Emergency medicine journal : EMJ
-
Maxillofacial injuries are often seen in the emergency department. Fractures of the facial skeleton are commonly seen after assault, road traffic accidents, falls, and sporting injuries in a ratio mandibular:zygoma:maxillary of 6:2:1. Clinicians must be familiar with their management so that appropriate treatment may be used.
-
A short-cut review was carried out to establish whether the administration of aspirin before computed tomography scanning improved outcome in patients with symptoms suggestive of stroke. In all, 866 papers were found using the reported searches, two of which presented the best evidence to answer the clinical question. The author group, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. If a computed tomography scan is to be carried out within 48 h of onset of symptoms, then it is prudent to await the result before starting aspirin.
-
A short-cut review was carried out to establish whether emergency department ultrasound scanning had clinical utility for the diagnosis of abdominal aortic aneurysm (AAA). A total of 73 papers were found using the reported searches, of which 4 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. It is concluded that in patients suspected of having AAA, emergency department bedside ultrasound scanning for AAA is sensitive and specific and may improve patient care.
-
A short-cut review was carried out to establish whether myringotomy is of value in cases of haemotympanum. In all, 205 papers were found in Medline and 105 in Cochrane using the reported searches. None presented any evidence to answer the clinical question. Hence, it is concluded that there is no evidence available to guide this decision and that local expert advice should be followed.
-
Where is the present flurry of activity in medical education leading and what sort of future is envisaged? This paper looks at trends in postgraduate medical education. Four themes and two trends for each theme have been identified. ⋯ Any limitations in implementing change will likely result from a lack of imagination in those planning postgraduate medical education and their ability to bring about the necessary changes. To avoid a growing gap developing between what is possible educationally and what is delivered, it is clear that we need a new paradigm for postgraduate medical education.