Emergency medicine journal : EMJ
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To describe the case mix, activity, and outcome for admissions to intensive care units (ICUs) from emergency departments (EDs). ⋯ A large proportion of admissions to ICU (26%) originate in EDs, and differ from those not originating in EDs in terms of both case mix and outcome. Additionally, those admitted directly to ICU from EDs differ from those admitted indirectly via a ward. The observed differences in outcome between different admission routes require further investigation and explanation.
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Review Comparative Study
Best evidence topic report. Magnetic resonance imaging or bone scintigraphy in the diagnosis of plain x ray occult scaphoid fractures.
A short cut review was carried out to establish whether magnetic resonance scanning or bone scintigraphy is better at identifying scaphoid fractures not apparent on plain x rays. Altogether 11 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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This is the first case report of a ruptured aortic aneurysm presenting with acute right buttock pain. The patient was an 80 year old man. ⋯ Thus the present case is another unusual presentation of ruptured abdominal aortic aneurysm and highlights the importance of careful history taking and clinical examination. A high index of clinical suspicion of aneurysm rupture should be maintained in elderly patients presenting with a history of collapse.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effectiveness of intravenous diltiazem and metoprolol in the management of rapid ventricular rate in atrial fibrillation.
To compare the effectiveness of intravenous (IV) diltiazem and metoprolol in the management of rapid ventricular rate in atrial fibrillation (AF). ⋯ Both diltiazem and metoprolol were safe and effective for the management of rapid ventricular rate in AF. However, the rate control effect began earlier and the percentage decrease in ventricular rate was higher with diltiazem than with metoprolol.
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A short cut review was carried out to establish whether terlipressin or somatostatin is more effective at reducing acute bleeding in adults with known oesophageal varices. Altogether 170 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.