Research and Reviews in the Fastlane 050
This study compared bedside US by EPs vs radiology US vs CT as the INITIAL test in patients expected with nephrolithiasis. It found there was no difference in serious outcomes between the groups, but the rate of serious outcomes was overall very low.
Obviously patients that got only an US had lower radiation exposure and lengths of stay. But what is interesting is that 40% of patients with an initial ED US went on to get a CT also.
This study does not state that patients should ONLY undergo US, just that it should be the INITIAL test. If it cuts down on our CT ordering, it sounds like a good start. (Zack Repanshek)
Recommended by: Ryan Radecki, Andy Neill, Zack Repanshek
Read More: Farewell, CT Stone Protocol (EM Literature of Note), RCT of ED Renal Ultrasound for renal colic (Emergency Medicine Ireland)
The Best of the Rest
Resuscitation, Emergency Medicine
Marik P. Early management of severe sepsis: concepts and controversies. Chest 2014; 145(6):1407-18. PMID: 24889440
A great review from Paul Marik on severe sepsis. Discusses our current understanding of sepsis and highlights a number of controversies including fluid resuscitation, CVP, ScvO2, lactate clearance and more.
Recommended by: Anand Swaminathan
Emergency Medicine
Mellick LB. Torsion of the Testicle It Is Time to Stop Tossing the Dice. Pediatr Emerg Care 2012; 28(1):80-6.PMID: 22217895
Excellent literature review of a relatively uncommon but serious disease where time and rapidity of diagnosis matters. T...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Clinical Research Emergency Medicine Infectious Disease R&R in the FASTLANE Radiology Resuscitation critical care Education Intensive Care literature recommendations Research and Review Source Type: blogs
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