Emergency medicine journal : EMJ
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Multicenter Study
Descriptive epidemiology of adult critical care transfers from the emergency department.
To describe the nature, frequency, and characteristics of adult critical care transfers originating from the emergency department (ED). ⋯ Trauma is the most common reason for transfer of the critically ill adult from the ED. A significant number of patients are transferred, however, with medical and surgical conditions and for non-clinical reasons. There continues to be problems with the quality of care that these patients receive. Emergency medicine clinicians must be actively involved in the development of regional critical care systems as a significant proportion of all critically ill adults transferred originate from the ED.
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Review Comparative Study
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Colourimetric CO(2) detector compared with capnography for confirming ET tube placement.
A short cut review was carried out to establish whether colourimetric carbon dioxide detectors are as reliable as capnometry at verifying tracheal placement of endotracheal tubes after emergency intubation. A total of 69 papers were found using the reported search, of which four 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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Review Comparative Study
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Type of oral cortiosteroid in mild to moderate croup.
A short cut review was carried out to establish whether oral dexamethasone is better than oral prednisolone at improving outcome in children with mild to moderate croup. Altogether 139 papers were found using the reported search, of which none presented any evidence to answer the clinical question. It is concluded that there is no evidence available to answer this question. Further research is needed.
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Randomized Controlled Trial Clinical Trial
Randomised controlled trial of single, subacromial injection of methylprednisolone in patients with persistent, post-traumatic impingment of the shoulder.
To evaluate the impact on recovery, of single subacromial injection of methylprednisolone in patients with persistent, post-traumatic impingement of the shoulder. ⋯ Single subacromial injection of methylprednisolone has no beneficial impact on reducing the pain, or the duration of immobility in patients with persistent post-traumatic impingement of the shoulder
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The case of a patient with an unusual medical condition and an occult pneumothorax is presented. The evidence for management of occult pneumothorax particularly in patients with underlying lung disease is reviewed and solutions to the acute clinical problems that may arise are suggested.