R&R In The FASTLANE 007

Research and Reviews in the Fastlane 600

Welcome to the 7th 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

Croskerry P. The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them. Academic Medicine 2003;78:775-780. PMID: 12915363

  • You won’t be able to avoid cognitive errors such as anchoring, confirmation bias, psych-out error, and Yin-Yang out unless you’re aware of them. Pat Croskerry gives suggestions on tuning up your medical decision-making.
  • Recommended by Leon Gussow

RR Mona Lisa

Magder SA. The ups and downs of heart rate. Crit Care Med. 2012 Jan;40(1):239-45. PMID: 22179340.

  • How heart rate affects Everything!… and why tachycardia isn’t always bad.
  • Recommended by: Mike Jasumback

RR WTF

McPherson PA, McEneny J. The biochemistry of ketogenesis and its role in weight management, neurological disease and oxidative stress. J Physiol Biochem. 2011 Oct 8. [Epub ahead of print] PMID: 21983804 – [Fulltext]

  • Ketosis in all its glory! The biochemical basis to manage all forms of ketosis!!
  • Recommended by: Mike Jasumback

RR Eureka

Walkey AJ, Soylemez Wiener R, Ghobrial JM & al. Incident Stroke and Mortality Associated With New-Onset Atrial Fibrillation in Patients Hospitalized With Severe Sepsis. JAMA. 2011;306(20):2248-2254. PMID: 22081378.

  • Severe sepsis + new onset AF increases mortality. Should we then do something about the AF? Or is it simply a marker of sepsis-induced myocardial dysfunction?
  • Recommended by: Ioana Vlad

RR Landmark

Croskerry P. The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them. Academic Medicine 2003;78:775-780. PMID: 12915363.

  • You won’t be able to avoid cognitive errors such as anchoring, confirmation bias, psych-out error, and Yin-Yang out unless you’re aware of them. Pat Croskerry gives suggestions on tuning up your medical decision-making.
  • Recommended by Leon Gussow

RR Eureka

Dhaliwal G. The Mechanics of Reasoning. JAMA 2011;306:918-919. PMID: 21900128.

  • You’ll be surprised at who the best diagnostician(s) on television or radio is. (Hint: it’s not Dr. House or Dr. Oz)
  • Recommended by: Leon Gussow
  • Learn more: The Poison Review – The Mechanics of Reasoning

RR HOT STUFF

Jain S, Ting HT, Bell M, Bjerke CM, Lennon RJ, Gersh BJ, Rihal CS, Prasad A. Utility of left bundle branch block as a diagnostic criterion for acute myocardial infarction. Am J Cardiol. 2011 Apr 15;107(8):1111-6. Epub 2011 Feb 4. PMID: 21296327.

  • Time for a change in the guidelines…? Perhaps “New LBBB” at predicting acute MI will have a class downgrade.
  • Recommended by: Sa’ad Lahri

RR HOT STUFF

Keller T, Zeller T, Ojeda F, et al. Serial changes in highly sensitive troponin I assay and early diagnosis of myocardial infarction. JAMA. 2011 Dec 28;306(24):2684-93. PMID:
22203537.

  • Magical thinking with increased sensitivity and no decrease in specificity – picked up by the popular media as the greatest thing since sliced bread.
  • Recommended by: Ryan Radecki
  • Learn more: Emergency Medicine Literature of Note – Yet another highly sensitive troponin

RR Mona Lisa

Kanani A, Schellenberg R, Warrington R. Urticaria and angioedema. Allergy, Asthma & Clinical Immunology 2011 Nov.;7(Suppl 1):S9. PMID: 22165855.

  • Someone on Twitter linked this and I can’t remember who but it’s a nice summary of urticaria. Even better it justifies that what i do (1st gen, 2nd gen anti-hist, H2 blockers and steroids) are all ok to give together.
  • Recommended by: Andy Neill

RR Game Changer

Zier JL, Liu M. Safety of high-concentration nitrous oxide by nasal mask for pediatric procedural sedation: experience with 7802 cases. Pediatr Emerg Care. 2011 Dec;27(12):1107-12. PMID: 22134227.

  • Nitrous oxide – it’s time we had this routinely available as a safe, non-invasive tool for sedation.
  • Recommended by Ryan Radecki
  • Learn more: Emergency Literature of Note – Why aren’t you using nitrous yet?

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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