropenic fever and the role of oseltamivir in influenza. [AS]


• Excellent review of serious dermatologic diseases from Stuart Swadron, Mel Herbert and HIPPO EM. [AS]


• EMCrit features an interview with the lead author of the PROPPR trial, John Holcomb. [AS]


• Here’s a good review of opioid overdose in the ED from the St Emlyn’s crew. [SO]

The Best of #FOAMcc Critical Care

• Haney Mallemat discusses the care of the critically ill pregnant patient. Free content from Mel Herbert and Essentials of Emergency Medicine. [AS]


• Everyday EBM has a wonderful mini-review of the management of acute right heart failure. (Thanks to the Swamy for the heads up) [SO]


• Phillipe Rola and Jon-Emile Kenny join heads to discuss inferior vena cava appearances and fluid status. As people do when they hang out. [SO]

The Best of #FOAMtox Toxicology

• A couple of bits on lipid emulsion therapy from the chaps at the Poison Review- a discussion on its role in treating calcium channel and beta-blocker overdose, and a general overview of the literature on it so far. Worth a read! [SO]


• The Poison Review Podcast team are back with their latest episode where they discuss their favourite posters from the recent NACCT meeting in New Orleans [JAR]


• NZREM recently posted a nice little review on Carbon Monoxide Poisoning - an oldie but a goodie! [JAR]


• How do you manage opiate overdose in the ED? As discussed by the team at St Emlyn’s, no single approach suits every patient. A great read! [JAR]

The Best of #FOAMus Ultrasound

• Truly astounding images from Ultrasound of the week #39. Have a look for yourselves! [SO]


• The European Society of Intensive Care Medicine has a delightful summary of four simple echocardiograph parameters associated with increased mortality in PE. [SO]


• Consider adding the right parasternal view to your echo repertoire- it can be helpful, as Phillipe Rola demonstrates in this case. (I wonder what a suprasternal would have showed?) [SO]

The Best of #FOAMped Pediatrics

• Nice review of the strengths and weaknesses of the Alvarado and Pediatric Appendicitis scores for appendicitis risk stratification from Sean Fox and EMDocs.net. [AS]


• Damian Roland presents a great case (with video) of a scary, often-missed paediatric diagnosis. It’s not “just a fever”- or is it? [SO]

News from the Fast Lane

• The SMACC 2015 Schedule is now available!! [AS]


• Check out another jammed packed edition of Research and Review in the Fast Lane 072 [ML]

Reference Sources and Reading List

• Emergency Medicine and Critical Care blog/podcast list


• LITFL Global Blogroll


• FOAMEM RSS feed syndication for global FOAM


• Twitter streams for #FOAMed – #FOAMcc – #FOAMtox – #FOAMped – #FOAMus

Brought to you by:

• Anand Swaminathan [AS] (EM Lyceum, iTeachEM)


• Brent Thoma [BT] (BoringEM and Academic Life in EM)


• Chris Connolly [CC]


• Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC)


• Joe-Anthony Rotella [JAR]


• Kane Guthrie [KG]


• Mat Goebel [MG]


• Segun Olusanya [SO] (JICSCast)


• Simon Laing [SL] (HEFTEMCast)


• Tessa Davis [TRD] (Don’t Forget The Bubbles)


• Marjorie Lazoff [ML]

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The measles outbreak and vaccines: We need civil discourse

There has been an outbreak of measles, a vaccine preventable disease, along with an outbreak of people yelling at each other. There have been angry exchanges between people who would like all children vaccinated according to the recommended guidelines and people who support the rights of parents to choose which vaccines to give their children, […]



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Is a doctor allowed to become sick?

I awoke one Saturday morning to a terribly familiar feeling — a tight, barky cough, fast breathing, severe shortness of breath and burning in my chest. Another severe asthma attack. I knew I was in trouble. Twenty-three years ago, when I was an internal medicine resident, I went to be evaluated for recurrent pneumonia. I […]



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How To Chair Massage for Back Pain: Neck, Shoulders, Back, Most Relaxing Techniques ASMR

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Health care or abuse: Which are you receiving?

A physician in Texas posts this photo on Facebook. Caption: “My schedule one morning in January 2014. Never again …” Yay! Another physician breaks free from assembly-line medicine. High-overhead, high-volume offices sacrifice the sacred physicians-patient relationship and perpetuate a disease-billing management system. This is not health care. It’s abuse. Continue reading ... Your patients are […]



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Hair Loss: Treatments, Prevention and Causes

One of the most disconcerting things that occurs regarding our appearance is that we begin to notice our hair is thinning—both men and women. As a matter of fact, although everyone is familiar with male pattern baldness, female pattern baldness is actually much more common and is not really manifested as a slick scalp but a thinning of the hair.

Hair Loss Causes

To begin to understand what can be done, it must be understood that hair is not alive; it is a product of the skin manufactured just underneath the surface.

There are many causes of thinning hair or baldness from wearing hair in a tight hair-do like a pony tail to hormonal changes. In men, as male hormone levels decrease the scalp hair stops growing in the front and on the vertex and if it is not treated the hair actually dies. To treat male pattern baldness, the ultimate is a hair transplant and hair transplants now have come to the point they look completely natural, not like corn sticking in a field.

But before that approach is taken, there are a number of things that are available. Rogaine® is available without a prescription and is effective especially in early stages of loss. It works better if used in conjunction with a retinol product, which can also be obtained over the counter. There is also a drug (Finasteride) that can be taken by mouth if prescribed by a physician. This drug does work and is used mainly for prostate enlargement and does have some side-effects.

What about Female Hair Loss?

The most common cause of hair loss in women is pregnancy. Hair grows in phases and in some areas the resting phase is long and the growing short (e.g. eyelashes), but in some the growing phase is longer and on the scalp at any time about 70% is growing and 30% resting.

During pregnancy the percentage growing is above 90% and then when the pregnancy ends it reverts back and there is a noticeable loss of hair. It is important to understand that this is temporary and is normal and the hair almost always comes back. This may also occur with the discontinuation of birth control pills.

Women also begin to have thinning hair as they age due to changes in hormones of various types and Rogaine actually works better for them than it does for men. Hair transplants are also done for women when necessary and desirable and work very well.

The main thing to remember is that if you are experiencing thinning hair, there is treatment available!

The post Hair Loss: Treatments, Prevention and Causes appeared first on Dr. Melvin Elson - Official Website.

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What do bridges and public health have in common?

Infrastructure is never quite as interesting or exciting as innovation. The grand opening of a new building incorporating all the latest integrated technology is far more exciting than bridge repairs. In our fascination for the innovation, we often turn a blind eye to our nation’s crumbling infrastructure. In the United States today, one quarter of […]



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