Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether colour Doppler ultrasound is more sensitive than clinical examination in ruling out testicular torsion. A total of 284 papers were found using the reported search, of which seven 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
A review of emergency equipment carried and procedures performed by UK front line paramedics on paediatric patients.
In 1997 a review of paramedic practice upon adult patients in the UK found many inconsistencies and deficiencies in basic care. A follow up review in 2002 identified widespread improvement in provision of equipment and skills to provide basic and advanced life support.Paediatric care was not assessed in either review. The authors conducted this study to identify current standards of care in paediatric paramedic practice and areas of potential improvement. ⋯ Ambulance Trusts not meeting standards set out in the JRCALC guidelines must address their areas of deficiency. Failure to do so endangers children's lives and leaves Trusts open to criticism.
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Cranial computed tomography (CT) is replacing skull radiography in head trauma. Rapid radiological opinions on these images may not always be available. We assessed the ability of our permanent emergency department staff to interpret the images. ⋯ Our results for CT scans are similar to studies of interpretation of other radiographic images in emergency departments. Our emergency staff could safely make the initial interpretation of cranial CT images in trauma out of hours, and formal reporting may wait until a suitably experienced radiologist is available.
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To evaluate the usage of computed tomography (CT) head scanning in children at the Royal Aberdeen Children's Hospital after the publication of the National Institute of Clinical Excellence (NICE) guidelines on the management of head injury. ⋯ Rigid adherence to the NICE guidelines in all children with head injuries would have resulted in an almost eightfold increase in CT head scans performed. None of these children had clinical signs of intracranial injury and would have been exposed to a large amount of ionising radiation. The use of guidelines in practice must always be considered in conjunction with clinical judgement.