Emergency medicine journal : EMJ
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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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A short cut review was carried out to establish whether low dose CT can be used successfully in the diagnosis of renal tract disease in the ED. 280 papers were found using the reported search, of which 7 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 unenhanced low dose CT can be used effectively in the investigation of suspected renal colic.
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The purpose of this review was to determine the rate of those that leave the emergency department (ED) without being seen and their reasons, to clarify if such behaviour poses a health risk, to analyse the impact initiatives have made on the leave without being seen (LWBS) rate, and to discuss the implications of using it as a national performance indicator within the NHS. ⋯ LWBS is an issue experienced in many countries that has responded in a varying manner to many initiatives in attempts to reduce it; however, it is clearly associated with the waiting times experienced in ED and therefore working within a packet of performance measures it would assess the effect of waiting times from another perspective.
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A short cut review was carried out to establish whether there is any evidence for induced hypothermia in paediatric brain injury. 80 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 there is no evidence to support the use of hypothermia in brain injured children, and it may be associated with increased mortality.