Emergency medicine journal : EMJ
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Editorial Comment
Antimicrobial stewardship in emergency departments: a neglected topic.
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Randomized Controlled Trial
Does a single dose of intravenous dexamethasone reduce Symptoms in Emergency department patients with low Back pain and RAdiculopathy (SEBRA)? A double-blind randomised controlled trial.
To assess the effect of a single dose of intravenous dexamethasone in addition to routine treatment on visual analogue scale (VAS) pain scores at 24 h in emergency department (ED) patients with low back pain with radiculopathy (LBPR). ⋯ In patients with LBPR, a single dose of intravenous dexamethasone in addition to routine management improved VAS pain scores at 24 h, but this effect was not statistically significant at 6 weeks. Dexamethasone may reduce EDLOS and can be considered as a safe adjunct to standard treatment.
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Clinical handover plays a vital role in patient care and has been investigated in hospital settings, but less attention has been paid to the interface between prehospital and hospital settings. This paper reviews the published research on these handovers. ⋯ This review raises concerns about handovers at the interface between prehospital and hospital settings. The quality of existing research in this area is relatively poor and further high-quality research is required to understand this important part of emergency care. We need to understand the complexity of handover better to grasp the challenges of context and interprofessional relationships before we reach for tools and techniques to standardise part of the handover process.
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A short cut review was carried out to establish whether point-of-care abdominal ultrasound could affect the emergency department (ED) length of stay (LOS) of children attending with suspected appendicitis. Using the reported searches, one paper presented the best evidence to answer the clinical question. ⋯ It is concluded that point-of-care abdominal ultrasound has sufficient specificity to be used to reduce LOS of paediatric patients in the ED with positive results for appendicitis. It is insufficiently sensitive to be used to rule out appendicitis.
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A short cut review was carried out to establish whether local anaesthetic should be instilled before or after eye examination in suspected corneal foreign body. 83 papers were found in Medline, Embase and the Cochrane Library using the reported searches, but none presented any evidence to answer the clinical question. It is concluded that there is no evidence to guide the time of installation and that local advice should be followed.