Emergency medicine journal : EMJ
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To determine the impact of the GP-led walk-in centre (WIC) in Sheffield (England) on the demand for emergency department (ED) care. ⋯ There was a statistically significant reduction in GP-type daytime attendances at the adult ED after the opening of the GP WIC. Since this reduction was not mirrored in changes in night-time attendances (when the GP WIC was closed), and our survey responses suggested some people were diverted from going to the ED, it is possible that the opening of the GP WIC caused this reduction.
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A shortcut review was carried out to establish whether topical lignocaine patches (LP) are effective for rib fractures. 48 papers were found of which 2 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 tabulated. The clinical bottom line is that there is currently no evidence to support the use of topical LP to improve pain control and reduce opiate analgesic use, in patients with traumatic rib fractures.
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Can routinely collected ambulance data about assaults contribute to reduction in community violence?
The 'law of spatiotemporal concentrations of events' introduced major preventative shifts in policing communities. 'Hotspots' are at the forefront of these developments yet somewhat understudied in emergency medicine. Furthermore, little is known about interagency 'data-crossover', despite some developments through the Cardiff Model. Can police-ED interagency data-sharing be used to reduce community-violence using a hotspots methodology? ⋯ A hotspots approach to sharing data circumvents the problem of disclosing person-identifiable data between different agencies. Practically, at least half of ambulance hotspots are unknown to the police; if causal, it suggests that data sharing leads to both reduced community violence by way of prevention (such as through anticipatory patrols or problem-oriented policing), particularly of more severe assaults, and improved efficiency of resource deployment.
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To determine by chest CT the proper compression landmark and depth for cardiopulmonary resuscitation in patients with pectus excavatum (PE). ⋯ The LH of the sternum is an appropriate chest compression landmark in PE patients to compress LV, although the centre of LV shows slightly leftward displacement. Since PE patients have sunken chest, a 3-4 cm may be the proper compression depth in the patients when considering the current compression guideline in normal subjects is 5-6 cm.