Emergency medicine journal : EMJ
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It has been proposed that formalisation of training to encompass prehospital and retrieval medicine should be considered in the UK, using those currently involved in immediate care as the core providers of these services.(1) Although there is an overlap in some aspects of "prehospital" and "retrieval" medicine, there are some distinct differences, both in terms of the skill base and service provision required. Retrieval medicine is the term used to indicate the use of an expert team to assess, stabilise and transport patients with severe injury or critical illness. ⋯ In the UK, there is currently no national and often no regional strategy to coordinate the provision of secondary retrieval services for critically ill patients. International models do exist, which may be of help in this respect.
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The majority of mandibular fractures occur in young males aged 16-30 years. As with all traumas, the history and examination cannot be over emphasised as diagnoses can be made with these tools. It is important when taking an accurate history to ascertain the mode and mechanism of injury (fall, punch, road traffic accident), and the magnitude and direction of the force involved (high or low velocity impact).
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A short-cut review was carried out to establish whether the presence of affective disorder in victims of assault alters the chances of developing post-traumatic stress disorder (PTSD). In all, 133 papers were found using the reported searches, of which 8 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 PTSD and affective disorder are related and often occur at the same time.
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Multicenter Study
Use of non-invasive ventilation in UK emergency departments.
To describe the current use of non-invasive ventilation in UK emergency departments. ⋯ NIV is commonly used in UK emergency departments. Practices vary significantly. One solution would be the development of guidelines on when and how to use NIV in emergency medicine practice.
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A short-cut review was conducted to establish whether any of the available drugs used for procedural sedation in patients with tachydysrhythmias are safer or more effective than the alternatives. In all, 135 papers were found using the reported searches, of which 7 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 propofol, methohexital, thiopentone and etomidate all seem to be good choices.