Emergency medicine journal : EMJ
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Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in their day-to-day practice. Within several countries there has been a move to disseminate the actions to take in the event of such attacks: in the UK, Run, Hide, Tell, and in the USA, Fight Back This paper outlines how a very basic medical knowledge combined with everyday high-street items can render highly effective first aid and save lives. ⋯ Analgesia is discussed in the context of a prehospital setting. Pharmacy-obtained oral morphine and diclofenac suppositories can be used to treat moderate pain without relying on equipment for intravenous/intraosseous infusion in prolonged hold situations. The differentiation between concealment and cover is summarised: scene safety remains paramount.
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A 37-year-old man with history of lymph node tuberculosis presented with bilateral inguinal swelling with night sweats but no fever for 2 weeks. He had a cat but he had no history of scratches. He had an extraconjugal sexual intercourse a few weeks before. Physical examination revealed 5 cm tender, erythematous and painful bilateral inguinal adenopathy (figure 1A) and a small ulceration at the base of the penis (figure 1B). Vital signs were normal.emermed;35/8/522/F1F1F1Figure 1(A) Inguinal lymphadenopathy. (B) Ulceration at the base of the penis. ⋯ What is the most likely diagnosis?ToxoplasmosisTuberculosisCat-scratch diseaseLymphogranuloma venereumSyphilis.
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The purpose of our study was to determine if cephalexin 500 mg orally four times daily was non-inferior to cefazolin 2 g intravenously daily plus probenecid 1 g orally daily in the management of patients with uncomplicated mild-moderate skin and soft tissue infection (SSTI) presenting to the ED. ⋯ Cephalexin at appropriate doses appears to be a safe and effective alternative to outpatient parenteral cefazolin in the treatment of uncomplicated mild-moderate SSTIs who present to the ED.
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A short cut review was carried out to see if administering anti-emetics reduced the incidence of vomiting when sedating children for procedures. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. Three randomised, controlled trials were found and one cohort study. The studies suggested that administration of an anti-emetic was associated with a reduced risk of vomiting during the procedural sedation.
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A short-cut review was carried out to see if administering tranexamic acid reduced mortality in patients with postpartum haemorrhage. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. Two randomised controlled trials were found, a smaller one suggesting that treatment with tranexamic acid reduced the volume of blood lost and a much larger study that showed a reduction in mortality due to bleeding in this patient group. There were no significant side effects from this treatment found in either study.