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PubMed Journal Database | Emergency medicine journal : EMJ RSS

05:06 EDT 20th October 2017 | BioPortfolio

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Showing PubMed Articles 1–25 of 145 from Emergency medicine journal : EMJ

A frog in the throat?

A 44-year-old woman, with an unremarkable medical history, presented in the middle of the night with discomfort in her throat. She described being assaulted by an assailant who put his 'fist in her mouth', trying to suffocate her. On examination, she had normal observations and no signs of injury, other than scratch marks around her mouth; she reported no odynophagia and was able to swallow fluids readily. During examination, she complained that lying flat made her increasingly uncomfortable and was causing...

Man with leg rash.

A 51-year-old male presented to the ED with a rash to his left thigh (figure 1) with erythema, swelling and pain. He endorsed paraesthesias, pruritus, fevers, vomiting and diarrhoea. Initial vitals were unremarkable. He was well appearing with an 8×8 cm violaceous patch on his left medial thigh with vesicles, surrounding erythema and induration with a second, smaller lesion on the right thigh. Both rashes were extremely tender.emermed;34/10/686/F1F1F1Figure 1Erythematosus and vesicular rash in bilateral l...

BET 1: Prednisolone for the treatment of acute gouty arthritis.

A short cut review was carried out to establish whether corticosteroids are safe and effective in managing the symptoms of acute gouty arthritis. Five studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that corticosteroids are an effective and safe alternative to non steroidal anti inflammatory drugs (NSAIDs) in patients prese...

BET 2: Treatment of frostbite with iloprost.

A short cut review was carried out to establish whether an infusion of iloprost can be used to treat frostbite to reduce the risk of needing an amputation. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that iloprost may reduce the risk of amputation after frostbite.

Global Abstracts.

Editor's note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

Correction: Organ donation in the emergency department.

Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?

Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stre...

Is less more, or is it less? The growing evidence on high-intensity hospital care.

Use of the low-frequency/high-frequency ratio of heart rate variability to predict short-term deterioration in emergency department patients with sepsis.

To examine the ability of the low-frequency/high-frequency (LF/HF) ratio of heart rate variability (HRV) analysis to identify patients with sepsis at risk of early deterioration.

Characteristics of youth agreeing to electronic sexually transmitted infection risk assessment in the emergency department.

Adolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested.

Predicting outcomes in traumatic out-of-hospital cardiac arrest: the relevance of Utstein factors.

Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA.

Identifying discordance between senior physicians and trainees on the root cause of ED revisits.

Analysis of 72-hour ED revisits is a common emergency medicine quality assurance (QA) practice. Our aim was to compare the perceived root cause for 72-hour ED revisits between senior physicians (attendings) and trainees. We proposed that discordance in perception of why the revisit occurred would guide improvements in 72-hour revisits QA and elucidate innovative educational opportunities.

An introduction to the Emergency Department Adult Clinical Escalation protocol: ED-ACE.

This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monit...

Risk factors and outcomes associated with post-traumatic headache after mild traumatic brain injury.

To determine the prevalence and potential risk factors of acute and chronic post-traumatic headache (PTH) in patients with mild to moderate traumatic brain injury (TBI) in a prospective longitudinal observational multicentre study. Acute PTH (aPTH) is defined by new or worsening of pre-existing headache occurring within 7 days after trauma, whereas chronic PTH (cPTH) is defined as persisting aPTH >3 months after trauma. An additional goal was to study the impact of aPTH and cPTH in terms of return to work (...

Can the prehospital National Early Warning Score identify patients most at risk from subsequent deterioration?

The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition.

Emergency medicine pharmacists on an international scale.

Detection of pneumothoraces in patients with multiple blunt trauma: use and limitations of eFAST.

Extended focused assessment with sonography for trauma (eFAST) has been shown to have moderate sensitivity for detection of pneumothorax in trauma. Little is known about the location or size of missed pneumothoraces or clinical predictors of pneumothoraces in patients with false-negative eFAST.

Feasibility of the Manchester Acute Coronary Syndromes (MACS) decision rule to safely reduce unnecessary hospital admissions: a pilot randomised controlled trial.

Observational studies suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule can effectively 'rule out' and 'rule in' acute coronary syndromes (ACS) following a single blood test. In a pilot randomised controlled trial, we aimed to determine whether a large trial is feasible.

Spotting the black swan: why emergency medicine is ahead of the curve.

"Black Swans", originally described as an economic theory, are unexpected events whose potential to occur only becomes apparent after they have happened. The concept is very relevant to the practice of Emergency Medicine and this article explores how black swans impact on emergency care and how staff unconsciously aim to mitigate against them.

An exploration of patients' experiences of participation in a randomised controlled trial of the Manchester Acute Coronary Syndromes (MACS) decision rule.

As an important part of a pilot study to determine the feasibility of a large randomised controlled trial (RCT) comparing use of the Manchester Acute Coronary Syndromes (MACS) decision rule with standard care, we aimed to explore patient attitudes and potential barriers to participation in a trial of this nature.

Validating the Manchester Acute Coronary Syndromes (MACS) and Troponin-only Manchester Acute Coronary Syndromes (T-MACS) rules for the prediction of acute myocardial infarction in patients presenting to the emergency department with chest pain.

The Manchester Acute Coronary Syndromes (MACS) rule and the Troponin-only MACS (T-MACS) rule risk stratify patients with suspected acute coronary syndrome (ACS). This observational study sought to validate and compare the MACS and T-MACS rules for assessment of acute myocardial infarction (AMI).

An elderly woman with bilateral raccoon eyes.

BET 1: Tranexamic acid in epistaxis: who bloody nose?

A shortcut review was carried out to establish whether tranexamic acid is effective in controlling epistaxis. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these studies are tabulated. The clinical bottom line is that there is not enough evidence to recommend tranexamic acid in the standard management of epistaxis.

Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary.

BET 2: Usefulness of IV lidocaine in the treatment of renal colic.

A shortcut review was carried out to establish whether intravenous lidocaine is effective in the management of renal colic. Two studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these studies are tabulated. The clinical bottom line is that intravenous lidocaine may be of some benefit in renal colic. However, there are other maybe more effective drugs available.


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