Emergency medicine journal : EMJ
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To identify the incidence of intracranial pathology in a population of patients with trauma with an on-scene Glasgow Coma Score (GCS) of 13 or 14, and the proportion that required prehospital intubation and ventilation. ⋯ For this group of patients with trauma with a drop of only one or two points on the GCS, the incidence of intracranial pathology was almost one in three and that of intracranial haemorrhage was one in five.
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Elbow injuries account for approximately 2-3% of presentations to the emergency department. This is associated not only with a very high rate of x rays but also with a very high rate of "missed fractures" This study examines which components of elbow examination have the best correlation with a normal radiograph. ⋯ A two-tier clinical rule for management of elbow injury is proposed: (1) Those patients aged < or = 16 years with a ROM equal to the unaffected side may be safely discharged; (2) Those patients with normal extension, flexion and supination do not require emergent elbow radiographs.
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Randomized Controlled Trial
Emergency department use of a continuous femoral nerve block for pain relief for fractured femur in children.
This study examined whether an effective continuous femoral nerve block could be inserted by emergency department staff for pain relief in children presenting with a fractured femur.
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Septic arthritis remains a challenging diagnosis in which the doctor often relies on laboratory tests. ⋯ jWBC was the best diagnostic test for septic arthritis, WBC and ESR were poor tests. However, no test was diagnostic, and the clinician must be careful with patients with a potential septic joint.