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Research and Reviews in the Fastlane 117
This study looked at adding the high frequency linear transducer after failure to identify IUP with the standard transducer. Of 81 initial scans, 27 patients did not have an IUP visualized with the curvilinear probe. Of those, 9 (33%) were found to have an IUP by using the linear probe. (It seems like it is helpful if you can see a probable gestational sac, but can’t identify a fetal pole or yolk sac). Recommended by: Justin Morgenstern Pediatrics Padua AP et al. Isotonic versus hypotonic saline solution for maintenance intravenous fluid therapy in children: a systematic review. Pediatr Nephrol. 2015; 30(7): 1163-7...
Source: Life in the Fast Lane - January 13, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Disaster Education Emergency Medicine Emergency Medicine Update Pediatrics Pre-hospital / Retrieval Radiology Trauma critical care examination Intensive Care R&R in the FASTLANE recommendations research and reviews Resuscitatio Source Type: blogs

Research and Reviews in the Fastlane 116
This article raises the question of how important MIC is and whether we should be developing and testing alternate ways to assess antibiotic efficacy. Recommended by: Anand Swaminathan Emergency Medicine Piazza G et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. JACC Cardiovasc Interv 2015; 24;8(10):1382-92. PMID: 26315743 This is simple prospective data on a highly selected group of patients with massive or sub massive PEs. There were almost as many authors as patients here...
Source: Life in the Fast Lane - January 6, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Airway Anaesthetics Cardiology Education Emergency Medicine Infectious Disease Intensive Care Pediatrics Radiology Respiratory critical care examination R&R in the FASTLANE recommendations research and reviews Resuscitation Source Type: blogs

Advanced Cooling Therapy Releases New Temperature Modulation Device
Advanced Cooling Therapy (ACT), a medical device firm, has expanded personnel in its commercial launch of the Esophageal Cooling Device (ECD).     “The ECD is the first device on the market cleared for temperature modulation via the esophagus. This enables efficient core-cooling, or core-warming, without the complexity and risks associated with intravascular catheter placement, and without the obstruction of patient access seen with surface pads and wraps,” said Robin Drassler, the vice president of North American sales.   The device is placed like a standard gastric tube, making placement quick. Placement ...
Source: Technology & Inventions - November 20, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Why Don’t We Wash Our Hands?
Courtesy of the SMACC Podcast, my hand hygiene talk from SMACC Chicago has just been released… Enjoy! Hand hygiene is widely regarded as the bedrock for the prevention of healthcare associated infections (HAIs). HAIs are among the biggest killers in modern medicine. Yet, hand hygiene compliance among healthcare workers remains woefully poor. Why can’t we learn the lessons that Semmelweis taught us nearly 150 years ago? If we can’t teach intelligent healthcare workers to wash their hands properly, what hope do we have as medical educators? This is both a patient safety and a medical education priority. Our patien...
Source: Life in the Fast Lane - November 13, 2015 Category: Emergency Medicine Authors: Chris Nickson Tags: Emergency Medicine Infectious Disease Intensive Care SMACC chicago culture change hand hygiene hand washing infection control Source Type: blogs

LITFL Review 195
Welcome to the 195th 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 Australia and New Zealand Intensive Care Society (ANZICS) have a superb YouTube page with lots of great lectures from their 2014 ASM being uploaded. Why not get started with the oration lecture from the legendary Simon Finfer? [SO] The Best o...
Source: Life in the Fast Lane - August 30, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Red Dust, dingoes, trauma and Sepsis
Guest post by Dr Chris Edwards of EMJourney recounts his time as a remote retrieval registrar based in Alice Springs – @EMtraveller I’ve had the privilege to work as a Retrieval Registrar for the Alice Springs Hospital Retrieval Service in Central Australia for the last 6 months. How to describe it – words that spring to mind include: Challenging (unlike many other retrieval jobs, you often are intimately involved in the logistics planning) Satisfying (providing ICU level care to the most remote parts of Australia) Scary (providing ICU level care to the most remote parts of Australia!) Clinical character formi...
Source: Life in the Fast Lane - July 25, 2015 Category: Emergency Medicine Authors: Mike Cadogan Tags: Pre-hospital / Retrieval Alice Springs chris edwards Retrieval Medicine Source Type: blogs

Hacking Medical Education
Today, Thursday 9th of July 2015, I have the opportunity to speak to Australia’s medical students at The AMSA National Convention Melbourne 2015 about ‘Hacking Medical Education’. This post contains the resources for the talk. The talk is dedicated to the memory of Dr John Hinds, who tragically died last weekend. The simplest advice one can give to any medical student is “Be like that guy – Dr John Hinds“. Ride on, John. What do I mean by Hacking Medical Education? Hacking means many things – all of which apply to this talk to some extent (especially the latter): “gaining un...
Source: Life in the Fast Lane - July 8, 2015 Category: Emergency Medicine Authors: Chris Nickson Tags: Education AMSA hacking medical education medical student conference Source Type: blogs

Real ED Stories – Book Review
Emergency is an anatomy book. It is a collection of stories penned by Emergency Physicians across Australia, and through them the heart of the Emergency Department is meticulously dissected. The raw stories of individuals, of both patients and their clinicians, are laid wide open, for all to see. Emergency is a book that is by turns painful, occasionally gruesome, many times uplifting, but always, in its honesty, brilliantly authentic. These are short stories, written not by masterful authors, but by the doctors working at the coalface of Australasian ED’s. And in that is its strength. Some of the stories read like catha...
Source: Life in the Fast Lane - June 22, 2015 Category: Emergency Medicine Authors: Michelle Johnston Tags: Book Review ACEM Foundation Real ED Stories Source Type: blogs

LITFL Review 184
Welcome to the 184th 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 Here’s an awesome new echo resource from the Nepean Hospital ICU in Penrith, NSW, Australia, containing basic and advanced physics and scanning resources. [SO]   The Best of #FOAMed Emergency Medicine Boring EM reviews the relevance of IN...
Source: Life in the Fast Lane - May 31, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Airway Lessons from the Austere Environment
The Critically Ill Airway course, run by The Alfred ICU and Monash University, is taking place this week. Among the lineup of elite instructors is Dr Brent May (@docbrent), who  has created a 12 minute video lecture on ‘Airway Lessons from the Austere Environment’.Brent is a trauma anaesthetist at The Alfred, a retrieval physician with Adult Retrieval Victoria, and is Chief Medical Officer for the Australian Formula 1 Grand Prix, Motorcycling Australia and Karting Australia. I asked Brent to speak on this topic because I believe that all airway practitioners can benefit from the lessons learned by those wh...
Source: Life in the Fast Lane - May 4, 2015 Category: Emergency Medicine Authors: Chris Nickson Tags: Airway Anaesthetics Education Emergency Medicine Intensive Care Pre-hospital / Retrieval austere environment brent may critically ill airway course prehospital Source Type: blogs

Research and Reviews in the Fastlane 077
This article sheds some light on the issue. In this study of ICU patients in Australia and New Zealand, the standard SIRS criteria missed 1 in 8 patients who went on to severe sepsis. These results call into question the reliability of the SIRS criteria.Recommended by: Anand SwaminathanThe R&R iconoclastic sneak peek icon keyThe list of contributorsThe R&R ARCHIVER&R Hall of famer You simply MUST READ this!R&R Hot stuff! Everyone’s going to be talking about thisR&R Landmark paper A paper that made a differenceR&R Game Changer? Might change your clinical practiceR&R Eureka! Revolutionary i...
Source: Life in the Fast Lane - April 2, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Emergency Medicine Haematology Immunology Infectious Disease Intensive Care R&R in the FASTLANE critical care Education literature recommendations research and reviews Source Type: blogs

A History of General Refrigeration
Ancient societies figured out that hypothermia was useful for hemorrhage control, but it was Hippocrates who realized that body heat could be a diagnostic tool. He caked his patients in mud, deducing that warmer areas dried first.   Typhoid fever, the plague of Athens in 400 BC and the demise of the Jamestown Colony in the early 1600s, led Robert Boyle to attempt to cure it around 1650 by dunking patients in ice-cold brine. This is likely the first application of therapeutic hypothermia, but it failed to lower the 30 to 40 percent mortality rate. One hundred years later, James Currie tried to treat fevers by applying hot,...
Source: Spontaneous Circulation - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

LITFL Review 174
Welcome to the 174th 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 WeekThe 15th International Symposium on Intensive Care and Emergency Medicine (ISICEM-15) took place from the 17th to the 20th of March. Lots of FOAMy goodness bubbled up from the event, including:A neat summary from Adrian Wong in the OXICM blog: day 1 ...
Source: Life in the Fast Lane - March 22, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs