Emergency medicine journal : EMJ
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Paramedics are involved in examining, treating and diagnosing patients. The accuracy of these diagnoses is evaluated using diagnostic accuracy studies. We undertook a systematic review of published literature to provide an overview of how accurately paramedics diagnose patients compared with hospital doctors. A bivariate meta-analysis was incorporated to examine the range of diagnostic sensitivity and specificity. ⋯ CRD42016039306.
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With the increasing role of point-of-care coagulation testing in trauma, we sought to test the reliability of the thromboelastography (TEG)6s machine in a simulated rotary wing environment. ⋯ The TEG6s is a viable technology in the simulated rotary wing environment, and it is feasible to conduct further studies using human blood in live rotary wing conditions. Extreme flight conditions should be avoided during further testing.
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Achieving just outcomes in sexual assault cases is one of the most serious and complex problems facing the healthcare and justice systems. This study was designed to determine the prevalence and correlates of Sexual Assault Evidence Kit (SAEK) completion and release to police among sexual assault cases presenting to the ED. ⋯ Even with access to specialised forensic evidence collection, many sexual assault survivors do not complete a SAEK, and even fewer release the evidence to police for investigation. The ED is a common entry points into the healthcare system, and this study has highlighted the need to strengthen services and reduce attrition along the health-justice continuum.
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A 17-year-old male patient was brought by ambulance to the ED following a witnessed collapse while playing rugby. He denied any significant trauma, chest pain or breathlessness, and was alert and uncomplaining on arrival, with normal observations and a normal physical exam. Witnesses described a loss of consciousness, with a period of respiratory arrest requiring rescue breaths at the scene. Paramedics reported frequent ventricular extrasystoles on their arrival.The patient had no medical history and was on no medication, although admitted to 'fainting' some 3 weeks previously, again while playing rugby. A paternal uncle had died suddenly at the age of 45.His initial ECG is shown in figure 1.emermed;35/12/764/F1F1F1Figure 1Initial ECG. ⋯ What is the most likely diagnosis?Pulmonary embolism (PE)Hypertrophic obstructive cardiomyopathy (HOCM)Arrhythmogenic right ventricular cardiomyopathy (ARVC)Right ventricular outflow tract tachycardia (RVOT).