Emergency medicine journal : EMJ
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The clinical presentation of stroke usually includes sensory-motor impairment, cranial nerve palsies, or cognitive dysfunction. Disorders in behaviour are less frequently seen. The case of a patient with a very disturbing presentation, which included a disturbance in vigilance, bilateral third nerve palsy and masturbating behaviour, is presented. The topography of the lesions and its implications on the deficits observed are discussed.
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Case Reports
Chest compressions for a patient in cardiac arrest after penetrating trauma with a knife still in situ.
A 45-year-old man was brought by ambulance to the emergency department. He was in shock, with a knife handle protruding from his abdomen. ⋯ Resuscitation and haemostasis were achieved and the patient was eventually discharged from hospital. This case report discusses the risks of chest compressions for trauma patients with a penetrating weapon still in situ.
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Review Comparative Study
Midazolam or ketamine for procedural sedation of children in the emergency department.
A short cut review was carried out to establish whether ketamine or midazolam is superior at providing safe and effective conscious sedation in children in the emergency department. A total of 203 papers were found using the reported searches, of which four 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 summarised in table 1. It is concluded that midazolam and ketamine have similar efficacy and safety profiles but that ketamine is preferred by parents and physicians.
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Randomized Controlled Trial Comparative Study
Tracheal intubation by non-anaesthetist physicians using the Airway Scope.
To evaluate the performance of the Airway Scope for tracheal intubation by non-anaesthetist physicians. ⋯ The Airway Scope may reduce the time to secure the airway and the incidence of failed tracheal intubation in novice laryngoscopists.
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Comparative Study
Short stay emergency admissions to a West Midlands NHS Trust: a longitudinal descriptive study, 2002 2005.
To describe changes and characteristics in emergency admissions to a West Midlands National Health Service Trust, 2002-2005, with a focus on short stay emergency admissions. ⋯ Increases in emergency admissions were greater in short stay than long stay cases. Reasons for this may be both appropriate (increased use of clinical protocols and falling average length of stay) and detrimental (pressure to meet 4 h emergency department target, changing primary care provision). Further research is needed before generalising findings to other Trusts.