R&R in the FASTLANE 004

Research and Reviews in the Fastlane 600

Welcome to the 4th 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

RR Hall of FAMER

Green SM. Cheerio, laddie! Bidding farewell to the Glasgow Coma Scale. Ann Emerg Med. 2011 Nov;58(5):427-30. Epub 2011 Jul 30. PMID: 21803447

  • Is GCS obsolete in emergency medicine? You may well think so after reading this. A potential paradigm shift.
  • Recommended by Trevor Jackson

RR Eureka

Smith GC, Pell JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ. 2003 Dec 20;327(7429):1459-61. Review. PMID: 14684649; PMCID: PMC300808.

  • The perfect paper to have up your sleeve whenever you encounter the tedious refrain “but there are no RCTs supporting that…”
  • Recommended by: Chris Nickson

RR HOT STUFF

Kessler C, Hockberger R, Kuhn G. PeRLs: Changing the Way We View Lectures. Acad Emerg Med. 2011 Nov;18(11):1191-2. doi: 0.1111/j.1553-2712.2011.01211.x.  PMID: 22092903.

  • The journal Academic Emergency Medicine is starting a project to post online peer-reviewed lectures on various emergency medicine topics, so that “”there would no longer be a need for every training program to develop lectures on every topic in the didactic curriculum””. An interesting idea, but it seems to me one with significant negatives.
  • Recommended by: Leon Gussow
  • Learn more: LITFL – Peer Reviewed Lectures

RR Game Changer

Seggie J. Revitalising professionalism. S Afr Med J. 2011 Jul 25;101(8):508-9. PMID: 21920118Full Text]

  • Medical professionalism is not optional. It is an essential part of being a doctor, no matter how many challenges face us.
  • Recommended by: Sa’ad Lahri

RR Mona Lisa

Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, Moran GJ, Nicolle LE, Raz R, Schaeffer AJ, Soper DE; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar 1;52(5):e103-20. Review.  PMID: 21292654.

  • What antibiotics should you give for simple cystitis, in the world of resistant bugs and regional antibiotic resistance patterns? The ID Society of America and the European Society for Microbiology and Infectious Diseases guidelines sum up the 2010 recommendations.
  • Recommended by: Michelle Lin
  • Learn more: Academic Life in EM – Paucis Verbis – Antibiotics for cystitis

RR Game Changer

Harrison M, Williams M. The diagnosis and management of transient global amnesia in the emergency department.Emerg Med J. 2007 Jun;24(6):444-5. PMID: 17513554; PMCID: PMC2658295.

  • Transient global amnesia – if these words don’t mean much to you, you’d better read this brief review.
  • Recommended by: Antonio Celenza

RR WTF

Rosenberg H, Beck J. Jujitsu kick to the abdomen: a case of blunt abdominal trauma resulting in hematochezia and transient ischemic colitis. Ann Emerg Med. 2011 Aug;58(2):189-91. Epub 2011 Mar 9. PMID: 21392850.

  • A while back I had a patient who was an Aussie Rules player who presented with haematochezia following a blow to the abdomen during a game. It had settled so I let him home without a scope, and with advice to return if symptoms recurred… In retrospect, I suspect this is what he had.
  • Recommended by: Chris Nickson

RR Mona Lisa

Sarraf KM, Sadri A, Thevendran G, Vedi V. Approaching the ruptured anterior cruciate ligament. Emerg Med J. 2011 Aug;28(8):644-9. Epub 2010 Nov 22. Review. PMID: 21097944.

  • Great review article on the ACL. Written by a thoughtful orthopod who is happy not to have an MRI on every knee! Full of pearls on anatomy, diagnosis and management.
  • Recommended by: Andy Neill
  • Learn more: Emergency Medicine Ireland – Tasty morsels of EM #20

RR WTF

Wiener RS, Schwartz LM, Woloshin S. Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. Arch Intern Med. 2011 May 9;171(9):831-7.  PMID: 21555660;   PMCID: PMC3140219.

  • A really important paper on PE (i know there are too many…) that shows that there has been a big increase in the number of PEs diagnosed over time, but no change in the mortality rate. This implies that we are just finding lots of PEs that don’t seem to kill people…
  • Recommended by: Andy Neill
  • Learn more: Emergency Medicine Ireland – Time Trends in PE in the US: Evidence of Overdiagnosis

RR Boffintastic

Smith GC, Pell JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ. 2003 Dec 20;327(7429):1459-61. Review. PMID: 14684649; PMCID: PMC300808.

  • The perfect paper to have up your sleeve whenever you encounter the tedious refrain “but there are no RCTs supporting that…”
  • Recommended by: Chris Nickson

Research and Reviews icon glossary

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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