Emergency medicine journal : EMJ
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An 11-year-old girl presented with pain and deformity in her right little finger distal interphalangeal joint (DIPJ). She was active in several sports including hurling and had a history of dyspraxia with frequent minor soft tissue injuries which had not required hospital assessment. Her mother was concerned about the possibility of a recent injury. ⋯ There was mild swelling and tenderness of the DIPJ with no bruising, erythema or warmth. An X-ray was performed (figure 1). emermed;35/11/679/F1F1F1Figure 1An teroposterior (AP) and lateral radiographs of the right little finger. QUESTION: What is the diagnosis?Salter-Harris type 1 fracture of distal phalanxDystelephalangyExtensor digiti minimi tendon injuryClinodactyly.
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Review Meta Analysis
Understanding better how emergency doctors work. Analysis of distribution of time and activities of emergency doctors: a systematic review and critical appraisal of time and motion studies.
Optimising the efficiency and productivity of senior doctors is critical to ED function and delivery of safe patient care. Time and motion studies (TMS) can allow quantification of how these doctors spend their working time, identify inefficiencies in the current work processes and provide insights into improving working conditions, and enhancing productivity. Three questions were addressed: (1) How do senior emergency doctors spend their time in the ED? (2) How much of their time is spent on multitasking? (3) What is the number of tasks completed per hour? ⋯ The review revealed that senior doctors spent a large percentage of their time on direct face-to-face contact with patients. The review findings provided a grounded understanding of how senior doctors spent their time in the ED and could be useful in implementing improvements to the emergency care system.
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Brief training courses in bedside ultrasound are commonly done by visiting faculty in low-income and middle-income countries, and positive short-term effects have been reported. Long-term outcomes are poorly understood. We held a training course on a cardiopulmonary ultrasound (CPUS) protocol over two separate 10-day periods in 2016. In 2017, 9-11 months after the initial training, we assessed skill and knowledge retention as well as perceived impact on local practice. ⋯ Long-term ultrasound knowledge and skill retention was high after a brief and intensive training intervention at an academic tertiary hospital in Ghana. Clinicians reported improvements in patient care and local practice patterns.
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Accidental hypothermia (AH) has higher incidence and mortality in geriatric populations. Japan has a rapidly ageing population, and little is known about the epidemiology of hypothermia in this country. ⋯ Active prevention and intervention should occur for this important public health issue.
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Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist. ⋯ A list of significant childhood conditions has been created using UK and Irish expert consensus, for research purposes, for the first time. This will be used as the benchmark endpoint list for future research into PEWS/safety systems performance in EDs.