R&R In The FASTLANE 014

Research and Reviews in the Fastlane 600

Welcome to the 14th 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 8 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

Lerner EB, Moscati RM. The golden hour: scientific fact or medical “urban legend”? Acad Emerg Med. 2001 Jul;8(7):758-60. Review. PubMed PMID: 11435197

  • The story of trauma’s mythical ‘golden hour’ is a story worth knowing.
  • Recommended by: Chris Nickson

RR Game Changer

Weingart SD, Levitan RM. Preoxygenation and Prevention of Desaturation During Emergency Airway Management. Ann Emerg Med. 2012; 59(3): 165-175 [Epub 2011 Nov 1. PMID: 22050948 – [Full text]

  • Outstanding review of preoxygenation (and oxygenation) for airway management.Editor’s note: This paper entered the hall of fame in the very first edition of R&R, but is so good it deserves another recommendation now its in print. Plus it has been made free access – nice one Annals of Emergency Medicine!
  • Recommended by David Newman
  • Learn more: EMCrit — Preoxygenation, reoxygenation and deoxygenation

RR Game Changer

Habboushe JP, Walker G. Novel use of a urine pregnancy test using whole blood. Am J Emerg Med. 2011 Sep;29(7):840.e3-4. Epub 2010 Aug 13. PubMed PMID: 20708881.

  • A nice little practical tip for finding out if your sick patient is pregnant.
  • Recommended by Chris Nickson

RR Game Changer

Peterson MC, Holbrook JH, Hales Von D, Smith NL, Staker LV. Contributions of the history, physical examination, and laboratory investigation in making medical diagnoses. West J Med. 1992 Feb.;156(2):163–165. Pubmed PMID: 1536065

  • Not the perfect study but confirms what we know by intuition that so much of our diagnosis is made by the history. They say about 80%. A good history of course will avoid premature closure and all those other cognitive biases that screw us up but history is the key.
  • Recommended by Andy Neill
  • Learn more: Emergency Medicine Ireland — The mechanics of reasoning

RR Landmark

Sandercock P, Lindley R, Wardlaw J, Dennis M, Innes K, Cohen G, et al. Update on the third international stroke trial (IST-3) of thrombolysis for acute ischaemic stroke and baseline features of the 3035 patients recruited. Trials. BioMed Central Ltd; 2011 Nov. 30;12(1):252. Pubmed PMID: 22129158<

  • IST-3 is a 3000 pt RCT of lytics for stroke which enrolled people outside the current indications for tPA. It’s definitely not the repeat of NINDS that a lot of us has wanted but it’s stil a big important trial. So far they’ve only published the baseline data (eg 50% were >80 yrs) but it’s an interesting read as to things to come.<
  • Recommended by Andy Neill
  • Learn more: Emergency Medicine Ireland — Some updates on IST-3

RR Landmark

Stergiopoulos K, Brown DL. Initial Coronary Stent Implantation With Medical Therapy vs Medical Therapy Alone for Stable Coronary Artery Disease: Meta-analysis of Randomized Controlled Trials. Arch Intern Med. 2012 Feb 27;172(4):312-9. PubMed PMID: 22371919.

  • PCI for patients not having a STEMI doesn’t save lives, prevent heart attacks, or reduce symptoms.

RR Game Changer

Schutz et al. Clinical management of tuberculosis and HIV-1 co-infection. Eur Respir J. 2010 Dec;36(6):1460-81. Epub 2010 Oct 14 Pubmed PMID: 20947678

  • State of the Art clinical review. Highly relevant for some of us where up to 60 % of our Emergencies in the Emergency Centre are HIV/TB related.
  • Recommended by Sa’ad Lahri

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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