Emergency medicine journal : EMJ
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Pelvic fractures are one of the potentially life-threatening injuries that should be identified during the primary survey in patients sustaining major trauma. Early suspicion, identification and management of a pelvic fracture at the prehospital stage is essential to reduce the risk of death as a result of hypovolaemia and to allow appropriate triage of the patient. ⋯ It is advocated that the pelvis should not be examined by palpation or springing, and that the patient should not be log rolled. Pelvic immobilisation should be used routinely if there is any suspicion of pelvic fracture based on the mechanism of injury, symptoms and clinical findings.
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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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The Lund University Cardiopulmonary Assist System (LUCAS) is a gas-driven mechanical cardiopulmonary resuscitation device. If oxygen is used as the driving gas in a confined environment, there is a potential fire hazard. 24% oxygen is considered the threshold for increased risk. ⋯ The LUCAS is safe for normal-duration flights in an MD902 helicopter. It is potentially unsafe in a static MD902 and, by extrapolation, in other static aircraft of similar or smaller size such as the EC135 or Bolkow 105.
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Necrotising myositis is a surgical emergency. It is underappreciated that it may present without changes in the skin. ⋯ Remarkable features were the absence of skin signs and the rapidity with which the patient became extremely septic. A review of the literature has shown the importance of early diagnosis and quick decision making to minimise mortality.
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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.