Emergency medicine journal : EMJ
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To assess the validity of the Manchester Triage System (MTS) in paediatric emergency care, using information on vital signs, resource utilisation and hospitalisation. ⋯ The MTS has moderate sensitivity and specificity in paediatric emergency care. Specific modifications of the MTS should be considered in paediatric emergency care to reduce overtriage, while maintaining sensitivity in the highest urgency categories.
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A short-cut review was carried out to establish whether silver sulphadiazine cream is better than normal dressing in promoting healing without infection. A total of 410 papers were found using the reported searches, of which 12 showed 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 although there is evidence of antibacterial effect, there is no direct evidence of improved healing or reduced infection.
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Multicenter Study
Predictors of ambulance use in patients with acute myocardial infarction in Australia.
To determine ambulance transport rates and investigate predictors for ambulance use by patients with acute myocardial infarction (AMI) in Australia. ⋯ A substantial number of patients do not call for an ambulance as their first medical contact after the onset of AMI symptoms. Public education on the benefits of ambulance transport and early treatment, as well as recognition of AMI symptoms, is required.
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A 45-year-old man developed Horner's syndrome after sustaining an intraoral gunshot in a suicide attempt. Examination did not show any major vascular injury or other neurological symptoms. ⋯ Horner's syndrome resulting from intraoral trauma rarely presents as an isolated sign and is generally associated with carotid injuries. It may herald a life-threatening artery injury and needs urgent investigation.