Emergency medicine journal : EMJ
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The incidence of anaphylaxis is under-reported. Children with asthma are frequently atopic and prone to allergic reactions. ⋯ Survivors of "acute asphyxic asthma" should be screened for reactions to common allergens that provoke anaphylactic reactions. Even if no provoking factor is identified, the asthma management plan of children who survive an episode of acute asphyxic asthma should include intramuscular adrenaline (epinephrine) in addition to conventional bronchodilators.
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A short cut review was carried out to establish whether serum amylase was better than serum lipase in the diagnosis of pancreatitis in patients presenting with abdominal pain. Altogether 320 papers were found using the reported search, of which seven presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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A short cut review was carried out to establish whether a period of bed rest reduces the incidence of headache or other complications in patients undergoing diagnostic lumbar puncture. Altogether 85 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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To describe the demographic and clinical characteristics of patients who are not transported to hospital after an emergency (999) call to the East Midlands Ambulance Service, the reason for non-transportation, and the priority assigned when the ambulance is dispatched. ⋯ This study shows that falls in elderly people account for a significant proportion of non-transported 999 calls and are often assigned a low priority when the call is first received. There could be major gains if some of these patients could be triaged to an alternative response, both in terms of increasing the ability of the ambulance service to respond faster to clinically more urgent calls and improving the cost effectiveness of the health service. The AMPDS priority dispatch system has been shown to be sensitive but this study suggests that its specificity may be poor, resulting in rapid responses to relatively minor problems. More research is required to determine whether AMPDS prioritisation can reliably and safely identify 999 calls where an alternative to an emergency ambulance would be a more appropriate response.
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A short cut review was carried out to establish whether a single white cell count has clinical utility in the diagnosis of acute appendicitis in adults. Altogether 176 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.