Having been away for a few months due to the distractions of SMACC, moving across a continent and an untold number of other side projects, our series of eminence-based evidence is back with the 29th edition:
A free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 8 recommended reads. Find out more about the R&R in the FASTLANE project here and check out the team of contributors from all around the world.
This edition’s R&R Hall of Famer
- Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323. [Epub ahead of print] PubMed PMID: 23106947.
This paper attempts to put to rest the myth of loss of hypoxic drive leading to type 2 respiratory failure when oxygen is administered to a COPD patient. COPD patients improve their gas exchange through hypoxic pulmonary vasoconstriction to alter their V/Q ratios – this is lost when excess O2 is given. Target SaO2 of 88 to 92% in these patients. Recommended by Joe Lex
Learn more: LITFL CCC — Oxygen and Carbon Dioxide Retention in COPD
This edition’s R&R recommendations
- Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984 Nov;39(11):1105-11. PubMed PMID: 6507827
A classic that belongs in everyone’s collection. Recommended by Joe Lex
- Kerrey BT, Rinderknecht AS, Geis GL, Nigrovic LE, Mittiga MR. Rapid sequence intubation for pediatric emergency patients: higher frequency of failed attempts and adverse effects found by video review. Ann Emerg Med. 2012 Sep;60(3):251-9. doi: 10.1016/j.annemergmed.2012.02.013. Epub 2012 Mar 15. PubMed PMID: 22424653; PubMed Central PMCID: PMC3400706
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Recommended by Michael Baker
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- Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323. [Epub ahead of print] PubMed PMID: 23106947.
This paper attempts to put to rest the myth of loss of hypoxic drive leading to type 2 respiratory failure when oxygen is administered to a COPD patient. COPD patients improve their gas exchange through hypoxic pulmonary vasoconstriction to alter their V/Q ratios – this is lost when excess O2 is given. Target SaO2 of 88 to 92% in these patients. Recommended by Joe Lex
- Pollack CV, Schreiber D, Goldhaber SZ, Slattery D, Fanikos J, O’Neil BJ, Thompson JR, Hiestand B, Briese BA, Pendleton RC, Miller CD, Kline JA. Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry). J Am Coll Cardiol. 2011 Feb 8;57(6):700-6. doi: 10.1016/j.jacc.2010.05.071. PubMed PMID: 21292129.
PE mortality in this 1800 patient registry with PE was 1%. Either anticoagulation is the best treatment ever developed or the base line PE mortality isn’t as bad as we think it is. Recommended by Andy Neill
Learn more: EMI
- Yuen CK, Mok KL, Kan PG. The validity of 9 physical tests for full-thickness rotator cuff tears after primary anterior shoulder dislocation in ED patients. Am J Emerg Med. 2012 Oct;30(8):1522-9. doi: 10.1016/j.ajem.2011.12.022. Epub 2012 Mar 3. PubMed PMID: 22386341
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Recommended by Andy Neill
Learn more: EMI
- Bergeron JW. The crucifixion of Jesus: review of hypothesized mechanisms of death and implications of shock and trauma-induced coagulopathy. J Forensic Leg Med. 2012 Apr;19(3):113-6. doi: 10.1016/j.jflm.2011.06.001. Epub 2011 Jul 12. PubMed PMID: 22390994.
Christ’s mode of death? My theory: positional asphyxia Recommended by Joe Lex
- Pomero F, Dentali F, Borretta V, Bonzini M, Melchio R, Douketis JD, Fenoglio LM. Accuracy of emergency physician-performed ultrasonography in the diagnosis of deep-vein thrombosis. A systematic review and meta-analysis. Thromb Haemost. 2013 Jan 8;109(1):137-45. doi: 10.1160/TH12-07-0473. Epub 2012 Nov 8. PubMed PMID: 23138420
A large meta-analysis for emergency physician performed ultrasound for DVT evaluation compared to radiology performed, vascular lab, radiology showing very high sensitivity and specificity >95% ! Emergency physicians can and SHOULD perform bedside ultrasound evaluation for DVT. Recommended by Laleh Gharahbaghian
- Seif D, Perera P, Mailhot T, Riley D, Mandavia D. Bedside ultrasound in resuscitation and the rapid ultrasound in shock protocol. Crit Care Res Pract. 2012;2012:503254. doi: 10.1155/2012/503254. Epub 2012 Oct 24. PubMed PMID: 23133747; PubMed Central PMCID: PMC3485910.
New additions to the RUSH (rapid ultrasound in shock) protocol for all interested – M mode for LV contractility and EPSS evaluation! Recommended by Laleh Gharahbaghian
Learn more: Sonospot
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The R&R iconoclastic sneak peek icon key
The list of contributors The R&R ARCHIVE R&R Hall of fame
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 idea or conceptR&R WTF!
Weird, transcendent or funtabulous!R&R Boffintastic
High quality researchR&R Trash
Must read, because it is so wrong!R&R Mona Lisa
Brilliant writing or explanation
That’s it for now…
That should keep you busy for a week at least… Leave a comment below if you have any queries, suggestions, or comments about this week’s R&R in the FASTLANE or if you want to tell us what you think is worth reading.
About Chris Nickson
