Emergency medicine journal : EMJ
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Multicenter Study
The relationship between body temperature, heart rate and respiratory rate in children.
To describe and quantify the effect that increasing body temperature has on heart rate and respiratory rate in children attending a paediatric emergency department (ED). ⋯ Body temperature is an independent determinant of heart rate, causing an increase of approximately 10 beats per minute per degree centigrade. Body temperature is also an independent determinant of respiratory rate. This quantification may help in the assessment of the hot and unwell child, to determine whether any tachycardia or tachypnoea is caused solely by fever, or whether there may be an element of concurrent shock.
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To describe and assess outcomes of adult out-of-hospital cardiac arrest cases occurring in the greater Johannesburg metropolitan area recorded over a 7-year period in a student paramedic clinical learning database. ⋯ The proportion of cardiac arrest patients resuscitated was small as was the proportion of patients found in shockable rhythms and those with ROSC. Long response times may explain these findings, but a larger, prospective study on out-of-hospital cardiac arrest in Johannesburg is needed to confirm this.
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Enlargement of the optic nerve sheath has been described in patients with raised intracranial pressure (ICP), thereby serving as one of its indicators. Optic nerve sonography offers rapid bedside assessment of the optic nerve sheath diameter and has recently been introduced for the non-invasive detection of raised ICP, particularly in patients with severe brain injury. This review explains the pathophysiology of optic nerve sheath enlargement as a result of intracranial hypertension, describes the technique and clinical use of optic nerve sonography, and summarises the studies which have tested this modality in the non-invasive evaluation of ICP.
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To describe the demographics, referral mechanism and outcome of the emergency consultation in patients presenting to a secondary hospital emergency centre (EC). ⋯ Clear trends are seen for patient demographics and temporal attendance patterns which are important for resource allocation and planning. Many low-acuity patients, largely non-referred, are being seen in the EC and should be managed by primary health care level staff outside the EC.
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Case Reports
U-shaped sacral fracture: an easily missed fracture with high morbidity. A report of two cases.
U-shaped sacral fracture is a very rare injury. This injury is easily missed and the diagnosis is often delayed as it is difficult to detect on the anteroposterior view of the pelvic radiograph. ⋯ In these two cases, full recoveries were achieved following surgical decompression. A high index of suspicion with proper clinical and radiographic assessments will decrease the incidence of missed diagnosis and prevent the occurrence of delayed neurological deficits.