Research and Reviews in the Fastlane 053

This study combines the results from the WARFASA and ASPIRE trials looking at aspirin prophylaxis. The results are promising. Aspirin 100 mg reduced the rate of recurrent VTE from 7.5%/year to 5.1%/year (HR = 0.68) without a significant change in bleeding rate (0.5%/year vs 0.4%/year). We often see patients in the ED with a history of unprovoked VTE who are on no long-term prophylaxis. This article argues that we consider aspirin for all these patients. Recommended by: Anand Swaminathan Trauma Stevens AC, Trammell TR, Billows GL, Ladd LM, Olinger ML. Radiation Exposure as a Consequence of Spinal Immobilization and Extrication. J Emerg Med. 2014 Sep 23. PMID: 25256410 Retrospective study comparing extrication by EMS vs. self-extrication in awake, alert, cooperative, neurologically intact drivers involved in IndyCar crashes. Patients who arrive in the ED with backboard and C spine collar receive dramatically more CT scans than otherwise. No firm conclusions can be drawn from this methodology, but it is likely that emergency clinicians are much more likely to use CT on patients arriving with backboard and collar, irrespective of other clinical features of the case. Most healthy blunt trauma patients with normal vitals and mentation should be taken off the backboard and their cervical spine cleared clinically at the outset of care. Recommended by: Reuben Strayer Pediatrics Pflaumer A1, Davis AM. Guidelines for the diagnosis and management of Catecholaminergic Polymorphic Ve...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Alternative Medicine Anaesthetics Cardiology Education Emergency Medicine Haematology Intensive Care Neurology Pediatrics R&R in the FASTLANE Respiratory Resuscitation Toxicology and Toxinology Trauma critical care literature Source Type: blogs