LITFL Update 065

Sending you free open-access medical (FOAM) content from around the globe. We keep an eye on all the trends and best articles and share them with you so that you stay on top of your field.

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Latest updates from the #FOAMed world

GLP-1 agonists such as Ozempic, Wegovy, and Mounjaro are rapidly reshaping emergency medicine. This excellent EMOttawa review highlights key ED complications, including gastroparesis, aspiration risk, biliary disease, euglycaemic DKA and AKI. The article provides a practical emergency-focused approach to recognising and managing these increasingly common presentations as GLP-1 use expands beyond diabetes into obesity and cardiovascular disease prevention.

• Beyond Weight Loss: ED Implications of the GLP-1 Era

Paediatric agitation in the ED is one of those presentations that can escalate quickly and leave even experienced clinicians feeling on edge. It is high-risk, resource-intensive, and often unfolds in an already overstimulating environment, where small missteps can make things worse. So how do we approach these patients in a way that is safe, systematic, and effective?

• Paediatric Agitation: Assessment and Management

The EMCrit 2026 PE update follow-up reviews evolving management of intermediate and high-risk PE, including controversies around thrombolysis, mechanical thrombectomy, clot-in-transit, and the new AHA/ACC PE classification system. Key themes include early PERT activation, physiologic risk stratification over rigid scoring systems, and the importance of structured follow-up to detect complications such as CTEPH.

• EMCrit Wee – 2026 PE Update F/u with Josh Farkas & Justin Morgenstern

This ICUedu episode explores the practical use of diuretics in critical care, focusing on why de-resuscitation matters after initial stabilisation. Key concepts include recognising venous congestion, choosing the right diuretic strategy, overcoming diuretic resistance, and balancing fluid removal against renal perfusion. The episode reinforces that effective fluid management is essential for improving oxygenation, reducing organ dysfunction, and avoiding the harms of persistent fluid overload.

• Diuretics: Why, When, and How?