Emergency medicine journal : EMJ
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No specific early warning score universally validated for use in all children presenting to the Emergency Department (ED) exists. POPS is a novel aggregate scoring system, designed for ED use. ⋯ POPS is a useful tool to predict the admission likelihood from the ED. POPS≥2 correctly predicts 50% of children who should be admitted and 85% of children who should be discharged. Multi-centre validation would help to refine POPS, increasing its sensitivity and specificity to admission likelihood, to improve the safety of discharge decisions and healthcare resource utilisation.
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Anaphylaxis is under-reported in emergency settings and the potential for diagnostic confusion with acute asthma has been reported, especially in children who experience predominantly respiratory symptoms. However, no previous study has directly investigated the probability of unrecognised anaphylaxis in either adults or children presenting with acute asthma. ⋯ The results support the conclusion that some cases of anaphylaxis are unidentified and managed as acute asthma in children. The local frequency was estimated at 4.1% of children admitted to PICU but larger prospective multi-centre studies are required to better define the true prevalence nationally.
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Observational Study
Comparison of outcomes in patients with head trauma, taking preinjury antithrombotic agents.
This study compares clinical outcomes in patients with head trauma, taking preinjury antiplatelet drugs (aspirin, clopidogrel) and anticoagulants (warfarin). ⋯ A high proportion of patients taking warfarin underwent neuroimaging, but brain injury and admission rates were comparable between groups. There were no significant differences in short-term outcomes between the groups. The overall mortality is higher for patients on antiplatelet agents than warfarin.
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A shortcut review was carried out to establish whether night shift working worsens health and shortens life. 127 papers were found using the reported searches, of which one systematic review 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 paper are tabulated. It is concluded that shift work is associated with an increased risk of vascular events but does not appear to have an effect on mortality.