Archive | Reviews RSS feed for this section

#EMDutch Review – 4

1 Aug

Here is the review from July 2013:


Academic Life in Emergency Medicine: Geriatric Blunt Trauma: Respect the Lactate

Lactate is often elevated as a result of activation of the sympathetic system. A negative lactate certainly doesn’t rule out serious pathology, but a positive lactate, particularly in the elderly, who may not be able to mount a lactate as robustly as younger patients, might indicate serious pathology. Lactate levels in trauma, however, have not been discussed as often. Some patients may be able to compensate enough that their vital signs appear normal, even if they are at high risk for decompensation, or their vitals may be inappropriately normal because they are unable to elevate their heart rate (due to age, cardiac disease, or beta-blockers). An elevated lactate could help identify patients early on who have normal vital signs with occult hypoperfusion.

“The data supports the use of arterial lactate and base deficit testing to identify elderly normotensive trauma patients who are at increased risk of death and who might benefit from early monitoring and admission to higher levels of care”


#EMDutch Review – 3

1 Jul

It’s time for the 3rd #EMDutch Review. This month is full of interesting posts, presentations and podcasts! Lets get started!


Emergency Medicine Tutorials: Low and Slow. Calcium Channel Blocker Overdose
Decreased LOC and junctional bradycardia….think Calcium Channels overdose (and B-blokker overdose)! Specific treatment = Calcium, Pressors & HIGH DOSE INSULINE!

Continue reading

#EMDutch Review – 2

3 Jun

A new month means….a new EMDutch Review. And it has been a great month on twitter. We have learned a lot and now it is time to share that knowledge with you! Here we go:


OA Critical Care: Lactate clearance as a target of therapy in sepsis: a flawed paradigm

Lactate metabolism and as a marker of metabolic stress. Patients with sepsis and an increased lactate do not have an oxygen debt and that increasing oxygen delivery will not increase oxygen consumption and that such an approach is unlikely to be beneficial and may be harmful. Furthermore, while a failure of blood lactate levels to decline after the initiation of treatment is an ominous sign, adequate lactate clearance does not guarantee survival.
(Lactate can also be caused just by exercise: )

Academic Life in Emergency Medicine: PV Card: Contraindications to Thrombolytics in Stroke
Thrombolytic Contraindications for CVA based on the Stroke 2013 AHA/ASA new guidelines that were just published, with some changes.

Continue reading

#EMDutch Review – 1

9 May


Here is the 1st #EMDutch Review! This is a monthly summary of everything that people have been twittering about using #EMDutch! Because it is the 1st time we do this, the tweets were from ourselves, the webmasters, but from now on we would like you to put interesting tweets on #EMDutch. If you see something that would be interesting for the (Dutch) Emergency Physicians, tweet it using #EMDutch (or e-mail us at: It can be both in English and Dutch.

You already know the  “LITFL Review:, which is a “regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care.” Well, there are 2 differences between our review and the LITFL review. 1.) Our review will also show older post and podcasts, which are still very interesting for all (Dutch) ED docs to read. 2.) Our review will also post Dutch posts / discussions / articles / protocols etc.

#EMDutch Review – 1

While the 1st tweet using #EMDutch was from Carianne Deelstra from, the 1st tweet with a post attached was from Femke Geijsel called: Schrodinger’s Fence. Later ones followed shortly!


LITFL: Schrödinger’s Fence…or, where we currently sit on the matter of thrombolysis in Acute Stroke:

PHARM: Intranasal ketamine for paediatric limb injury analgesia

underneathEM: Great overview about O2!

Continue reading