R&R In The FASTLANE 024

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

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

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

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

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

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

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