Emergency medicine journal : EMJ
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A short-cut review was carried out to establish whether the measurement of plasma heart fatty acid binding protein at the time of presentation is of any help in the accurate early diagnosis of acute myocardial infarction (AMI). Six papers presented evidence addressing the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 1. The clinical bottom line is that although heart fatty acid binding protein is a promising biomarker it cannot be used alone to rule out the diagnosis of AMI.
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The Australasian Triage Scale is a simple five-point system of triage that forms the basis of triage in most emergency departments in Australia. The Manchester Triage System (MTS) is an algorithmic aid to the process of triage. It utilises a series of flow charts that lead the triage nurse to a logical choice of triage category also using a five-point scale. ⋯ The MTS is a reliable system of triage in the emergency department.
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Head injury outcome is influenced by the initial insult and the various pathophysiological changes that take place in the posttraumatic phase, some of which may be amenable to intervention. Appropriate measures taken during initial emergency department management and subsequently in the intensive therapy unit can significantly improve outcome. ⋯ Early imaging, rather than admission and observation for neurological deterioration, reduces the time to the detection of life-threatening complications. This paper discusses the current management of severe head injury, some prognostic indicators and methods used to rule out an associated spinal injury.