R&R In The FASTLANE 031

Welcome to the 31st 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

Young NS, Ioannidis JP, Al-Ubaydli O. Why current publication practices may distort science. PLoS Med. 2008 Oct 7;5(10):e201. PMC2561077

  • This essay makes the underlying assumption that scientific information is an economic commodity, and that scientific journals are a medium for its dissemination and exchange. When subjected to an economic analysis the scientific publication process looks distinctly ugly… The authors make suggestions for a better way forward.
  • Recommended by Chris Nickson
  • Learn more: LITFL CCC – Publication Practices Distort Science

Ertmer C, Kampmeier T, Van Aken H. Fluid therapy in critical illness: a special focus on indication, the use of hydroxyethyl starch and its different raw materials. Curr Opin Anaesthesiol. 2013 Jun;26(3):253-60. doi: 10.1097/ACO.0b013e3283606b71. PubMed PMID: 23492982.

  • It takes a bunch of anaesthetists to nit pick their way to the bottom of the pharmacological differences between therapeutic agents. Leave the potatoes and grab your waxy maize … 6%HES may not yet be dead.
  • Recommended by: Matthew Mac Partlin

Holley A, Marks DC, Johnson L, Reade MC, Badloe JF, Noorman F. Frozen blood products: clinically effective and potentially ideal for remote Australia. Anaesth Intensive Care. 2013 Jan;41(1):10-9. Review. PubMed PMID: 23362885.

  • An exploration of the feasibility of cryopreservation to extend the shelf life and facilitate the transport of blood products, while minimising post-thawing complications. Particularly relevant for remote and regional centres facing the challenge of occasional need for massive blood transfusion.
  • Recommended by: Matthew Mac Partlin

Marik PE, Monnet X, Teboul JL. Hemodynamic parameters to guide fluid therapy. Ann Intensive Care. 2011 Mar 21;1(1):1. PMC3159904

  • Great overview of the hemodynamic parameters we can use to guide fluid administration – warts and all.
  • Recommended by: Chris Nickson

American College of Emergency Physicians; American Academy of Neurology. Clinical Policy: Use of intravenous tPA for the management of acute ischemic stroke in the emergency department. Ann Emerg Med. 2013 Feb;61(2):225-43. doi: 10.1016/j.annemergmed.2012.11.005. PubMed PMID: 23331647.

  • Like it or lump it, ACEP officially endorses tPA in stroke.
  • Recommended by: Seth Trueger

Canto JG, Rogers WJ, Goldberg RJ, Peterson ED, Wenger NK, Vaccarino V, Kiefe CI, Frederick PD, Sopko G, Zheng ZJ; NRMI Investigators. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA. 2012 Feb 22;307(8):813-22. doi: 10.1001/jama.2012.199. PubMed PMID: 22357832. [Free Full Text]

  • A tweet from a talk by Amal Mattu led me to this study based on a registry of over 1 million American patients. It is important because of this finding: “The proportion of MI patients who presented without chest pain was significantly higher for women than men (42.0% [95% CI, 41.8%-42.1%] vs 30.7% [95% CI, 30.6%-30.8%]; P < .001).” The rates of MI without chest pain are even higher in women <45 years of age. Burn your textbooks and reflect on the external validity of the historical mass of medical literature based on studies of white anglo-saxon males.
  • Recommended by: Chris Nickson

Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, West CP, Sloan J, Oreskovich MR. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012 Oct 8;172(18):1377-85. PubMed PMID: 22911330.

  • EM is like a puppy: for life not just for Christmas. Burn out is a huge problem and this study documents that we’re not winning the burn out race. Any solutions?
  • Recommended by: Andy Neill
  • Learn more: EMI

Serinken M, Eken C, Turkcuer I, Elicabuk H, Uyanik E, Schultz CH. Intravenous paracetamol versus morphine for renal colic in the emergency department: a randomised double-blind controlled trial. Emerg Med J. 2012 Nov;29(11):902-5. doi: 10.1136/emermed-2011-200165. Epub 2011 Dec 20. PubMed PMID: 22186009

  • Intravenous paracetamol works for renal colic – but should we use it?
  • Recommended by: Andy Neill
  • Learn more: EMLON

Young NS, Ioannidis JP, Al-Ubaydli O. Why current publication practices may distort science. PLoS Med. 2008 Oct 7;5(10):e201.PMC2561077

  • This essay makes the underlying assumption that scientific information is an economic commodity, and that scientific journals are a medium for its dissemination and exchange. When subjected to an economic analysis the scientific publication process looks distinctly ugly… The authors make suggestions for a better way forward.
  • Recommended by: Chris Nickson
  • Learn more: LITFL CCC – Publication Practices Distort Science

Aguilera AL, Volokhina YV, Fisher KL. Radiography of cardiac conduction devices: a comprehensive review. Radiographics. 2011 Oct;31(6):1669-82. doi: 10.1148/rg.316115529. Review. PubMed PMID: 21997988. [Free Full Text]

  • A well-written guide to detecting CCD (PPMs & ICDs) problems on plain films, with lots of helpful images and clear explanations. Gold for fellowship candidates.
  • Recommended by: Matthew Mac Partlin, Chris Nickson

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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