Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether primary split skin grafting is better than simple wound edge approximation at reducing time to healing in patients with pretibial flap lacerations. A total of 72 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 a period of fasting increases the safety of Biers' block (intravenous regional anaesthesia). A total of 50 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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Multicenter Study
Survey of attitudes of senior emergency physicians towards the introduction of emergency department ultrasound.
Emergency department ultrasound (EDU) is widely practised in the USA, Australia, parts of Europe, and Asia. EDU has been used in the UK since the late 1990s but as yet, few areas have established a practice. ⋯ Despite the vast majority of ED consultants being in favour of EDU, very few actually perform it on a regular basis or have had any formal training. Highlighted difficulties in EDU implementation included financial constraints, lack of support from radiology departments, and lack of formal training.
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Most sternal fractures are transverse, and a lateral chest radiograph is diagnostic. We report a case of vertical sternal fracture that was not seen on plain radiographs but was revealed using computed tomography (CT). Thoracic CT with coronal reformatted images can also demonstrate sternal fracture lines, supernumerary synchondrosis, and costosternal joint abnormalities.
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Spinal epidural haematoma is increasingly picked up using magnetic resonance imaging, especially following trauma. The presentation can be varied especially if there is a trivial history of trauma. ⋯ The key to early diagnosis is a strong suspicion and careful repeated neurological examination. We present an illustrative case.