Emergency medicine journal : EMJ
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Case Reports
Caesarean delivery during maternal cardiopulmonary resuscitation for status asthmaticus.
A patient who sustained a recurrent cardiopulmonary resuscitation due to status asthmaticus during one pregnancy followed by a birth of an apparently normal infant is described. Promptly performed caesarean delivery might have saved the mother and her infant. Cardiopulmonary resuscitation is less effective in a near term pregnant woman.
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Multicenter Study
National audit of emergency department child protection procedures.
To assess the compliance with national guidelines on child protection procedures and provision of paediatric services in major English emergency departments. ⋯ Many nationally agreed recommendations are being met, but there is a need for improved training, increased numbers of specialised staff, and improved communication between professionals. There is considerable variation in practice between departments.
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A short cut review was carried out to establish whether morphine is better than diamorphine at allieviating chest pain after an acute myocardial infarction. Altogether 66 papers were found using the reported search, of which one 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 this best paper are tabulated. A clinical bottom line is stated.
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A short cut review was carried out to establish whether buscopan (hyoscine butylbromide) is better than analgesics at controlling pain in abdominal colic. A total of 31 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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Multicenter Study
Barking up the wrong tree? A survey of dog bite wound management.
Several trials have been published examining the role of antibiotics in dog bite wound management. A meta-analysis of these suggests that there is very little benefit to routine antibiotic prescription in these patients. All papers however incorporated rigorous wound care regimens involving large volume irrigation. ⋯ Management of dog bite wounds would not seem to be evidence based in most departments in this sample.