Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether inferior vena cava filters were better than standard anticoagulation therapy in reducing pulmonary emboli in patients with proximal vein lower limb DVTs. Altogether 463 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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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective, randomised, double blind, controlled comparison of metoclopramide and pethidine in the emergency treatment of acute primary vascular and tension type headache episodes.
To compare analgesic effects of metoclopramide (MTP), pethidine (PET), and combination of metoclopramide-pethidine (M-PET) in the treatment of adult patients with acute primary vascular and tension type headache admitted in the emergency department (ED). ⋯ These data suggest that MTP produces more effective analgesia than PET in both vascular and tension type headache in patients with acute primary headache episodes.
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Blackthorn (Prunus spinosus), a member of Rosacea family is well known for causing infections and tissue reactions of synovial structures. Three interesting cases of cystic blackthorn granuloma, blackthorn synovitis with digital nerve entrapment, and multiple blackthorn syndrome are presented. Removal of foreign body fragments and surrounding reactive tissues resulted in an uneventful recovery with full return of joint and tendon functions.
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A short cut review was carried out to establish whether nimodipine is better than placebo at reducing mortality and neurological sequelae in patients with subarachnoid haemorrhage. Altogether 465 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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Emergency rapid sequence intubation (RSI) performed outside the operating room on emergency patients is the cornerstone of emergency airway management. Complication rates are unknown for this procedure in the United Kingdom and the factors contributing to immediate complications have not been identified. ⋯ RSI has a significant immediate complication rate, although the clinical significance of transient events is unknown. The likelihood of immediate complications depends on the patient's underlying condition, and relevant diagnoses should be emphasised in airway management training. Complication rates are comparable between anaesthetists and non-anaesthetists. The significantly lower complication rates in emergency department RSI can be explained by a larger proportion of patients with comparatively stable cardiorespiratory function.