Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether BGC scar changes can aid in the diagnosis of Kawasaki's disease. 24 unique relevant papers were found using the reported searches, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. It is concluded that BCG scar changes may help in suggesting that diagnosis of Kawasaki's disease should be considered.
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To evaluate the efficacy of routine follow-up CT scans of the head after complicated mild traumatic brain injury (TBI). ⋯ Routine follow-up CT scans rarely alter treatment for patients with complicated mild TBI. Follow-up CT scans based on neurological decline alter treatment five times more often than routine follow-up CT scans.
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Is the Clinical Safety Chart clinical improvement programme (CIP) effective at improving paramedic key performance indicator (KPI) results within the Ambulance Service of New South Wales? ⋯ The strategies used within this CIP are recommended for further consideration.
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Most patients involved in motor vehicle crashes (MVCs) are not seriously injured. However, dispatch protocols require an ambulance be sent with lights and sirens (L&S) to the vast majority of MVCs. L&S have been shown to reduce response times minimally. The rate of injuries among prehospital workers is nearly 15 times higher among ambulances operating with L&S than those without. ⋯ A simple three-step dispatch rule for MVCs can safely reduce L&S responses by one-third, as judged by need for transport to a trauma centre or use of trauma centre resources. Prospective validation is needed.
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Benzodiazepine (BZD) overdose (OD) continues to cause significant morbidity and mortality in the UK. Flumazenil is an effective antidote but there is a risk of seizures, particularly in those who have co-ingested tricyclic antidepressants. A study was undertaken to examine the frequency of use, safety and efficacy of flumazenil in the management of BZD OD in the UK. ⋯ Flumazenil is used infrequently in the management of BZD OD in the UK. It was effective and associated with a low incidence of seizure. These results compare favourably with the results of published randomised controlled trials and cohort studies, although previous studies have not reported the use of flumazenil in such a high-risk population. This study should inform the continuing review of national guidance on flumazenil therapy.