R&R In The FASTLANE 024

Research and Reviews in the Fastlane 600

Welcome to the 24th 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 6 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

Hurst JW. Naming of the waves in the ECG, with a brief account of their genesis. Circulation. 1998 Nov 3;98(18):1937-42. Review. PubMed PMID: 9799216 – [Fulltext]

  • Ever wondered how the different waves on the ECG got their names? Or the physiology behind them? Read this and wonder no more.
  • Recommended by Chris Nickson

RR Game Changer

Reiter DA, Strother CG, Weingart SD. The quality of cardiopulmonary resuscitation using supraglottic airways and intraosseous devices: A simulation trial. Resuscitation. 2012 Jul 13. [Epub ahead of print] PubMed PMID: 22796543.<

  • Great article in Resuscitation by my former co-chief Dena Asaad Reiter et al on time to access + airway in simulated arrest, showing that LMA+IO is much faster than ETI+CVC in arrested mannekins. (Disclaimer: I was one of the study subjects)
  • Recommended by: Seth Trueger

RR Eureka

Swadron SP. Pitfalls in the management of headache in the emergency department. Emerg Med Clin North Am. 2010 Feb;28(1):127-47, viii-ix. PubMed PMID: 19945603.

  • This is a great review of the pitfalls in assessing headache in the ED. It makes sense and resonates with my own practice.
  • Recommended by: Chris Nickson

RR Game Changer

Martin M, Conlon LW. Does Platelet Transfusion Improve Outcomes in Patients With Spontaneous or Traumatic Intracerebral Hemorrhage? Ann Emerg Med. 2012 Jul 27. [Epub ahead of print] Pubmed PMID: 22841709<

  • Your patient with traumatic subdural haemorrhage takes clopidogrel. You prescribe a platelet transfusion – like we do, right? But what’s the evidence for that? Here’s a very nice summary…
  • Recommended by: Richard Body

RR Mona Lisa

Isbister GK. Antivenom efficacy or effectiveness: the Australian experience. Toxicology. 2010 Feb 9;268(3):148-54. Epub 2009 Sep 25. Review. PubMed PMID: 19782716.

  • The work of Geoff Isbister strikes at the heart of many of the controversies in Australian toxinology. Does Redback antivenom work? Does brown snake antivenom correct venom-induced consumptive coagulopathy? In this review he explores the reasons why different antivenoms may or may not work – both in the lab (efficacy) and in the patient (effectiveness).
  • Recommended by: Chris Nickson

RR Mona Lisa

Stuke L, Diaz-Arrastia R, Gentilello LM, Shafi S. Effect of alcohol on Glasgow Coma Scale in head-injured patients. Ann Surg. 2007 Apr;245(4):651-5. PubMed PMID: 17414616; PubMed Central PMCID: PMC1877033.

  • Although a retrospective trawl through a database (of over 100,000 patients mind) this paper is about as good as the evidence gets for this topic. The conclusion is worth paying heed to: “Alcohol use does not result in a clinically significant reduction in GCS in trauma patients” (Though we’ve all seen it – it is a trap for the unwary)
  • 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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