Research & Reviews in the Fastlane 103

This study is quite limited as it doesn’t include potential recommendations for these over the counter medications but is a good reminder to prescribe stool softeners/laxatives with opioids. Recommended by Lauren Westafer Emergency medicineRodrigo GJ et al. Assessment of acute asthma severity in the ED: are heart and respiratory rates relevant? Am J Emerg Med 2015. PMID 26233619 The authors of this paper want to tell us that vitals signs aren’t helpful in asthma, but I think their conclusions are entirely backwards. This is a retrospective look at data that was collected prospectively as part of 7 other asthma trials done at a single Emergency Department. In total, 1192 adult patients were included. They compared heart rate and respiratory rate between two predefined groups: severe asthma (defined as an FEV1 31-50% of expected) and life threatening asthma (defined as an FEV1 <= 30% expected). The HR and RR were not different between the groups (mean of 102 and 22 respectively). They then use logistic regression to show that only FEV1 and O2 saturation were related to the outcome of admission to hospital. Based on this, they conclude that HR and RR are not determinants of acute asthma severity. I think this is probably the wrong interpretation. They use FEV1 as their definition of illness severity rather than hard outcomes. The lack of correlation between FEV1 and vital signs in this study might equally indicate that FEV1 is not a good indicator of disease se...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Airway Anaesthetics Education Emergency Medicine Immunology Infectious Disease Intensive Care Pre-hospital / Retrieval R&R in the FASTLANE Resuscitation Trauma critical care Review Source Type: blogs