LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog – Emergency medicine and critical care medical education blog
Welcome to the 193rd edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Justin Morgenstern and Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the full list of R&R contributors
This Edition’s R&R Hall of Famer
Kovacs G, Sowers N. Airway Management in Trauma.
Emergency medicine clinics of North America. 2018; 36(1):61-84. PMID: 29132582
- Airway management in trauma is full of dogmas most often not supported by evidence. This article is the most comprehensive and intelligent written on this topic in years – simply a most read!
- Recommended by: Soren Steemann Rudolph
The Best of the Rest
Spiegel R, Mallemat H. Emergency Department Treatment of the Mechanically Ventilated Patient. Emergency medicine clinics of North America. 2016; 34(1):63-75. PMID: 26614242
- This is the best written guide to mechanical ventilation in the emergency department that I have ever read. Highly recommend it for everyone.
- Recommended by: Justin Morgenstern
Lewis J, et al. Acute Management of Refractory and Unstable Pediatric Supraventricular Tachycardia. J Pediatr. 2017 Feb;181:177-182.
- For Pediatric SVT, go big… with your dose of Adenosine. This is especially true for those who are more likely to be refractory to standard 0.1mg/kg dose (like kids < 1 year of age). Start with 0.2 mg/kg dose.
- Recommended by: Sean Fox
- Read more: Adenosine Dose (Pediatric EM Morsels)
Ultrasound and imaging
Hu K et al. Variability in Interpretation of Cardiac Standstill Among Physician Sonographers. Ann Emerg Med 2017. PMID: 28870394
- Can we use the presence of cardiac standstill on US to declare death and stop resuscitation? The REASON study showed a small rate of ROSC in this group but, this article questions the basic premise of using cardiac standstill for prognostication since it’s unclear if all providers agree on what standstill is. In this study, inter-rater agreement was moderate at best (kappa = 0.47). This variability reflects a lack of a single definition of standstill as well as training and skill in assessment. The authors call for a unified definition of standstill which would be a good start.
- Recommended by: Anand Swaminathan
Clattenburg EJ et al. Point-of-care ultrasound use in patients with cardiac arrest is associated prolonged cardiopulmonary resuscitation pauses: a prospective cohort study. Resuscitatio 2017. PMID: 29175356
- Another small prospective article reminding us that the use of POCUS in cardiac arrest must be done mindfully. This group showed longer pauses in CPR when POCUS employed but, did not look at patient centered outcomes. Bottom line isn’t to avoid POCUS but rather to understand the potential issues and apply it intelligently.
- Recommended by: Anand Swaminathan
The R&R iconoclastic sneak peek icon key
||The list of contributors
||The R&R ARCHIVE
||R&R Hall of famer You simply MUST READ this!
||R&R Hot stuff! Everyone’s going to be talking about this
||R&R Landmark paper A paper that made a difference
||R&R Game Changer? Might change your clinical practice
||R&R Eureka! Revolutionary idea or concept
||R&R Mona Lisa Brilliant writing or explanation
||R&R Boffintastic High quality research
||R&R Trash Must read, because it is so wrong!
||R&R WTF! Weird, transcendent or funtabulous!
That’s it for this week…
That should keep you busy for a week at least! Thanks to our wonderful group of editors and contributors Leave a comment below if you have any queries, suggestions, or comments about this week’s R&R in the FASTLANE or if you want to tell us what you think is worth reading.
Research and Reviews in the Fastlane 193
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Author: Justin Morgenstern
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