Emergency medicine journal : EMJ
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Review
Use of a full-body digital X-ray imaging system in acute medical emergencies: a systematic review.
To evaluate the available evidence for the clinical effectiveness and biohazard safety of a full-body digital X-ray imaging system (Lodox) in acute medical emergencies. ⋯ The Lodox machine is capable of rapidly scanning the entire body and offers an equivalent diagnostic assessment tool compared with conventional X-rays. It seems to have the potential to reduce cumulative radiation dosage for emergency patients compared with conventional X-rays. Application of Lodox might be helpful to reduce resource use and simplify care in lower-resourced areas.
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Comparative Study Observational Study
Beyond triage: the diagnostic accuracy of emergency department nursing staff risk assessment in patients with suspected acute coronary syndromes.
To establish the accuracy of emergency department (ED) nursing staff risk assessment using an established chest pain risk score alone and when incorporated with presentation high-sensitivity troponin testing as part of an accelerated diagnostic protocol (ADP). ⋯ The diagnostic accuracy of ED nursing staff risk assessment is similar to that of ED physicians and interobserver reliability between assessor groups is fair. When incorporating high-sensitivity troponin testing, a nurse-led ADP has a miss rate of 1.1% for MACE at 30 days.
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Care guidelines can improve the quality of care by making current evidence available in a concise format. Emergency departments (EDs) are an ideal site for guidelines given the wide variety of presenting conditions and treating providers, and the need for timely decision making. We designed a programme for guideline development and implementation and evaluated its impact in an ED. ⋯ A programme for guideline development and implementation helped to improve efficiency, and standardise and eliminate disparities in emergency care without jeopardising patient outcomes.
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A short cut review was carried out to establish ultrasound can assist. 9 papers were found of which 4 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 using ultrasound assisted landmarks prior to LP improves success rate and reduces the number of attempts and traumatic taps.
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To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. ⋯ While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties.