Research and Reviews in the Fastlane 059

This study looked at national survey data from 2009-2010 of patients >18 y/o presenting to the ED (n=44,448 visits) and found that cardiac enzyme testing was performed in 16.9% of visits, including in 8.2% of visits lacking ACS-related symptoms (which includes things like nausea, vomiting, abdominal pain, dyspnea, etc). This begs the question, why then, was a troponin (or ck-mb) ordered? It’s probably not changing management. In an era in which we’re discovering that there are harms to downstream testing, this study calls out just how trigger happy we may be. As more sensitive cardiac assays are used, this may mean even more for our patients.Recommended by: Lauren WestaferThe Best of the RestCritical CareCurtis JR, et al. The importance of word choice in the care of critically ill patients and their families. Intensive Care Med. 2014; 40(4): 606-8. PMID: 24441669.Word choice in critical care is critically important. This article shows why, and gives you alternatives to these shockers: “Withholding or withdrawing care”, “there is nothing more that we can do”, “Withholding and withdrawing life-sustaining measures are morally equivalent”, “consider an end-of-life decision” and “no escalation of treatment”.Recommended by: Chris NicksonResuscitation, Neurosurgery Scotter J et al. Prognosis of patients with bilateral fixed dilated pupils secondary to traumatic extradural or subdural haematoma who undergo sur...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: R&R in the FASTLANE airway brain failure critical care Emergency Medicine General Surgery hypothermia Intensive Care prehospital recommendations Review Trauma Source Type: blogs