R&R in the FASTLANE 003

Welcome to the 3rd 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 10 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the : Overview; Archives and Contributors

This Edition’s R&R Hall of Famer

Campbell SG, Sinclair DE. Strategies for managing a busy emergency department. CJEM. 2004 Jul;6(4):271-6.). PMID: 17382005 – [Full Text]

• An intangible skill that the new emergency physician is expected to acquire is how to manage a busy ED. This paper makes the intangible tangible!
• Recommended by Chris Nickson, Trevor Jackson
• Learn more: LITFL – Managing the busy ED

Kazmi RS, Lwaleed BA. New anticoagulants: how to deal with treatment failure and bleeding complications.Br J Clin Pharmacol. 2011 Oct;72(4):593-603. doi: 10.1111/j.1365-2125.2011.04060.x.  PMID: 21752066; PMCID: PMC3195736.

• New anticoagulants are coming on the market every month.  A boon to internists and cardiologists, a pain to ER docs who have to deal with the consequences when something goes wrong.  You’re going to see a lot of papers like this in the near future.
• Recommended by Joe Lex, Chris Nickson

Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J. 2011;38(2):111-21. Review. PMID: 21494516;  PMCID: PMC3066819.

• One of my residents came to ask me about how to manage electrical storm. I realized crashingpatient.com has nothing on this. So to keep her busy, I sent her to Rob’s excellent ERCAST on the subject (see external link). Then I searched the blogosphere and immediately came up with an excellent article courtesy of Dr. RW.
• Recommended by Scott Weingart
• Learn more: Dr RW – Managing patient with electrical storm

Mebazaa A, Gheorghiade M, Piña IL, Harjola VP, Hollenberg SM, Follath F, Rhodes A, Plaisance P, Roland E, Nieminen M, Komajda M, Parkhomenko A, Masip J, Zannad F, Filippatos G. Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes. Crit Care Med. 2008 Jan;36(1 Suppl):S129-39. Review. PMID: 18158472.

• Fantastic summary of the classification of different types of heart failure, and the principles and specifics of the emergency management of each.
• Recommended by Chris Nickson

Mullins ME, Empey M, Jaramillo D, Sosa S, Human T, Diringer MN. A prospective randomized study to evaluate the antipyretic effect of the combination of acetaminophen and Ibuprofen in neurological ICU patients. Neurocrit Care. 2011 Dec;15(3):375-8.  PMID: 21503807<

• Hot of the press, more evidence supporting ibuprofen and paracetamol for fever in neuro-ICU patients.
• Recommended by Oliver Flower

Cheng VY, Berman DS, Rozanski A, Dunning AM, Achenbach S, Al-Mallah M, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Chow BJ, Delago A, Gomez  M, Hadamitzky M, Hausleiter J, Karlsberg RP, Kaufmann P, Lin FY, Maffei E, Raff G, Villines TC, Shaw LJ, Min JK. Performance of the Traditional Age, Sex, and Angina Typicality-Based Approach for Estimating Pretest Probability of Angiographically Significant Coronary Artery Disease in Patients Undergoing Coronary Computed Tomographic Angiography: Results From the Multinational Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry (CONFIRM). Circulation. 2011 Oct 24. [Epub ahead of print] PMID: 22025600.

• All the classic risk models for coronary artery disease are probably wrong – it’s a lot lower than we thought.
• Recommended by Ryan Radecki
• Learn more: EM Literature of Note – We overestimate CAD pretest probability

Green RS, Djogovic D, Gray S, Howes D, Brindley PG, Stenstrom R, Patterson E, Easton D, Davidow JS; CAEP Critical Care Interest Group. Canadian Association of Emergency Physicians Sepsis Guidelines: the optimal management of severe sepsis in Canadian emergency departments. CJEM. 2008 Sep;10(5):443-59. PMID: 18826733.

• Sepsis is our “crying baby”… deserves our full attention with lots of TLC. An excellent evidenced based guideline for managing sepsis in the ED! Although written in 2008, it still is useful with a unique style. Perhaps we should be doing this in each of our countries?
• Recommended by Sa’ad Lahri

Toorenvliet BR, Wiersma F, Bakker RF, Merkus JW, Breslau PJ, Hamming JF. Routine ultrasound and limited computed tomography for the diagnosis of acute appendicitis. World J Surg. 2010 Oct;34(10):2278-85. PMID: 20582544; PMCID: PMC2936677.

• Appendicitis is a clinical diagnosis…. maybe not so fast!
• Recommended by Sa’ad Lahri

Purssell E. Systematic review of studies comparing combined treatment with paracetamol and ibuprofen, with either drug alone. Arch Dis Child. 2011 Dec;96(12):1175-9. Epub 2011 Aug 24. PMID: 21868405.

• Systematic review of studies comparing combined treatment with paracetamol and ibuprofen  – ‘there is little to recommend the unnecessary use of polypharmaceutical methods to treat a symptom that does not require treatment, when effective monotherapies exist.
• Recommended by Cliff Reid

Danzl DF. Flatology. J Emerg Med. 1992 Jan-Feb;10(1):79-88. Review. PMID: 1629596.

• A classic paper on an unpleasant subject – farts.  Danzl approaches this sticky subject with tongue firmly planted in cheek, but he’s done his homework well.  This remains the classic article on this unmentionable topic.
• Recommended by Joe Lex