Research and Reviews in the Fastlane 075

This study further defends the pathway of early discharge from the ED without evocative testing in subsets of patients with low risk chest pain.Recommended by Anand SwaminathanNeurology Edwards C, et al. Residency Training: A failed lumbar puncture is more about obesity than lack of ability. Neurology 2015; 84(10):e69-72. PMID: 25754807This is an interesting article exploring the reasons for LP failure. The authors reviewed all elective LPs done by Neurology residents in a LP clinic. They recorded all the demographic of the patient and the characteristics of the proceduralist. The overall LP failure rate was 19% and it was associated with a high patient BMI, other variables such as the level of the training of the resident did not have an effect. The authors made the recommendation that in patients with a high BMI (>35) an image-guided LP is recommended.Recommended Daniel CabreraToxicology De Lange DW et al. Extracorporeal membrane oxygenation in the treatment of poisoned patients. Clin Toxicol 2013; 51: 385-393. PMID 23697460Improved technology and advances in emergency critical care have made it feasible at some institutions to initiate extracorporeal membrane oxygenation (ECMO) in the Emergency Department. As a “Bridge to Recovery” ECMO has potential to benefit the crashing toxicology patient, buying time while the body (perhaps aided by hemodialysis or another enhanced elimination technique) rids itself of the poison. Veno-arterial ECMO can provide circu...

Source: Life in the Fast Lane - March 19, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Emergency Medicine Infectious Disease Neurology R&R in the FASTLANE Respiratory Toxicology and Toxinology literature recommendations research and reviews Source Type: blogs