Emergency medicine journal : EMJ
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A short cut review was performed to assess the effect of the presence of family members on the efficiency of paediatric trauma resuscitation. Two studies with a total of 999 patients were included. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are tabulated. The clinical bottom line is that the presence of the patient's family does not adversely affect the outcome of paediatric trauma resuscitation.
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The authors report the case of a 4-year-old boy who presented to the emergency department with acute post-traumatic winging of right scapula following a fall onto his back. The x-ray of his right shoulder showed no fracture. An MRI Scan of cervical spine and brachial plexus did not reveal any abnormalities. ⋯ At 2 years follow-up, there was no improvement in the winging of his right scapula. He was asymptomatic at rest but complains of pain in the right scapular and shoulder region during swimming limiting his swimming activity. Currently he was being evaluated by the orthopaedic team for corrective surgery.
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A short cut review was performed to assess the utility of emergency physician echocardiography in patients with cardiac arrest. Six studies with a total of 434 patients were found. The authors, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are tabulated. The clinical bottom line is that cardiac standstill witnessed in emergency physician echocardiography is predictive of a poor outcome in cardiac arrest.
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Increasingly emergency departments (ED) and other acute services in the hospital provide first access care, especially out of hours and for poorer families. Studies of detection of child maltreatment in the hospital have focused on children presenting with injury, although maltreatment may be suspected when parents present to the hospital with problems related to violent behaviour, drug abuse or mental health problems. ⋯ Clinicians need to be aware that half the vulnerable children in hospital are identified through one or other parent. It is hypothesised that the availability of an experienced child protection advisor on-site, combined with child protection training, makes it possible for clinicians caring for adults with problems related to violence, drug abuse or acute mental illness, to take action to address the potential vulnerability of their children.
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Cranial CT (CCT) is the gold standard to rule out traumatic brain injury. The serum level of the protein S-100B has recently been proposed as promising marker of traumatic brain injury. We prospectively investigated whether it might be a reliable tool for CCT triage in mild brain injury at a peripheral trauma centre with limited CT resources. ⋯ The S-100B serum level showed a high sensitivity and negative predictive value in the screening of patients with mild head injury. The use of serum S-100B as a biomarker for CCT triage may improve patient screening and decrease the number of CCT scans performed. This would reduce unnecessary radiation exposure and free up capacity in the emergency rooms of peripheral hospitals to enable them to cope better with multiple admissions.