Emergency medicine journal : EMJ
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A common presentation to the emergency department (ED) is the trauma patient with altered sensorium who is presumed to be alcohol intoxicated by physicians based on their olfactory sense. ED physicians may often leave patients suspected of alcohol intoxication aside until the effects wear off, potentially missing trauma as the source of confusion. This often results in delays in diagnosing acute potentially life-threatening injuries in patients with presumed alcohol intoxication. ⋯ Although the physicians had a high degree of accuracy in identifying patients with alcohol intoxication based on their olfactory sense, they still falsely overestimated intoxication in significant numbers of non-intoxicated trauma patients.
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A short-cut review was carried out to establish whether the parents of children with anaphylaxis are proficient in the use of autoinjectors. Seven hundred and three papers were found of which nine 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 these best papers are shown in table 2. The clinical bottom line is that competence varies widely and that further efforts are required to train and monitor training outcomes.
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To determine the difference between rocuronium and succinylcholine with regard to post-intubation sedative initiation in the emergency department. ⋯ Patients intubated with rocuronium had greater delays in post-intubation sedative initiation compared with succinylcholine.
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To describe trends regarding snakebite enquiries to the UK National Poisons Information Service (NPIS) from 2004 to 2010. ⋯ Snakebites account for one to two NPIS cases per week. Adder bites account for over half of cases. A quarter of cases were due to non-UK snakes kept in captivity within the UK. Envenoming was said to have occurred in just under half of all cases. Advice given by the NPIS appears to closely reflect national practice guidelines.