Emergency medicine journal : EMJ
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Review Case Reports Comparative Study
BET 2: Treating migraines with diclofenac instead of a triptan.
A shortcut review was carried out to establish whether diclofenac is better than a triptan in treating migraine. 32 papers were found of which only 1 addressed this question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. It is concluded that there is insufficient evidence that either treatment is superior to the other for migraine therapy.
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Observational Study
Observational study to understand interpreter service use in the emergency medicine: why the key may lie outside of the initial provider assessment.
To characterise the use of interpreter services and other strategies used to communicate with limited English proficient (LEP) patients throughout their emergency department visit. ⋯ Emergency department staff use various mechanisms to communicate with LEP patients throughout their length of stay. Utilisation of interpreter services was poorest during evaluation and treatment tasks, indicating that this area should be a focus for improving communication with LEP patients.
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With the ageing population, the prevalence of mild traumatic brain injury (mTBI) among older patients is increasing, and the age criteria of the Canadian CT head rule (CCHR) is challenged by many emergency physicians. We modified the age criteria of the CCHR to evaluate its predictive capacity. ⋯ Adjusting the age criteria of the Canadian CT head rule to 75 years old could be safe while reducing radiation and ED resources. A future prospective study is suggested to confirm the proposed modification.
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Observational Study
Pulmonary embolism following complex trauma: UK MTC observational study.
To describe the incidence of pulmonary embolism (PE) in a critically ill UK major trauma centre (MTC) patient cohort. ⋯ This is the largest study of the incidence of PE in UK MTC patients and describes the greatest number of immediate PEs in a civilian complex trauma population to date. Immediate PEs are a rare phenomenon whose clinical importance remains unclear. Tranexamic acid was not significantly associated with an increase in PE in this population following its introduction into the UK trauma care system.