Emergency medicine journal : EMJ
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Multicenter Study Comparative Study
To lead or not to lead? Prospective controlled study of emergency nurses' provision of advanced life support team leadership.
In many emergency departments advanced life support (ALS) trained nurses do not assume a lead role in advanced resuscitation. This study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation. ⋯ ALS trained nurses performed as well as ALS trained and non ALS trained emergency SHOs in a simulated cardiac arrest situation and had greater awareness of the potentially reversible causes of cardiac arrest. Thus if a senior or middle grade doctor is not available to lead the resuscitation team, it may be appropriate for experienced nursing staff with ALS training to act as ALS team leaders rather than SHOs.
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Review Case Reports
Cardiovascular complications induced by cannabis smoking: a case report and review of the literature.
Cannabis is generally considered a drug of low toxicity. Although attention has focused on its neuropsychiatric effects, little has been given to cardiovascular side effects. Here we report a case of atrial tachyarrhythmias following cannabis use, and review the literature on its cardiovascular effects and complications.
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A short cut review was carried out to establish whether antibiotics are indicated for human bites. Eighty nine papers were found using the reported search, of which two represent 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. Prophylactic antibiotics should be given to all patients with human bites to the hands, feet, and skin overlying joints or cartilaginous structures, and to all patients with bites that penetrate deeper than the epidermal layer.
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Baclofen has become increasingly popular in the treatment of spasticity disorders. Its availability for misuse has also increased. ⋯ He was treated successfully with full supportive management, and was discharged from the hospital on the 12th day following admission. If a past medication history is not immediately available, baclofen overdose should be included in the differential diagnosis of an acutely confused patient complicated with rhabdomyolysis, as routine toxicology screening does not include baclofen.
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A short cut review was carried out to establish whether the addition of nebulised furosemide to beta-agonist therapy improves outcomes in acute asthma. Altogether 87 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 origin, patient group studied, study type, relevant outcome, results, and study weaknesses of the best papers are tabulated. There is currently insufficient evidence to support the routine addition of nebulised furosemide to standard beta agonist therapy in acute asthma in adults.