Research and Reviews in the Fastlane 074

This study is further evidence that the HEART pathway is a safe approach to the management of low risk chest pain and decreases unnecessary health care utilization.Recommended by Anand SwaminathanThe Best of the Rest Resuscitation Sanghavi BS et al. Outcomes After Out-of-Hospital Cardiac Arrest Treated by Basic vs Advanced Life Support. JAMA Intern Med. 2015;175(2):196-204. PMID: 25419698The OPALS trial, published in 2004, demonstrated the lack of added benefit of ACLS over BLS in out-of-hospital cardiac arrest (OHCA). ACLS continues to be standard care despite repeatedly demonstrating improved ROSC without improved RONF. This observational cohort sampling from Medicare beneficiaries in the US shows an association of BLS with better outcomes in comparison to ACLS (survival to hospital discharge 13.1% vs. 9.2%). Robust observational studies like this demonstrate the need for a true RDCT to definitively put the issue to rest.Recommended by Anand Swaminathan Neurology Perry JJ et al.Differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage: prospective cohort study. BMJ 2015. PMID: 25694274This study was a planned substudy from the Ottawa SAH rule derivation and validation studies. The authors investigated a way to definitively determine whether a lumbar puncture was traumatic or not. Ultimately, the authors states that an RBC < 2000 in the final tube AND the absence of xanthochromia defines a traumatic tap and the diagnosis of SAH is not presen...

Source: Life in the Fast Lane - March 11, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Clinical Research Emergency Medicine LITFL R&R in the FASTLANE critical care literature recommendations research and reviews Trauma Source Type: blogs