Emergency medicine journal : EMJ
-
The aim of this study was to derive and internally validate a prediction rule for short stay admissions (SSAs) in trauma patients admitted to a major trauma centre. ⋯ We report a prediction rule that could be used to establish admission criteria for a trauma short stay unit. Further studies are required to prospectively validate the prediction rule.
-
Multicenter Study Observational Study
Modified TIMI risk score cannot be used to identify low-risk chest pain in the emergency department: a multicentre validation study.
The Thrombolysis in Myocardial Infarction (TIMI) risk score (range 0-7), used for emergency department (ED) risk stratification of patients with suspected acute coronary syndrome (ACS), underestimates risk associated with ECG changes or cardiac troponin elevation. A modified TIMI score (mTIMI, range 0-10), which gives increased weighting to these variables, has been proposed. We aimed to evaluate the performance of the mTIMI score in ED patients with suspected ACS. ⋯ mTIMI score performs better than standard TIMI score for ED risk stratification of chest pain, but neither is sufficiently sensitive at scores >0 to allow safe and early discharge without further investigation or follow-up. Observed differences in performance may be due to incorporation bias.
-
Review
BET 2: The use of bedside ultrasound in diagnosing retinal detachment in emergency department.
A short-cut review was carried out to determine whether retinal detachment can be reliably diagnosed by an Emergency Department ocular ultrasound scan. Fifty eight papers were identified using the reported search, of which, eight were considered relevant to the three-part question. It is concluded by the limited evidence available that Emergency Department ocular ultrasound has promise as a sensitive test for retinal detachment.
-
A short-cut review was carried out to determine whether the International Normalised Ratio (INR) value was a predictor of the risk of intracranial haemorrhage in patients taking warfarin after head injury. 796 papers were found using the reported search, of which eighteen were directly relevant. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are shown in the accompanying table. It is concluded that level of the INR correlates poorly with the risk of haemorrhage and that the risk of haemorrhage remains significant even in patients with a sub-therapeutic INR.