How good of a clinician are you?

In psychology, the Lake Wobegon effect refers to a mythical town where “all the women are strong, all the men are good-looking, and all the children are above average.” In other words, humans have a tendency to overestimate their capabilities, particularly in relation to others. As a physician, I have yet to meet a fellow […]

via Medicine Joint Channels

4 things on the horizon in childhood cancer

The 20th century saw striking advances in curing childhood cancer, primarily as a result of the discovery that broadly toxic chemotherapy agents could kill malignant cells. As a result, pediatric cancer, once a virtually incurable disease, now enjoys an overall long-term survival rate that tops 80 percent. In the 21st century, attention is turning to newer […]

via Medicine Joint Channels

Pain tolerance: A story of two patients

One thing I learned early on as a doctor is different people have different tolerances for pain.  At one end of the spectrum, for example, I recall a woman who came to the emergency department with a small splinter in her foot.  She arrived wailing in pain, and we had to take her back to […]

via Medicine Joint Channels

Innovation in health care: Too much, too little, or just right?

I was recently discussing all the changes going on in healthcare at a summer cookout with a few doctors in private practice.  The topic of accountable care organizations (ACOs) came up, and the group started debating the pros and cons of them.  At one point in the conversation, I brought up Medicare’s Innovation Center (the […]

via Medicine Joint Channels

LITFL Review 198

Welcome to the 198th 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

A great new #FOAMcc website is born: ICM Case Summaries! This is what it is all about: “Writing ten expanded case summaries is a requirement of the CCT in Intensive Care Medicine training program for doctors in the UK. These summaries are usually the result of hours of work collecting, synthesising and distilling the most up-to-date evidence on specific clinical questions relevant to intensive care practice in the UK. For most of us though, once they are completed they just sit on our hard drives gathering e-dust. Our aim is to release the untapped potential of these resources and create an online repository of ICM expanded case summaries. As ICM Case Summaries grows it will form a continuously expanding and updating free online educational resource for intensive care medicine professional”. This is an excellent initiative that I hope all UK-based trainees and ICU consultants consider contributing to. The collection of posts is growing rapidly… One to watch! [CN]

The Best of #FOAMed Emergency Medicine

• Excellent review of the evidence behind the use of nitrates and NIPPV in decompensated heart failure in the ED from HEFT EM Cast. Includes the disutility of loop diurectics. [AS]
• More great podcasts coming at a quick-fire rate from CORE EM. This time it’s the management of DKA. [SL]
• The All NYC EM Podcast features Pik Mukherji discussing heuristics and diagnostic errors. [AS]
• Rebecca Maxwell from the Severn FOAMed Network delivers a fantastic podcast on Tricyclic Antidepressant Overdose and discusses the role of intralipid. [SL]
• EM Lit of Note discusses new targets for finding patients amenable to catheter-directed therapy in ischemic CVA for reperfusing at-risk (as opposed to infarcted) tissue. [AS]
• An interesting update on The Alteplase Controversy Goes Prime Time, as the concern over stroke thrombolysis gains more momentum. [SL]
• The Bottom Line reviews an excellent RDCT comparing low dose ketamine to morphine for acute pain management in the ED. [AS]
• Mistakes in medicine are inevitable but rarely gets discussed. This fantastic blog from Sweat the Small Stuff talks about medical errors in a open, honest and informative manner. It is essential reading for all. [SL]
• The latest episode of ERCast delves into the difficulty of deciding “is my patient suicidal”? [MG]

The Best of #FOAMcc Critical Care

• Video demonstration of the core micro-skills necessary for expert central line placement from EM Crit. [AS]
• There has been a surge in case-based Q&As over at INTENSIVE, courtesy of Chris Sia: congenital heart disease in an adult is the focus of Cyanosis, Boots and the 5Ts, key finds on AXR in Belly ache and Rigler’s Sign, and the differential diagnosis of different types of lung opacitites on CXR in Why the alveolar opacities?. [CN]
• Deirdre Murphy (aka ‘ECMO Goddess’!) talks to San Diego’s finest podcasters Joe and Zack about Weaning VA ECMO on the EDECMO.org podcast. The discussion provides great insights into the management and weaning of VA ECMO patients in the ICU. I could have done with hearing this a few years ago! [CN]
• Cardio-pulmonary physiology maven Jon-Emile Kenny has made his Critical Care Medicine board exam review notes available on PulmCCM.org. [CN]
• ScanCrit reviews the recent article in Annals of Surgery looking at the utility of FAST in predicting patients who will not benefit from ED thoracotomy after trauma. [AS]

The Best of #FOAMtox Toxicology

• ECMO makes a double mention this week at the Poison Review: ECMO as a bridge to lung transplantation in paraquat poisoning and ECMO in colchicine poisoning [JAR]
• How does obesity affect the poisoned patient? The Poison Review discusses a recent article on the topic. [AS]

The Best of #FOAMped Paediatrics

• New free iBook – Pediatric Emergency Medicine Guidelines. [AS]

The Best of Medical Education and Social Media

• Excellent podcast discussing how we can reconcile novel education (i.e. FOAM) with the traditional models at Injectable Orange featuring Vic Brazil and Damian Roland. [AS]
• If you’ve got a presentation to give soon then this is a must listen! Jonathan Downham talks to Ross Fisher on how to make a fantastic presentation. [SL]

News from the Fast Lane

• There are now over 1,600 entries in the Critical Care Compendium… and counting! [CN]

Reference Sources and Reading List

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

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]

The post LITFL Review 198 appeared first on LITFL: Life in the Fast Lane Medical Blog.

via Medicine Joint Channels

Why doctors and digital experts should work together to improve patient health

As a family doctor, I have seen a dramatic shift in the range of people I work alongside every day — all for the better. When I was in training, most family doctors worked only with other family doctors and registered nurses. Today my health care team is rich with a variety of critical skills, […]

via Medicine Joint Channels

I despise my EHR. But I’m still using it.

Modern electronic health records (EHRs) have become the norm in U.S. health care — nearly 80 percent of office-based physicians use them, up from 40 percent in 2009, according to federal data. But while adoption is up, satisfaction has plummeted. In 2010, about 61 percent of physicians liked their EHRs (were satisfied or very satisfied, according […]

via Medicine Joint Channels