Emergency medicine journal : EMJ
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Injuries to the foot are a common cause for presentation to the emergency department (ED), and imaging is often used to aid in the diagnosis. The foot can be divided into three distinct anatomic regions: the forefoot, midfoot and hindfoot. ⋯ We provide pearls to radiographic interpretation and discuss prognostic implications and classification systems. Part 1 addressed forefoot injuries, Part 2 reviews midfoot injuries and Part 3 covers the hindfoot.
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Scientists have called for strategies to identify ED patients with unmet needs. We identify the unique profile of ED patients who arrive by ambulance and subsequently leave without consulting a provider (ie, a paradoxical visit, PV). ⋯ PV patients have needs that do not align with the acute model of ED care. These patients may benefit from a more integrated care approach likely involving allied health professionals.
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Observational Study
Capillary and Venous Lactate Agreement: a pilot prospective observational study.
Blood lactate is a marker of patient illness severity. Capillary lactate (CAP-LACT) measurement can potentially improve patient screening; however, it has poor evidence of clinical utility. ⋯ CAP-LACT has poor agreement with PV-LACT. Further research is needed to improve its potential clinical utility.
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We sought to validate the accuracy and assess the efficacy of a newly developed electronic weight estimation device (ie, the rolling tape) for paediatric weight estimation. ⋯ The rolling tape is a good weight estimation tool for children compared with other methods. The rolling tape method significantly decreased the time from weight estimation to orders for essential drug dose, instrument size and defibrillation dose for resuscitation.
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Propensity score methodology is being increasingly used to try and make inferences about treatments when randomised trials are either impossible or not conducted and the only data are from observational studies. This paper reviews the basis of propensity scores and the current state of knowledge about them. It uses and critiques a current paper in the Emergency Medicine Journal to illustrate the methodology.