R&R In The FASTLANE 184

Welcome to the 184th 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 5 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

Jiang N, et al. Management of Pediatric Forearm Torus Fractures: A Systematic Review and Meta-Analysis. Pediatric emergency care 2016. PMID: 26555307

• This systematic review and meta-analysis looked at the management of pediatric forearm buckle fractures. They only included RCTs, of which there were 8, covering 781 patients. The results aren’t a huge surprise if you have been following this literature or reading the articles of the month. When compared to plaster, non-rigid removable splints or bandages had better functional recovery, a lower complication rate, and were preferred by patients.
• Recommended by: Justin Morgenstern

Kepreotes et al. High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial. Lancet 2017. PMID: 28161016.

• Despite its rapid uptake, there’s still a lack of good evidence for the clinical benefit of humidified high-flow oxygen in bronchiolitis.
• Recommended by: Natalie May

Bray JE et al. Changing target temperature from 33°C to 36°C in the ICU management of out-of-hospital cardiac arrest: A before and after study. Resuscitation 2017. PMID: 28159575

• Recommended by: Anand Swaminathan

Upchurch CP et al. Comparison of etomidate and ketamine for induction during rapid sequence intubation of adult trauma patients. Ann Emerg Med 2017. PMID: 27993308

• This study found no association between induction agent used for RSI (ketamine or etomidate) and in-hospital mortality. A prospective, RDCT should be undertaken to confirm or refute these findings. Clinicians should feel free to use whichever induction agent they prefer until better evidence becomes available.
• Recommended by: Anand Swaminathan
• Read more: Etomidate vs Ketamine in Trauma RSI (R.E.B.E.L. EM)

Obermeyer Z, et al. Early death after discharge from emergency departments: analysis of national US insurance claims data. BMJ 2017. PMID: 28148486

• There are some recurring themes on which patients have poor outcomes after discharge – “altered mental status” being the most prominent. However, while the odds ratios for mortality may seem impressive, the absolute increase in risk is tiny.
• Recommended by: RPR
• Read more: Discharged and Dropped Dead (Emergency Medicine Literature of Note)