Emergency medicine journal : EMJ
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Review Comparative Study
Midazolam or ketamine for procedural sedation of children in the emergency department.
A short cut review was carried out to establish whether ketamine or midazolam is superior at providing safe and effective conscious sedation in children in the emergency department. A total of 203 papers were found using the reported searches, of which four 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 summarised in table 1. It is concluded that midazolam and ketamine have similar efficacy and safety profiles but that ketamine is preferred by parents and physicians.
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Review Comparative Study
Ultrasound to detect haemothorax after chest injury.
A short cut review was carried out to establish whether ultrasonography is as sensitive and specific as chest x ray or computed tomography (CT) scan in detecting haemothorax after chest trauma. Thirty-nine papers were found using the reported searches, of which six 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 shown in table 3. It is concluded that ultrasonography is more sensitive and as specific as chest x ray at detecting haemothorax in patients with chest trauma.
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Tourniquets are an effective means of arresting life-threatening external haemorrhage from limb injury. Their use has not previously been accepted practice for pre-hospital civilian trauma care because of significant concerns regarding the potential complications. ⋯ This review explores the potential problems and mistrust of tourniquet use; explains the reasons why civilian pre-hospital tourniquet use may be necessary; defines the clear indications for tourniquet use in external haemorrhage control; and provides practical information on tourniquet application and removal. Practitioners need to familiarise themselves with commercial pre-hospital tourniquets and be prepared to use one without irrational fear of complications in the appropriate cases.
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Randomized Controlled Trial Comparative Study
Tracheal intubation by non-anaesthetist physicians using the Airway Scope.
To evaluate the performance of the Airway Scope for tracheal intubation by non-anaesthetist physicians. ⋯ The Airway Scope may reduce the time to secure the airway and the incidence of failed tracheal intubation in novice laryngoscopists.
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Comparative Study
Short stay emergency admissions to a West Midlands NHS Trust: a longitudinal descriptive study, 2002 2005.
To describe changes and characteristics in emergency admissions to a West Midlands National Health Service Trust, 2002-2005, with a focus on short stay emergency admissions. ⋯ Increases in emergency admissions were greater in short stay than long stay cases. Reasons for this may be both appropriate (increased use of clinical protocols and falling average length of stay) and detrimental (pressure to meet 4 h emergency department target, changing primary care provision). Further research is needed before generalising findings to other Trusts.