Emergency medicine journal : EMJ
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Acute respiratory failure (ARF) is a frequent emergency department (ED) presentation. The definition and common causes of ARF are discussed in this article and ED management of the condition is discussed, using an illustrative case report. ⋯ Intensive care unit admission denial is common in ARF, although the evidence base is lacking. Finally, the decision-making process is described when a patient with ARF fails to improve with NIV.
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Approximately 1% of the UK population receives anticoagulation with warfarin. Head injury accounts for some 1.4 million emergency department attendances in the country. Therefore, significant numbers of patients with head injury have a therapeutic coagulopathy. This review aims to examine the existing evidence for optimal management of warfarinised head injured patients, particularly with respect to the need for early CT imaging and the use of reversal agents in cases of proved haemorrhage.
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Emergency physicians were trained to perform echo in life support (ELS)--that is, limited transthoracic echocardiography during advanced life support (ALS) management of cardiac arrest. ⋯ It is concluded that ELS is feasible and that the scan findings may guide further interventions.
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The aim of this study was to examine the strength of correlation between initial pain severity score and systolic blood pressure, heart rate and respiratory rates among adults reporting pain in the prehospital setting as a means of validating the presence and severity of pain. ⋯ A lack of any meaningful correlation between pain scores and changes in vital signs in this population demonstrates that these signs cannot be used to validate the severity of pain reported by adult patients.