Emergency medicine journal : EMJ
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A shortcut review was carried out to investigate whether avulsion fractures of the base of the fifth metatarsal were best treated with tubular bandage, a walking boot or a short leg plaster cast. One paper presented the only evidence to answer one of the clinical questions (plaster cast or walking boot) but no evidence was found comparing tubular bandage and a walking boot. ⋯ It is concluded that while the only evidence available shows marginal benefit of walking boot over short plaster cast during recovery, there is no benefit to final outcome. Further research comparing tubular bandage and walking boot is required.
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Multicenter Study
Diagnostic accuracy of the magnetocardiograph for patients with suspected acute coronary syndrome.
We aimed to estimate the diagnostic accuracy of the VitalScan magnetocardiograph (MCG) for suspected acute coronary syndrome (ACS). ⋯ The VitalScan MCG is currently unable to accurately rule out ACS and is not yet ready for use in clinical practice. Further developmental research is required.
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Observational Study
QRS complex characteristics and patient outcomes in out-of-hospital pulseless electrical activity cardiac arrest.
Pulseless electrical activity (PEA) is increasingly observed in out-of-hospital cardiac arrest (OHCA), but outcomes are still poor. We aimed to assess the relationship between QRS characteristics and outcomes of patients with OHCA with initial PEA (OHCA-P). ⋯ OHCA-P outcomes were better when the initial QRS complex showed a higher amplitude or narrower width.
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For the prehospital diagnosis of raised intracranial pressure (ICP), clinicians are reliant on clinical signs such as the Glasgow Coma Score (GCS), pupillary response and/or Cushing's triad (hypertension, bradycardia and an irregular breathing pattern). This study aimed to explore the diagnostic accuracy of these signs as indicators of a raised ICP. ⋯ Traditional clinical signs of raised ICP may under triage patients to prehospital treatment with hyperosmolar drugs. Further research should identify more accurate clinical signs or alternative non-invasive diagnostic aids in the prehospital environment.