Research and Reviews in the Fastlane 130
In this study, valproate was less efficient and requiring more rescue medications compared to Ketorolac and Metoclopramide. It appears that valproate is not as helpful as a rescue medication as previously thought.
Recommended by: Daniel Cabrera
Emergency Medicine, Pre-Hospital/Retrieval
Bhalla MC et al. Simple Triage Algorithm and Rapid Treatment and Sort, Assess, Lifesaving, Interventions, Treatment, and Transportation mass casualty triage methods for sensitivity, specificity, and predictive values. Am J Emerg Med 2015; 33(11): 1687-91. PMID: 26349777
If you haven’t been exposed to mass casualty triage before, ...
Source: Life in the Fast Lane - April 13, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Emergency Medicine Gastroenterology Intensive Care Pediatrics Pre-hospital / Retrieval EBM Education literature R&R in the FASTLANE recommendations research and reviews Resuscitation Source Type: blogs
Percutaneous Translaryngeal Ventilation
Emergency medicine physicians Dr Blake Bailey and Dr Michael Nguyen from Allentown, PA. demonstrate how to perform a needle cricothyroidotomy without commercially available jet insufflation kits.
“While these techniques are described in texts, we found many of our younger learners and even experienced attendings did not know how to properly create these setups or found the written texts hard to follow. We found there to be a significant knowledge gap and therefore created a video to properly demonstrate how to perform the procedure and create bagging setups with items easily found in the ED.
//www.youtube.com/watch...
Source: Life in the Fast Lane - April 13, 2016 Category: Emergency Medicine Authors: Mike Cadogan Tags: Airway Education Procedure can't intubate can't ventilate cricothyroidotomy jet insufflation needle cric Percutaneous Translaryngeal Ventilation Source Type: blogs
Funtabulously Frivolous Friday Five 140
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 140
Question 1
What would you smoke to bring on acute diffuse alveolar haemorrhage?
+ Reveal the Funtabulous Answer
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Crack
that is…Cocaine. [Reference]
Question 2
What is the more common name for ephelides?
+ Reveal the Funtabulous Answer
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Source: Life in the Fast Lane - April 8, 2016 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five aide's pupil argyll robertson pupil cocaine crack crack cocaine ephelides freckles lhermitte's sign ms multiple sclerosis neurosyphilis nitrous oxide torus transverse myelitis Source Type: blogs
Research and Reviews in the Fastlane 129
This study looks at CMAC DL vs CMAC VL and found that 1st pass success rate was not statistically significantly different. The most important insights in this trial are in the discussion where the authors note a high number of protocol violations:
“This may demonstrate that emergency intubation is a dynamic process, and that plans may change second-to-second based on new information gained immediately before or during tracheal intubation.”
Airway management is a complex process and it’s unlikely that we’ll ever have a study looking at one particular facet that has a profound effect on success rates....
Source: Life in the Fast Lane - April 6, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Cardiology Education Emergency Medicine Pediatrics Resuscitation EBM literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
Yes, the VA is without doubt the model for American healthcare
Well, let’s consider their actual track record:
Shot:
The Pentagon reported Friday that 265 active-duty service members killed themselves last year, continuing a trend of unusually high suicide rates that have plagued the U.S. military for at least seven years.
http://www.usatoday.com/story/news/nation/2016/04/01/us-military-suicides-remain-stubbornly-high/82518278/
Chaser:
A VA suicide hotline designed to help distressed vets, at times instead sent their calls to a voicemail message, provided no immediate assistance, and did not even return some calls, according to a new report. … The crisis center wa...
Source: GruntDoc - April 4, 2016 Category: Emergency Medicine Authors: GruntDoc Tags: Medicine public-health Source Type: blogs
LITFL Review 226
Welcome to the 226th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Core EM features a surprisingly valuable video this week on how to set up an arterial line. A great post teaching the logistics of resuscitation. [AS]
Here’s a really great case, with even better images. Become more aware of this life-threaten...
Source: Life in the Fast Lane - April 3, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Funtabulously Frivolous Friday Five 139
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 139
Question 1
Who is likely to have given one of the first blood transfusion in the United States (clue: famous surgeon)?
+ Reveal the Funtabulous Answer
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William Halsted, at the age of 29.
His sister had delivered her first baby and severe haemorrhage followed.
His sister had uncontrolled haemorrhage and others thought ...
Source: Life in the Fast Lane - April 1, 2016 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five blood transfusion botulinum botulism FFFF herpes zoster hutchinson sign jarsich-herxheimer melanoma syphilis topagnosis William Halsted Source Type: blogs
TechTool Thursday 068 Triage ATS
TechTool review – Triage ATS Pro by Clinician Development on iOS
Wayne Varndell (Emergency Clinical Nurse Consultant) and Alister Hodge (Emergency Nurse Practitioner) are the creators of Triage ATS Pro – an iOS app that allows you to practice your triage skills.
The app is in quiz format and provides you with scenarios of patients presenting to ED. It’s your job to decide which Australian Triage Score they should get.
Website: – iTunes – Facebook – Website
Design
The design is nice and colourful and the app is very intuitive to navigate around. The text is clear and easy to read. I think the...
Source: Life in the Fast Lane - March 30, 2016 Category: Emergency Medicine Authors: Tessa Davis Tags: Education Review Tech Tool App Clinician Development iOs triage triage ats Triage ATS Pro Wayne Varndell Source Type: blogs
Research and Reviews in the Fastlane 128
This study looks at the accuracy of Emergency Physicians (EPs) in using POCUS to diagnose RV dysfunction. The small group of highly trained EPs were able to reliably identify RV issues with a (+) LR = 90 and a (-) LR of 0. While this looks great, it’s important to note the high level of training and the small number of patients (26) with RV dysfunction. More work needs to be done on how this applies to the typical EP.
Recommended by: Anand Swaminathan
Airway
Mosier JM et al. The Physiologically Difficult Airway. W J Emerg Med 2016. PMID: 26759664
This article reviews patient features portending a physiologicall...
Source: Life in the Fast Lane - March 29, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Cardiology Education Emergency Medicine R&R in the FASTLANE Respiratory critical care EBM literature recommendations research and reviews Source Type: blogs
LITFL Review 225
Welcome to the 225th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Never has Infectious Diseases sounded so interesting! This superb talk from Mark Crislip ‘The pus whisperer’ on the art of hunting out the offending organism! [SL]
Chris Hicks lays down some knowledge on making teams work: stress inoculation ...
Source: Life in the Fast Lane - March 27, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Research and Reviews in the Fastlane 127
This study didn’t look at simple abscesses but rather at ones that most clinicians would have given antibiotics to and in spite of that, they found only a relatively modest benefit. Despite the headline, this is NOT practice changing.
Recommended by: Anand Swaminathan
Further reading: Are Antibiotics Back in Favor for Abscesses? (EM Literature of Note), Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses? (R.E.B.E.L. EM)
The Best of the Rest
Emergency Medicine
Martin SP, et al. Double-dorsal single-volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department: A r...
Source: Life in the Fast Lane - March 23, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Anaesthetics Emergency Medicine Infectious Disease Neurology R&R in the FASTLANE Resuscitation EBM Education literature recommendations research and reviews Source Type: blogs
The World of FOAM and EMCC
Since 2009 we have reviewed, revised and revitalised the Emergency Medicine and Critical Care blogs (EMCC) database. It has been a great way to add new resources; marvel at the global collaboration and wealth of educational resources in the #FOAMed blogosphere and analyse the trends in the use of social media, and blogging platforms.
In this 2016 analysis we review the #FOAMed conversation, blogging platforms and global spread of Free Open Access Medical Education and compare growth to 2011, 2012 and 2013 reviews.
Readers can subscribe to 203 of the EMCC blogs/podcasts through FOAMEM either by RSS Feed or via a d...
Source: Life in the Fast Lane - March 22, 2016 Category: Emergency Medicine Authors: Mike Cadogan Tags: Education FOAM Review Social Media Web Culture blog EMCC FOAMed medical education research symplur Source Type: blogs
LITFL Review 224
Welcome to the 224th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
The International Symposium on Critical Care and Emergency Medicine (ISICEM) was held this week, with a number of landmark trials presented- as well as some excellent debates. Adrian Wong and Jamie Strachan of Oxford ICM have an excellent series ...
Source: Life in the Fast Lane - March 20, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Funtabulously Frivolous Friday Five 138
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 138
Question 1
Which tyre company invented the surgical glove?
+ Reveal the Funtabulous Answer
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Goodyear Tire and Rubber Company in 1890.
With the publication of germ theory, William Halsted was using carbolic acid (introduced by Joseph Lister), to sterilize his hands and his nurse’s hands. She was sensitive to th...
Source: Life in the Fast Lane - March 18, 2016 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five gonorrhoea Keraunoparalysis lethologica lightening seat of the devil signal node surgical gloves virchow's node William Halsted Source Type: blogs
Research and Reviews in the Fastlane 126
This article is a well done, RDCT comparing non-dissociative dose intravenous ketamine (0.3 mg/kg) to intravenous morphine (0.1 mg/kg). The authors found no statistically significant difference between the two at 30 minutes. This data gives further credence to the use of ketamine for acute pain relief in the ED though it does not demonstrate superiority.
Recommended by Anand Swaminathan
Cardiology
Kim S, et al. Searching for answers to clinical questions using google versus evidence-based summary resources: a randomized controlled crossover study. Academic medicine : journal of the Association of American Medical Coll...
Source: Life in the Fast Lane - March 16, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Cardiology Emergency Medicine R&R in the FASTLANE EBM Education literature recommendations research and reviews Source Type: blogs
