Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether bedside clinical examination and simpliRED D-dimer are sufficiently sensitive to rule out pulmonary embolus. A total of 272 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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Review Meta Analysis
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Antithrombotic treatment of below knee deep venous thrombosis.
A short cut review was carried out to establish whether oral anticoagulation is necessary to prevent pulmonary embolisation in patients with below knee deep venous thrombosis. A total of 425 papers were found using the reported search, of which 11 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
Salt of the earth or a drop in the ocean? A pathophysiological approach to fluid resuscitation.
The evolved endocrine response after injury leads to sodium, chloride, and water retention at a time when large volumes of sodium containing fluids are given to maintain the circulation and preserve tissue oxygenation. Sodium, chloride, and water are also retained because of increased systemic vascular permeability to plasma proteins, especially albumin, which sequesters fluid in the interstitial space and causes oedema. ⋯ This review attempts an overview of these processes and addresses the question, "Can manipulation of fluid resuscitation influence the inflammatory response to injury and organ function". Results of randomised controlled prospective clinical studies suggest that limiting the sodium and chloride input and optimal use of synthetic colloids, which are well retained in the vascular space, can reduce the inflammatory response to injury and improve organ function.
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A short cut review was carried out to establish whether negative dipstick urine analysis is sensitive enough to rule out urinary tract infection (UTI) in adults with urinary symptoms. Altogether 75 papers were found using the reported search, of which two 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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Multicenter Study
Management of whiplash injuries presenting to accident and emergency departments in Wales.
To assess the use of soft collars for whiplash injuries presenting to Welsh accident and emergency departments and compare with recommended treatment as suggested by other literature. ⋯ The study recommends treatment protocols for whiplash injuries prescribing regular analgesia, early home exercises with the help of an advice sheet, and physiotherapy if symptoms persist.