Emergency medicine journal : EMJ
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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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The aim of this study was to establish the feasibility of a Kenyan emergency department (ED)-based sexual assault centre; and to improve knowledge of the characteristics of sexual assault in the region. ⋯ Development of an ED-based sexual assault centre at a referral hospital in Kenya using a standardised history, physical, and treatment protocol was feasible, and high rates of prophylaxis were provided. Based on characteristics of people who have been assaulted, community prevention efforts should concentrate on decreasing the societal acceptability of rape. In conjunction with improvement of protocols at the centre under consideration, development of similar centres in sub-Saharan African ED should be encouraged.
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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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A 74-year-old woman received thrombolysis for pericarditis. She subsequently developed shock and cardiac arrest. The case report describes the events of how a simple immediate bedside focused echo proved to be a life saving assessment. Current availability and training issues in focused transthoracic echo are discussed.
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The aim of this study was to determine whether the current South African Emergency Medicine Curriculum is appropriate for the burden of disease seen by registrars in Cape Town Emergency Centres. ⋯ The curriculum did not cover all the clinical conditions, procedures and investigations encountered by emergency medicine (EM) registrars in Cape Town. In addition, there were multiple categories in the curriculum that were not encountered in EM practice at all. The investigations section of the curriculum correlated particularly poorly with the skills needed for the burden of disease seen in ECs in Cape Town. The curriculum should be redrafted guided by a practice analysis of EM.