Emergency medicine journal : EMJ
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ED visits have been rising year on year worldwide. It has been suggested that some of these visits could be avoided if low-acuity patients had better primary care access. This study explored patients' efforts to avoid ED presentation and alternative care sought prior to presentation. ⋯ Most low-acuity patients attempt to avoid ED presentation by seeking alternative care. This analysis identifies groups of individuals in the study region who are less likely to seek alternative care first and may benefit from targeted interventions/education. Other regions may wish to complete a similar profile to determine which patients are less likely to seek alternative care first.
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Maintaining the standard two-handed chest compression is difficult in high-speed ambulances in rural areas. ⋯ The chest compression fraction was low for patients with out-of-hospital cardiac arrest in a moving ambulance, irrespective of the number of providers. Reasons for this observation, as well as the effectiveness of the one-handed chest compression require further evaluation.
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A shortcut review was carried out to establish whether intravenous lidocaine is effective in the management of renal colic. Two studies were directly relevant to the question. ⋯ The clinical bottom line is that intravenous lidocaine may be of some benefit in renal colic. However, there are other maybe more effective drugs available.
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Non-invasive ventilation (NIV) therapy is widely used for the management of acute respiratory failure. The objective of this study was to investigate the current use of NIV during interhospital retrievals in an Australian physician-led aeromedical service. ⋯ With careful patient selection, the use of interhospital NIV is feasible and appears to be safe in a retrieval system with care provided by a critical care physician.
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A shortcut review was carried out to establish whether tranexamic acid is effective in controlling epistaxis. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these studies are tabulated. The clinical bottom line is that there is not enough evidence to recommend tranexamic acid in the standard management of epistaxis.