Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether there was any evidence to decide between oral or intravenous antidote in paracetamol (acetaminophen) poisoning. Altogether 330 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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A short cut review was carried out to establish whether patients with no recurrence of symptoms one hour after receiving naloxone for an opioid overdose can safely be discharged. Altogether 195 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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Spontaneous life threatening haemopneumothorax is an unusual but treatable cause of unexpected circulatory collapse in young patients. Two case histories are presented to illustrate the management of this condition. Diagnosis and initial management depends on early recognition of the clinical pattern by accident and emergency (A&E) staff and/or hospital physicians. ⋯ The cases illustrate potential problems. Not only early recognition of the clinical pattern but also proactive intervention in the A&E department are necessary before referral to a cardiothoracic surgeon. Furthermore, we suggest treatment would be improved by the introduction of management guidelines.
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A short cut review was carried out to establish whether prophylactic antibiotics reduced the incidence of infection after non-venemous snake bite. Altogether 60 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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To determine current practice in choice of fluid resuscitation in children following publication of a systematic review that demonstrated a higher mortality in patients treated with human albumin solution. ⋯ It is apparent that few paediatric departments have a written protocol or guidelines for the management of septic shock that is accessible to all those concerned in the acute treatment of seriously ill children. The systematic review into choice of fluid has had an impact on clinical practice with no data regarding whether this is in the patient's best interests.