Emergency medicine journal : EMJ
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Communication with survivors of severe motor vehicle crashes is challenging for emergency physicians. The appropriate timing of death notification to survivors of severe motor vehicle crashes is unknown. ⋯ Survivors of motor vehicles crashes are notified of fatalities most commonly by family members, most commonly in the hospital setting. Recommendations from survivors about the appropriate timing and setting for death notification varied significantly.
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The human dive reflex (HDR), a physiological phenomenon similar to the bradycardia reflex used by marine mammals during prolonged submersion, can be employed in managing paroxysmal supraventricular tachycardia (PSVT). This review aims to identify a standardised HDR technique for haemodynamically stable PSVT, to determine the effectiveness of the HDR and to define its usefulness in the prehospital setting. ⋯ The HDR represents an effective method of terminating PSVT in the hospital emergency department. Its usefulness in prehospital care requires further evaluation of the elements of the manoeuvre to determine appropriateness to this setting.
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A short cut review was carried out to establish the incidence of thrombembolic events in traumatically injured children. 75 papers were found using the reported search, of which 5 represent 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 these best papers are tabulated. The clinical bottom line is that the risk of VTE events in children is small. Risk factors for VTE can identify a high risk group.
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Unerring radiological interpretation is essential in discharged minor trauma patients without follow-up visits based on the rapid decision of emergency physicians (EPs). Misinterpretation may raise issues concerning patient care, reimbursement and lawsuits. The authors investigated the discrepancies and associated factors in radiological interpretation for discharged trauma patients between EPs and radiologists. ⋯ Despite a relatively low CSD rate, careful interpretation is recommended considering age and body areas imaged. A modified model would be needed as a supportive tool for training and improving the quality of care. A further development of the modified system for efficient use of resources will be needed to focus on quality improvement and education in each hospital.