MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Emergency Medicine Journal' source. Sun, 21 Mar 2010 14:59:46 +0100 http://www.medworm.com/index.php?rid=3380385&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F250%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380385 Fri, 19 Mar 2010 11:45:06 +0100 3380385 http://www.medworm.com/index.php?rid=3380384&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F249-c%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380384 Fri, 19 Mar 2010 11:45:06 +0100 3380384 http://www.medworm.com/index.php?rid=3380383&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F249-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380383 Fri, 19 Mar 2010 11:45:06 +0100 3380383 http://www.medworm.com/index.php?rid=3380382&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F249-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380382 Fri, 19 Mar 2010 11:45:06 +0100 3380382 http://www.medworm.com/index.php?rid=3380381&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F245%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380381 Fri, 19 Mar 2010 11:45:06 +0100 3380381 http://www.medworm.com/index.php?rid=3380380&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F243%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380380 Fri, 19 Mar 2010 11:45:06 +0100 3380380 http://www.medworm.com/index.php?rid=3380379&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F242-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380379 Fri, 19 Mar 2010 11:45:06 +0100 3380379 http://www.medworm.com/index.php?rid=3380378&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F242-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380378 Fri, 19 Mar 2010 11:45:06 +0100 3380378 http://www.medworm.com/index.php?rid=3380377&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F241%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380377 Fri, 19 Mar 2010 11:45:06 +0100 3380377 http://www.medworm.com/index.php?rid=3380376&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F239%3Frss%3D1 A young man presented to the emergency department with ventricular tachyarrhythmia later attributed to varicella zoster myocarditis. Myocarditis has an unpredictable clinical sequelae, making it a difficult condition to diagnose and manage in the emergency setting. The inconsistent clinical presentations, risks and management are demonstrated through a review of the literature. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380376 Fri, 19 Mar 2010 11:45:06 +0100 3380376 http://www.medworm.com/index.php?rid=3380375&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F238%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380375 Fri, 19 Mar 2010 11:45:06 +0100 3380375 http://www.medworm.com/index.php?rid=3380374&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F237%3Frss%3D1 Congenital central hypoventilation syndrome is a rare illness, which classically presents in the neonatal period; newborns present with shallow breathing and cyanosis, without a physiological rise in breathing rate. Incidence has been estimated from 1 in 10 000 to 1 in 200 000 live births. This case report describes the case of a young man who was asymptomatic until his presentation in acute respiratory failure at the age of 36 years. This case is reported to highlight the importance of considering this treatable illness as a potential cause of collapse and respiratory failure in adults presenting to emergency departments. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380374 Fri, 19 Mar 2010 11:45:06 +0100 3380374 http://www.medworm.com/index.php?rid=3380373&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F235%3Frss%3D1 We report a case of an 11-year-old girl presenting in acute confusional state, with few historical factors suggestive of an intracranial mass lesion and no objective localising signs on examination. Although initially treated as encephalitis, neuroimaging revealed a large craniopharyngioma with acute hydrocephalus and bilateral frontal lobe compression. She was transferred immediately to the local neurosurgical unit and underwent reservoir drainage of the cystic tumour within 24 h. This resulted in immediate symptomatic resolution. This case highlights the importance of early cerebral imaging in the paediatric patient with diagnostic uncertainty and suggests a high index of suspicion for space-occupying lesions in children, despite perceived duration of symptoms. (Source: Emergency Me... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380373 Fri, 19 Mar 2010 11:45:06 +0100 3380373 http://www.medworm.com/index.php?rid=3380372&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F234%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380372 Fri, 19 Mar 2010 11:45:06 +0100 3380372 http://www.medworm.com/index.php?rid=3380371&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F233%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380371 Fri, 19 Mar 2010 11:45:06 +0100 3380371 http://www.medworm.com/index.php?rid=3380370&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F226%3Frss%3D1 Paramedic tracheal intubation has been practised in the UK for more than 20 years and is currently a core skill for paramedics. Growing evidence suggests that tracheal intubation is not the optimal method of airway management by paramedics and may be detrimental to patient outcomes. There is also evidence that the current initial training of 25 intubations performed in-hospital is inadequate, and that the lack of ongoing intubation practice may compound this further. Supraglottic airway devices (eg, laryngeal mask airway), which were not available when extended training and paramedic intubation was first introduced, are now in use in many ambulance services and are a suitable alternative prehospital airway device for paramedics. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380370 Fri, 19 Mar 2010 11:45:06 +0100 3380370 http://www.medworm.com/index.php?rid=3380369&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F225%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380369 Fri, 19 Mar 2010 11:45:06 +0100 3380369 http://www.medworm.com/index.php?rid=3380368&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F224%3Frss%3D1 The case is presented of epiglottal and pre-epiglottal oedema secondary to infection of the pharyngolaryngeal area. The purpose of this report was to assess the utility of ultrasonography to image epiglottal and pre-epiglottal oedema. Bedside emergency department ultrasonography could be a valuable tool to detect pathological enlargement of the epiglottis. Ultrasonography may be used in unstable patients for diagnosing epiglottitis because it is cheap, rapid, non-invasive and does not aggravate the patient's symptoms. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380368 Fri, 19 Mar 2010 11:45:06 +0100 3380368 http://www.medworm.com/index.php?rid=3380367&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F221%3Frss%3D1 The East of England Ambulance Service NHS Trust (the Trust) was keen to engage young patients and to encourage them to give feedback about the service they had received. The standard Trust satisfaction survey was modified for use with young patients, and this had the effect of increasing the response rate from this patient group by 8%, and increasing the percentage of young patients aged 5–10 years completing the survey themselves by 29%. The vast majority of parents/guardians were happy for the Trust to survey their child, but the age of the child affected to whom they would like the survey sent. The Trust subsequently altered patient survey practice to write to parents/guardians of patients aged <12 years and directly to all patients aged ≥12 years. (Source: Em... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380367 Fri, 19 Mar 2010 11:45:06 +0100 3380367 http://www.medworm.com/index.php?rid=3380366&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F220%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380366 Fri, 19 Mar 2010 11:45:06 +0100 3380366 http://www.medworm.com/index.php?rid=3380365&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F216%3Frss%3D1 Conclusion Patients with traumatic brain injury during the early period accounted for a large proportion of the patients wounded in the Wenchuan earthquake, and their conditions changed quickly. The patients all came from the plain area which has convenient transportation. After admission, providing first-aid early had a significant effect on increasing the success of treatment for these patients. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380365 Fri, 19 Mar 2010 11:45:06 +0100 3380365 http://www.medworm.com/index.php?rid=3380364&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F213%3Frss%3D1 Conclusions GPs and consultants in emergency medicine both believe a high proportion of NHS 24 referrals to the ED should be handled by primary care services. This would suggest that, compared with previous out-of-hours practice, NHS 24 favours an ED outcome. The results indicate a large proportion of primary care patients are being handled inappropriately and uneconomically in the ED setting. There is a need for ongoing improvement of the telephone triage service provided by NHS 24. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380364 Fri, 19 Mar 2010 11:45:06 +0100 3380364 http://www.medworm.com/index.php?rid=3380363&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F212%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380363 Fri, 19 Mar 2010 11:45:06 +0100 3380363 http://www.medworm.com/index.php?rid=3380362&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F209%3Frss%3D1 Conclusions Serum S100B levels are raised in all patients with acute spinal fracture without head injury. Spinal fracture may therefore be one of the extracerebral sources of S100B. Serum S100B levels may be an effective tool for excluding subtle spinal fractures with no clear radiographic findings. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380362 Fri, 19 Mar 2010 11:45:06 +0100 3380362 http://www.medworm.com/index.php?rid=3380361&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F207%3Frss%3D1 Conclusion Infants who fall down stairs with their carer or are dropped while being carried down stairs require an especially close evaluation. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380361 Fri, 19 Mar 2010 11:45:06 +0100 3380361 http://www.medworm.com/index.php?rid=3380360&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F206%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380360 Fri, 19 Mar 2010 11:45:06 +0100 3380360 http://www.medworm.com/index.php?rid=3380359&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F203%3Frss%3D1 Conclusions There are readily measurable clinical features that are associated with repeat ED attendance as a result of domestic assault. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380359 Fri, 19 Mar 2010 11:45:06 +0100 3380359 http://www.medworm.com/index.php?rid=3380358&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F199%3Frss%3D1 Conclusion Episodic drinking is not only a problem in the 16–25 age group, it also concerns men of 35–45 years. This is a major public health problem in industrialised countries. Intoxicated patients are at acute risk of injuries and violence following alcohol abuse. Preventive measures should not only be limited to younger adults. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380358 Fri, 19 Mar 2010 11:45:06 +0100 3380358 http://www.medworm.com/index.php?rid=3380357&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F198%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380357 Fri, 19 Mar 2010 11:45:06 +0100 3380357 http://www.medworm.com/index.php?rid=3380356&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F194%3Frss%3D1 Conclusions POC testing for troponin in the ED tended to reduce the LOS for possible ACS patients. The degree of this benefit is likely to be markedly dependent on its acceptance and uptake by attending personnel, and on the ED setting in which it is used. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380356 Fri, 19 Mar 2010 11:45:06 +0100 3380356 http://www.medworm.com/index.php?rid=3380355&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F193%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380355 Fri, 19 Mar 2010 11:45:06 +0100 3380355 http://www.medworm.com/index.php?rid=3380354&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F191%3Frss%3D1 Conclusions There are few trauma teams in Scottish acute hospitals. There was little enthusiasm for introducing them for a variety of reasons. Local evidence of benefit is probably needed before their adoption becomes widespread. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380354 Fri, 19 Mar 2010 11:45:06 +0100 3380354 http://www.medworm.com/index.php?rid=3380353&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F189%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380353 Fri, 19 Mar 2010 11:45:06 +0100 3380353 http://www.medworm.com/index.php?rid=3380352&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F186%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380352 Fri, 19 Mar 2010 11:45:06 +0100 3380352 http://www.medworm.com/index.php?rid=3380351&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F183%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380351 Fri, 19 Mar 2010 11:45:06 +0100 3380351 http://www.medworm.com/index.php?rid=3380350&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F181%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380350 Fri, 19 Mar 2010 11:45:06 +0100 3380350 http://www.medworm.com/index.php?rid=3380349&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F179%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380349 Fri, 19 Mar 2010 11:45:06 +0100 3380349 http://www.medworm.com/index.php?rid=3380348&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F178%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380348 Fri, 19 Mar 2010 11:45:06 +0100 3380348 http://www.medworm.com/index.php?rid=3380347&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F173%3Frss%3D1 Conclusions The evidence NICE cited is of variable quality. Much of the research was conducted outside the UK, which raises questions about its relevance to the NHS. Care of traumatic brain injuries in the UK is already hampered by the inadequate capacity of regional neurosurgical units to meet demand, and transferring more patients would be likely to exacerbate this. Increasing the number of transfers could also worsen inequalities of access for other groups, such as elective patients, particularly in areas where facilities are most stretched. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380347 Fri, 19 Mar 2010 11:45:06 +0100 3380347 http://www.medworm.com/index.php?rid=3380346&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F172%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380346 Fri, 19 Mar 2010 11:45:06 +0100 3380346 http://www.medworm.com/index.php?rid=3380345&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F171%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380345 Fri, 19 Mar 2010 11:45:06 +0100 3380345 http://www.medworm.com/index.php?rid=3380344&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F167%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380344 Fri, 19 Mar 2010 11:45:06 +0100 3380344 http://www.medworm.com/index.php?rid=3380343&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F166%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380343 Fri, 19 Mar 2010 11:45:06 +0100 3380343 http://www.medworm.com/index.php?rid=3380342&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F3%2F165%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3380342 Fri, 19 Mar 2010 11:45:06 +0100 3380342 http://www.medworm.com/index.php?rid=3271879&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F164%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271879 Mon, 15 Feb 2010 10:33:10 +0100 3271879 http://www.medworm.com/index.php?rid=3271878&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F161%3Frss%3D1 Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischaemia with a high mortality. It most commonly occurs in young women with few risk factors for atherosclerosis. Presentation is varied, from sudden death to chest pain with features of myocardial ischaemia. The case presented highlights the dilemma of the need to treat a myocardial infarction within an acceptable time frame versus exploring a rare but entirely possible pathology, which may only be diagnosed in a tertiary referral centre a minimum of 90 min away. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271878 Mon, 15 Feb 2010 10:33:10 +0100 3271878 http://www.medworm.com/index.php?rid=3271877&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F160%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271877 Mon, 15 Feb 2010 10:33:10 +0100 3271877 http://www.medworm.com/index.php?rid=3271876&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F159%3Frss%3D1 A 46-year-old man took a lethal dose of an agent called dinitrophenol (DNP). He presented 11 h after ingestion with loin pain, diarrhoea and vomiting. He rapidly deteriorated with profound hyperthermia, acute renal failure, hyperkalaemia, metabolic acidosis and eventually haemodynamic instability. Despite aggressive supportive measures and rapid sequence induction, he deteriorated and died 21 h after ingestion. DNP is a metabolic poison that acts by uncoupling oxidative phosphorylation, leading to uncontrolled hyperthermia. It is an illegal weight loss agent that is used by body builders and is freely available on many internet websites. This case highlights the potential for patients to obtain and ingest exotic poisons. A summary of currently recommended treatment and a review o... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271876 Mon, 15 Feb 2010 10:33:10 +0100 3271876 http://www.medworm.com/index.php?rid=3271875&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F156%3Frss%3D1 We describe two patients who suffered multi-system trauma, with severe maxillofacial injuries that necessitated prompt definitive airway management and mid-face stabilisation in the pre-hospital and emergency department phases of resuscitation. The McKesson prop is a simple yet highly effective tool for use in these injuries. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271875 Mon, 15 Feb 2010 10:33:10 +0100 3271875 http://www.medworm.com/index.php?rid=3271874&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F151%3Frss%3D1 Conclusions Prehospital treatment with oxygen, aspirin, sublingual GTN and ECG monitoring remains underused by paramedics, even though only a small number of patients had documented contraindications to their use. The small number of patients who received a prehospital 12-lead ECG is a cause of particular concern and suggests that incomplete patient assessment may contribute to undertreatment. Further provision of training and equipment is necessary to enable paramedics to more accurately assess and treat patients with acute coronary syndromes. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271874 Mon, 15 Feb 2010 10:33:10 +0100 3271874 http://www.medworm.com/index.php?rid=3271873&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F147%3Frss%3D1 Conclusions We found medical students developed a significantly improved understanding of prehospital care. Without extraordinary effort, academic emergency departments could easily include a significant experience and education within fourth-year EM clerkships. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271873 Mon, 15 Feb 2010 10:33:10 +0100 3271873 http://www.medworm.com/index.php?rid=3271872&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F145%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271872 Mon, 15 Feb 2010 10:33:10 +0100 3271872 http://www.medworm.com/index.php?rid=3271871&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F144%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271871 Mon, 15 Feb 2010 10:33:10 +0100 3271871 http://www.medworm.com/index.php?rid=3271870&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F142%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271870 Mon, 15 Feb 2010 10:33:10 +0100 3271870 http://www.medworm.com/index.php?rid=3271869&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F141-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271869 Mon, 15 Feb 2010 10:33:10 +0100 3271869 http://www.medworm.com/index.php?rid=3271868&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F141-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271868 Mon, 15 Feb 2010 10:33:10 +0100 3271868 http://www.medworm.com/index.php?rid=3271867&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F133%3Frss%3D1 Hand, wrist and forearm injuries are common presentations to the emergency department. There is a huge variation of severity from small lacerations involving only skin to extensive upper limb composite loss. There is no minor injury in upper limb trauma. Even the most trivial of wounds may be associated with major tendon or nerve damage which, if missed, may have life-long functional implications for the patient. Although this review concentrates on soft tissue injury and not bony injury, it is not possible to separate the two completely. It is important to realise that all fractures have a soft tissue injury component that needs to be assessed and correctly treated. In some instances the soft tissue component is much more important than the fracture, and failure to recognise it will resul... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271867 Mon, 15 Feb 2010 10:33:10 +0100 3271867 http://www.medworm.com/index.php?rid=3271866&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F131%3Frss%3D1 Diffusion-weighted MRI, a type of MR technique that can distinguish between cerebral fat embolism and diffuse axonal injury, is presented in this report. Emergency physicians should consider using diffusion-weighted imaging in unconscious trauma patients when their brain CT scans are unremarkable. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271866 Mon, 15 Feb 2010 10:33:10 +0100 3271866 http://www.medworm.com/index.php?rid=3271865&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F128%3Frss%3D1 Conclusion The FFC was well-attended suggesting that families appreciated early follow-up and the opportunity to address their concerns and provide advice about what to do if there was a recurrence. The study also demonstrated that approximately one-third of children were misdiagnosed as having experienced a tonic-clonic seizure. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271865 Mon, 15 Feb 2010 10:33:10 +0100 3271865 http://www.medworm.com/index.php?rid=3271864&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F125%3Frss%3D1 Conclusions In this audit, most violence in which children were injured took place in schools and in the street. For children of secondary school age, ED treatment rarely prompted referral or discussion with agencies responsible for child safety. Particularly since youth and child violence are major national issues, policy and practice in this area were developed and built on disclosure of all such cases to a single referral point in the local authority education department. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271864 Mon, 15 Feb 2010 10:33:10 +0100 3271864 http://www.medworm.com/index.php?rid=3271863&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F124%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271863 Mon, 15 Feb 2010 10:33:10 +0100 3271863 http://www.medworm.com/index.php?rid=3271862&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F121%3Frss%3D1 Conclusions Survival of seriously injured combat casualties was good, although identical to that of a control group. Methodological limitations of this retrospective study preclude making firm conclusions about the effectiveness of rFVIIa. Future controlled studies are needed for safety and efficacy testing of rFVIIa in combat trauma patients. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271862 Mon, 15 Feb 2010 10:33:10 +0100 3271862 http://www.medworm.com/index.php?rid=3271861&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F116%3Frss%3D1 Conclusion The majority of CT head imaging scans can be interpreted safely by emergency physicians in trauma and suspected subarachnoid haemorrhage. We believe a safe and viable clinical service is provided and such a model is applicable in other centres. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271861 Mon, 15 Feb 2010 10:33:10 +0100 3271861 http://www.medworm.com/index.php?rid=3271860&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F110%3Frss%3D1 Conclusions Reported management of early sepsis varies between specialities and countries, and the responses do not follow SSC guidelines. Concerns relate to knowledge, attitudes and resources. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271860 Mon, 15 Feb 2010 10:33:10 +0100 3271860 http://www.medworm.com/index.php?rid=3271859&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F109%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271859 Mon, 15 Feb 2010 10:33:10 +0100 3271859 http://www.medworm.com/index.php?rid=3271858&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F105%3Frss%3D1 Conclusion An increased level of BUN is a more significant risk factor for ACS outcomes than that of creatinine. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271858 Mon, 15 Feb 2010 10:33:10 +0100 3271858 http://www.medworm.com/index.php?rid=3271857&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F100%3Frss%3D1 This paper describes the potential benefits, pitfalls and barriers to adopting e-learning in emergency medicine. While the benefits relating to access, engagement and quality assurance are clear, caution is urged in embracing e-learning for e-learning's sake. It is argued that, if educational strategies are to change, this must be to the benefit of learners and not just for the convenience of access or record keeping. A variety of e-learning approaches are available, but those that promote group discussion or provide feedback from an educator are more likely to lead to successful learning than stand-alone feedback-free modules. A blended approach to learning is advocated where e-learning opportunities form an important but limited part of the overall educational experience. Shop floor and ... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271857 Mon, 15 Feb 2010 10:33:10 +0100 3271857 http://www.medworm.com/index.php?rid=3271856&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F97%3Frss%3D1 Conclusions There will need to be an increase in the number of trained clinicians within emergency medicine to continue to deliver effective training and supervision and ensure a safe, good quality service to patients. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271856 Mon, 15 Feb 2010 10:33:10 +0100 3271856 http://www.medworm.com/index.php?rid=3271855&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F93%3Frss%3D1 Conclusions The clinical implication is that patients with any combination of previous main diagnoses of mental disorder, alcohol use, drug intoxication, a non-causative diagnosis or with the classification category factors influencing health status should be evaluated and assessed for potential risk of suicide or fatal drug poisoning. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271855 Mon, 15 Feb 2010 10:33:10 +0100 3271855 http://www.medworm.com/index.php?rid=3271854&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F92%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271854 Mon, 15 Feb 2010 10:33:10 +0100 3271854 http://www.medworm.com/index.php?rid=3271853&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F86%3Frss%3D1 Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countries and efforts made to ensure consistency of application. However, the ongoing crowding of emergency departments resulting from access block and increased demand has led to calls for a review of systems of triage. In addition, international variance in triage systems limits the capacity for benchmarking. The aim of this paper is to provide a critical review of the literature pertaining to emergency department triage in order to inform the d... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271853 Mon, 15 Feb 2010 10:33:10 +0100 3271853 http://www.medworm.com/index.php?rid=3271852&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F81%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271852 Mon, 15 Feb 2010 10:33:10 +0100 3271852 http://www.medworm.com/index.php?rid=3271851&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F80%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271851 Mon, 15 Feb 2010 10:33:10 +0100 3271851 http://www.medworm.com/index.php?rid=3271850&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F2%2F79%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3271850 Mon, 15 Feb 2010 10:33:10 +0100 3271850 http://www.medworm.com/index.php?rid=3112747&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F78%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112747 Tue, 22 Dec 2009 21:18:11 +0100 3112747 http://www.medworm.com/index.php?rid=3112746&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F77-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112746 Tue, 22 Dec 2009 21:18:11 +0100 3112746 http://www.medworm.com/index.php?rid=3112745&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F77-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112745 Tue, 22 Dec 2009 21:18:11 +0100 3112745 http://www.medworm.com/index.php?rid=3112744&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F76%3Frss%3D1 The case report is presented of a 14-year-old boy with persistent right hip and groin pain. After failing to respond to conventional management, the patient was admitted and investigated. He had a fever and raised inflammatory markers. MRI of the pelvis revealed pyomyositis of the right adductor compartment extending into the pelvis. Pyomyositis should be considered in a patient with pain disproportionate to the physical examination findings. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112744 Tue, 22 Dec 2009 21:18:11 +0100 3112744 http://www.medworm.com/index.php?rid=3112743&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F74%3Frss%3D1 We report a potential interaction between pomegranate juice and warfarin. Laboratory studies have shown that pomegranate juice inhibits cytochrome P450 enzymes involved in warfarin metabolism. As with previous reports of interactions between food and warfarin, this case does not definitively prove the association between pomegranate juice consumption and increased warfarin bioactivity but highlights the importance of taking a complete drug, food and juice history when assessing patients with unstable anticoagulation. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112743 Tue, 22 Dec 2009 21:18:11 +0100 3112743 http://www.medworm.com/index.php?rid=3112742&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F72%3Frss%3D1 A previously fit and well 18-year-old woman presented to the accident and emergency department following referral by her general practitioner with a provisional diagnosis of appendicitis. The history obtained from the patient revealed the presence of a bitemporal headache with associated neck stiffness, photophobia and vomiting for approximately 1.5 weeks. The patient complained of abdominal pain localised to her right iliac fossa and anorexia for approximately 1 week. She also noted the presence of a cough productive of green sputum for 3 weeks. A chest radiograph was obtained which showed a large area of consolidation in the right lower lobe consistent with infection and a linear density in keeping with a metallic foreign body. Following review of the chest radiograph, the patient was in... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112742 Tue, 22 Dec 2009 21:18:11 +0100 3112742 http://www.medworm.com/index.php?rid=3112741&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F62%3Frss%3D1 Conclusions: This review offers a starting point for services based on the evidence currently available. It is hoped that prehospital and retrieval clinicians will start to look analytically at what they carry and, through a process of audit, aim to improve the evidence in this area. Future reviews and comparisons of worldwide prehospital and retrieval databases are suggested. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112741 Tue, 22 Dec 2009 21:18:11 +0100 3112741 http://www.medworm.com/index.php?rid=3112740&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F61%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112740 Tue, 22 Dec 2009 21:18:11 +0100 3112740 http://www.medworm.com/index.php?rid=3112739&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F59%3Frss%3D1 This report demonstrates the importance of including external chest compression as a method of resuscitation in first aid for cases of life-threatening asphyxic asthma. Chest compression may be the only way that death of such patients may be avoided. Three such patients, two with respiratory arrest, were successfully treated by external chest compression. During the 1960s, there was an increase in asthma deaths, 81% of which occurred unexpectedly, outside the hospital. This coincided with the abandonment of the trusted methods of chest compression and the introduction of mouth-to-mouth resuscitation. Acute asphyxic asthma was the most common cause of death. In acute asphyxic asthma, the chest wall does not deflate spontaneously. The trapped air must be expelled by external compression. Mou... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112739 Tue, 22 Dec 2009 21:18:11 +0100 3112739 http://www.medworm.com/index.php?rid=3112738&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F57%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112738 Tue, 22 Dec 2009 21:18:11 +0100 3112738 http://www.medworm.com/index.php?rid=3112737&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F56%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112737 Tue, 22 Dec 2009 21:18:11 +0100 3112737 http://www.medworm.com/index.php?rid=3112736&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F55%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112736 Tue, 22 Dec 2009 21:18:11 +0100 3112736 http://www.medworm.com/index.php?rid=3112735&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F53-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112735 Tue, 22 Dec 2009 21:18:11 +0100 3112735 http://www.medworm.com/index.php?rid=3112734&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F53-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112734 Tue, 22 Dec 2009 21:18:11 +0100 3112734 http://www.medworm.com/index.php?rid=3112733&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F52%3Frss%3D1 Upper labial frenal tear in infants is classically taught as having associations with non-accidental injury. Collection of data for a 12-month period in our paediatric facial injury study revealed that this injury pattern is common in ambulant children and was associated with other facial trauma. In assessing the possibility of this injury being due to abuse, the importance of the mobility of the child and the mechanism of the injury are paramount. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112733 Tue, 22 Dec 2009 21:18:11 +0100 3112733 http://www.medworm.com/index.php?rid=3112732&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F50%3Frss%3D1 Conclusions: An online usergroup such as Google Groups may provide powerful support to an organisation’s clinical governance. We recommend this tool to other services with limited administrative personnel. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112732 Tue, 22 Dec 2009 21:18:11 +0100 3112732 http://www.medworm.com/index.php?rid=3112731&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F48%3Frss%3D1 Ice skating is becoming more popular throughout the UK, with temporary ice rinks opening in many city centres during holiday periods, especially during Christmas. Data were collected from patients who presented to the local emergency department with injuries sustained on a nearby city-centre temporary ice rink. Injuries related to ice rinks accounted for 0.76% of all emergency department attendances and represented 0.29% of ice rink participants (2.9 per 1000). Women in the older age range sustained the most significant injuries. Our study has shown that the rate of injuries per 1000 ice rink participants is comparable with data recorded when a new ice rink is opened. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112731 Tue, 22 Dec 2009 21:18:11 +0100 3112731 http://www.medworm.com/index.php?rid=3112730&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F43%3Frss%3D1 Conclusion: Implementation of a multifaceted change program reduced the number of D-dimer test requests in both hospitals and may have improved the diagnostic workup for PE at hospital 1. Processes that speed patient transit through the emergency department may impact negatively on other aspects of patient care. This should be the subject of further studies. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112730 Tue, 22 Dec 2009 21:18:11 +0100 3112730 http://www.medworm.com/index.php?rid=3112729&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F36%3Frss%3D1 Conclusions: TQS reliably predicts tetanus immunity and is reproducible by healthcare providers. Although it may not accurately discriminate between patients with ongoing and declining immunity, it is currently the most sensitive and specific tool for guiding tetanus prophylaxis and should be included in current guidelines on UTP. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112729 Tue, 22 Dec 2009 21:18:11 +0100 3112729 http://www.medworm.com/index.php?rid=3112728&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F32%3Frss%3D1 Conclusion: Most participants considered morning report sessions held in our hospital to be effective in the way it is; however, issues such as communication skill, emergency department management, critical thinking, ethics, professionalism and evidence-based medicine should also be added to the sessions. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112728 Tue, 22 Dec 2009 21:18:11 +0100 3112728 http://www.medworm.com/index.php?rid=3112727&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F29%3Frss%3D1 Conclusions: Chest x ray and CT scan are sufficient to diagnose SPM. Additional diagnostic assessments such as oesophagography and oesophagoscopy are not necessary in patients without evidence of mediastinitis or a history of oesophageal injury. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112727 Tue, 22 Dec 2009 21:18:11 +0100 3112727 http://www.medworm.com/index.php?rid=3112726&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F26%3Frss%3D1 Conclusion: The identification of children who attend EDs frequently may be useful for other reasons but is unlikely to be an effective way to detect child abuse. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112726 Tue, 22 Dec 2009 21:18:11 +0100 3112726 http://www.medworm.com/index.php?rid=3112725&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F22%3Frss%3D1 In this study, routinely collected coding data before, during and after the changes were analysed. Each September and October between 1999 and 2006 were included. Results: There was a steady increase in all attendances at our emergency department. The number and proportions of patients with non-traumatic conditions rose steadily throughout the study period. The number of patients presenting with traumatic conditions stayed the same. The number of patients presenting with non-traumatic conditions out-of-hours rose after the changes were implemented. Interpretation: The changes to the provision of out-of-hours primary care have been associated with an increase in patients with non-traumatic attendances presenting to our emergency department. This effect is most marked outside of office hou... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112725 Tue, 22 Dec 2009 21:18:11 +0100 3112725 http://www.medworm.com/index.php?rid=3112724&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F21%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112724 Tue, 22 Dec 2009 21:18:11 +0100 3112724 http://www.medworm.com/index.php?rid=3112723&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F17%3Frss%3D1 Conclusion: The education initiative resulted in significant improvements in the evidence-based use of bupivacaine, and its adoption by others is recommended. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112723 Tue, 22 Dec 2009 21:18:11 +0100 3112723 http://www.medworm.com/index.php?rid=3112722&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F13%3Frss%3D1 Conclusion: The FFC is a more realistic and preferred model for direct laryngoscopic orotracheal intubation training. Trucorp and Laerdal manikin can be used as alternative models. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112722 Tue, 22 Dec 2009 21:18:11 +0100 3112722 http://www.medworm.com/index.php?rid=3112721&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F8%3Frss%3D1 Conclusions: SMAC using left paramedian compression technique failed to improve CPP during CPR and resuscitation outcomes. Furthermore, this method could not avoid liver laceration. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112721 Tue, 22 Dec 2009 21:18:11 +0100 3112721 http://www.medworm.com/index.php?rid=3112720&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F5%3Frss%3D1 Conclusion: When planning early outbreak surveillance, provision of adequate PCR testing capacity rather than triaging specimens using rapid antigen testing for influenza is advisable. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112720 Tue, 22 Dec 2009 21:18:11 +0100 3112720 http://www.medworm.com/index.php?rid=3112719&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F3%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112719 Tue, 22 Dec 2009 21:18:11 +0100 3112719 http://www.medworm.com/index.php?rid=3112718&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F2%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112718 Tue, 22 Dec 2009 21:18:11 +0100 3112718 http://www.medworm.com/index.php?rid=3112717&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F27%2F1%2F1%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3112717 Tue, 22 Dec 2009 21:18:11 +0100 3112717 http://www.medworm.com/index.php?rid=3024156&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F920%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024156 Tue, 24 Nov 2009 18:04:19 +0100 3024156 http://www.medworm.com/index.php?rid=3024155&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F919-c%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024155 Tue, 24 Nov 2009 18:04:19 +0100 3024155 http://www.medworm.com/index.php?rid=3024154&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F919-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024154 Tue, 24 Nov 2009 18:04:19 +0100 3024154 http://www.medworm.com/index.php?rid=3024153&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F919%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024153 Tue, 24 Nov 2009 18:04:19 +0100 3024153 http://www.medworm.com/index.php?rid=3024152&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F918-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024152 Tue, 24 Nov 2009 18:04:19 +0100 3024152 http://www.medworm.com/index.php?rid=3024151&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F918-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024151 Tue, 24 Nov 2009 18:04:19 +0100 3024151 http://www.medworm.com/index.php?rid=3024150&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F915%3Frss%3D1 This report demonstrates that spontaneous splenic rupture requires a high index of suspicion for diagnosis in a patient who received haemodialysis with abdominal pain and should be considered in the differential diagnosis when a patient who received haemodialysis without any trauma history has abdominal pain with unexplained hypovolemic shock. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024150 Tue, 24 Nov 2009 18:04:19 +0100 3024150 http://www.medworm.com/index.php?rid=3024149&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F914%3Frss%3D1 Pneumothorax is a common presentation to the emergency department, arising from traumatic and non-traumatic aetiologies. Diagnosis of non-tension pneumothorax is by a visible lung edge on chest radiography together with the absence of lung markings more peripherally. The Advanced Trauma Life Support (ATLS) system recommends tube thoracostomy as the definitive treatment for traumatic pneumothorax. The case is described of a patient who presented following thoracic trauma with an unusual finding on chest radiography that led to diagnostic confusion by mimicking a pneumothorax. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024149 Tue, 24 Nov 2009 18:04:19 +0100 3024149 http://www.medworm.com/index.php?rid=3024148&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F913%3Frss%3D1 The case is reported of a 52-year-old woman who suffered a minor head injury and orbital trauma and returned 2 days later with a unilateral headache, vomiting and photophobia. This was initially thought to be secondary to her head injury but, once severe visual impairment and a dilated unreactive pupil developed, the true diagnosis became obvious. A diagnosis of acute angle closure glaucoma was made and she was treated with no complications. This case highlights acute angle closure glaucoma as an important diagnosis to consider in patients who present with unilateral headache and dilated pupil after head injury. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024148 Tue, 24 Nov 2009 18:04:19 +0100 3024148 http://www.medworm.com/index.php?rid=3024147&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F911%3Frss%3D1 Adenosine is frequently used as first-line therapy for supraventricular tachycardia in both adults and children. A large bore cannula is recommended to ensure a rapid rate of delivery, as adenosine has a relatively short half-life. This may not always be considered in paediatric patients. This case concerns a 15-year-old male patient who presented to the emergency department with a fast heart rate, who had previously required repeated high doses of adenosine. The case reinforces the need for a large bore cannula when giving intravenous adenosine. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024147 Tue, 24 Nov 2009 18:04:19 +0100 3024147 http://www.medworm.com/index.php?rid=3024146&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F909%3Frss%3D1 A rare cause of acute lower abdominal pain in pubertal girls is described. The diagnosis is often missed at initial presentation and this may result in multiple presentations to the emergency department or general practitioner. The clinical features, diagnosis, management and possible complications of this condition are discussed. The case illustrates the importance of keeping this diagnosis in mind when seeing teenage girls with lower abdominal pain. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024146 Tue, 24 Nov 2009 18:04:19 +0100 3024146 http://www.medworm.com/index.php?rid=3024145&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F908%3Frss%3D1 A case report is presented of an aortic dissection in a patient with Turner’s syndrome that went undignosed. A thorough discussion of this fatal condition in this group of patients is included. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024145 Tue, 24 Nov 2009 18:04:19 +0100 3024145 http://www.medworm.com/index.php?rid=3024144&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F906%3Frss%3D1 The case histories are presented of four athletes taking part in a 95-mile ultra-endurance foot race in Scotland who were hospitalised after developing exercise-associated hyponatraemia and rhabdomyolysis. Exercise-associated hyponatraemia is relatively uncommon in temperate climates. Risk factors disposing to this disorder are discussed. Exercise-associated hyponatraemia is thought to be due to overconsumption of hypotonic fluid with other associated pathophysiology including an inability to suppress fully antidiuretic hormone during exercise or to mobilise adequate sodium from osmotically inactive internal stores. Non-specific symptoms make this disorder difficult to diagnose on site without the assistance of serum sodium measurement, but any delay in treatment of patients with encephalo... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024144 Tue, 24 Nov 2009 18:04:19 +0100 3024144 http://www.medworm.com/index.php?rid=3024143&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F904%3Frss%3D1 A 58-year-old man presented to the emergency department with sudden onset rapid palpitations and significant presyncope while walking on the flat. The previous day he had undergone DC cardioversion for atrial fibrillation (AF) which had been initially successful. However, 6 h after cardioversion he was aware of intermittently raised but regular heart rates. On arrival at the emergency department (ED) he was well with no haemodynamic compromise. The ECG showed an atrial tachycardia instead of AF. Medications consisted of propafenone 300 mg twice daily, bisoprolol 5 mg at night and warfain. Bisoprolol was increased to 5 mg twice daily and he was discharged with a plan for outpatient ablation. He collapsed in the hospital car park with rapid palpations, chest tightness and vagal symptoms. On ... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024143 Tue, 24 Nov 2009 18:04:19 +0100 3024143 http://www.medworm.com/index.php?rid=3024142&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F903%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024142 Tue, 24 Nov 2009 18:04:19 +0100 3024142 http://www.medworm.com/index.php?rid=3024141&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F899%3Frss%3D1 Conclusions: Disaster medicine courses based on pattern recognition skill development improve triage performance of healthcare students during simulated MCI. This study may have a high impact on healthcare students and professionals’ education in the perspective of MCIs preparedness and response. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024141 Tue, 24 Nov 2009 18:04:19 +0100 3024141 http://www.medworm.com/index.php?rid=3024140&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F896%3Frss%3D1 Conclusions: After evaluating the current literature, the authors found no support for the view that the horizontal position may be potentially fatal for patients exposed to suspension trauma. In the absence of any evidence to the contrary, the authors suggest that the initial management of patients who have had suspension trauma should follow normal guidelines for the acute care of traumatised patients, without special modifications. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024140 Tue, 24 Nov 2009 18:04:19 +0100 3024140 http://www.medworm.com/index.php?rid=3024139&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F892%3Frss%3D1 Conclusions: Many reasons account for the differences in provision. There is a clear need for a standard to be set nationally in conjunction with locally implemented evaluation and re-accreditation processes. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024139 Tue, 24 Nov 2009 18:04:19 +0100 3024139 http://www.medworm.com/index.php?rid=3024138&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F888%3Frss%3D1 Conclusion: Paramedics use advanced airway skills infrequently. Continuing professional development programmes within ambulance trusts do not provide the necessary additional practice to maintain tracheal intubation skills at an acceptable level. Advanced airway management delivered by ambulance crews is likely to be inadequate with such infrequent exposure to the skill. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024138 Tue, 24 Nov 2009 18:04:19 +0100 3024138 http://www.medworm.com/index.php?rid=3024137&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F887%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024137 Tue, 24 Nov 2009 18:04:19 +0100 3024137 http://www.medworm.com/index.php?rid=3024136&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F883%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024136 Tue, 24 Nov 2009 18:04:19 +0100 3024136 http://www.medworm.com/index.php?rid=3024135&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F881-c%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024135 Tue, 24 Nov 2009 18:04:19 +0100 3024135 http://www.medworm.com/index.php?rid=3024134&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F881-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024134 Tue, 24 Nov 2009 18:04:19 +0100 3024134 http://www.medworm.com/index.php?rid=3024133&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F881-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024133 Tue, 24 Nov 2009 18:04:19 +0100 3024133 http://www.medworm.com/index.php?rid=3024132&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F880%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024132 Tue, 24 Nov 2009 18:04:19 +0100 3024132 http://www.medworm.com/index.php?rid=3024131&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F878%3Frss%3D1 This study looked at the time to treatment of four common medical conditions before and after the establishment of a dedicated MAU. Before the development of the MAU, treatment given in the emergency department (ED; median 111 minutes) was significantly quicker than on the admitting general medical ward (median 262 minutes, p<0.001). Following the establishment of the MAU, treatment given in the ED (median 70 minutes) remained significantly quicker than on the MAU (median 180 minutes, p<0.05). Treatment was given significantly quicker on the MAU compared with the antecedent admitting medical wards (p<0.05). In addition, more patients were treated within protocol-driven time guidelines. In summary, the establishment of a MAU significantly improved time to treatment, compared with a... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024131 Tue, 24 Nov 2009 18:04:18 +0100 3024131 http://www.medworm.com/index.php?rid=3024130&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F877%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024130 Tue, 24 Nov 2009 18:04:18 +0100 3024130 http://www.medworm.com/index.php?rid=3024129&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F871%3Frss%3D1 Conclusions: This study confirms the need for caution in the early discharge of patients with head injury taking anticoagulant medication. This study also raises concerns that patients taking antiplatelet medication prior to injury may also be at high risk of developing covert serious intracranial haemorrhage and suggests the need for a well-designed cohort study looking at antiplatelet risk in head injury. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024129 Tue, 24 Nov 2009 18:04:18 +0100 3024129 http://www.medworm.com/index.php?rid=3024128&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F866%3Frss%3D1 Conclusion: Clinical features have very limited value for diagnosing ACS in patients with a normal or non-diagnostic ECG. Radiation of pain to the right arm increases the likelihood of ACS. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024128 Tue, 24 Nov 2009 18:04:18 +0100 3024128 http://www.medworm.com/index.php?rid=3024127&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F864%3Frss%3D1 Conclusions: The utilisation of trauma resuscitation protocols and guidelines in British emergency departments is limited. Given the clear benefits of these strategies, consideration should be given to greater integration of such algorithms into practice. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024127 Tue, 24 Nov 2009 18:04:18 +0100 3024127 http://www.medworm.com/index.php?rid=3024126&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F863%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024126 Tue, 24 Nov 2009 18:04:18 +0100 3024126 http://www.medworm.com/index.php?rid=3024125&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F861%3Frss%3D1 Conclusions: On average, PSP size calculated on expiratory radiographs is 9% higher than that calculated on matched inspiratory radiographs. Applying current management guidelines, the size difference between inspiratory and expiratory x-rays may alter initial treatment recommendation for some patients. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024125 Tue, 24 Nov 2009 18:04:18 +0100 3024125 http://www.medworm.com/index.php?rid=3024124&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F857%3Frss%3D1 Conclusion: To design a system, the accessibility and confidentiality of information should be addressed in parallel. A balance between these two is needed, as the failure of each of these may negatively influence the use of the system. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024124 Tue, 24 Nov 2009 18:04:18 +0100 3024124 http://www.medworm.com/index.php?rid=3024123&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F856%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024123 Tue, 24 Nov 2009 18:04:18 +0100 3024123 http://www.medworm.com/index.php?rid=3024122&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F854%3Frss%3D1 Conclusions: There is a significant risk of a fracture in children sustaining hyperextension injuries to the PIPJ. These results show that, except in those with an obvious deformity, it is difficult to differentiate clinically between those with a sprain, minor or significant fracture. Even those with a significant fracture were managed conservatively. Children appear not to have the complications seen in the adult population with similar injuries. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024122 Tue, 24 Nov 2009 18:04:18 +0100 3024122 http://www.medworm.com/index.php?rid=3024121&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F850%3Frss%3D1 Conclusion: We have developed an evidence-based guideline that has subsequently been successfully implemented in the paediatric emergency departments and disseminated nationally. Results showing the effect of the guideline upon practice will be published separately. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024121 Tue, 24 Nov 2009 18:04:18 +0100 3024121 http://www.medworm.com/index.php?rid=3024120&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F849%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024120 Tue, 24 Nov 2009 18:04:18 +0100 3024120 http://www.medworm.com/index.php?rid=3024119&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F845%3Frss%3D1 Tetanus is a potentially fatal disease that occurs after contamination of a wound with Clostridium tetani spores. The introduction of comprehensive infant vaccination programmes in the 1960s dramatically reduced the incidence of tetanus in the UK. To achieve comprehensive protection against tetanus, the World Health Organization guidelines recommend the administration of the five-dose childhood immunisation regimen and an additional sixth dose, after approximately 10 years, to ensure long-lasting immunity. To supplement these measures, tetanus prophylaxis with human tetanus immunoglobulin is considered essential for incompletely immunised individuals presenting with dirty wounds. However, identifying those individuals who are not fully immunised has, until recently, been problematical. The... Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024119 Tue, 24 Nov 2009 18:04:18 +0100 3024119 http://www.medworm.com/index.php?rid=3024118&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F844%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024118 Tue, 24 Nov 2009 18:04:18 +0100 3024118 http://www.medworm.com/index.php?rid=3024117&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F12%2F843%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=3024117 Tue, 24 Nov 2009 18:04:18 +0100 3024117 http://www.medworm.com/index.php?rid=2917807&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F11%2F842%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=2917807 Thu, 22 Oct 2009 17:01:24 +0100 2917807 http://www.medworm.com/index.php?rid=2917806&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F11%2F841-b%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=2917806 Thu, 22 Oct 2009 17:01:24 +0100 2917806 http://www.medworm.com/index.php?rid=2917805&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F11%2F841-a%3Frss%3D1 (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=2917805 Thu, 22 Oct 2009 17:01:24 +0100 2917805 http://www.medworm.com/index.php?rid=2917804&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F11%2F840%3Frss%3D1 A very rare case is presented of a woman with subclavian vein thrombosis that resulted from a fragment of her fractured clavicle impinging on the subclavian vein. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=2917804 Thu, 22 Oct 2009 17:01:24 +0100 2917804 http://www.medworm.com/index.php?rid=2917803&cid=s_28223_14_f&fid=28223&url=http%3A%2F%2Femj.bmj.com%2Fcgi%2Fcontent%2Fshort%2F26%2F11%2F839%3Frss%3D1 Bullet embolism to the heart is an unusual complication of penetrating gunshot injuries. A bullet may reach the heart by direct cardiac penetration or entry into the peripheral venous system with embolisation to the heart, which must be differentiated. This is a report of an unusual case of bullet embolism to the heart that was extracted by direct cardiotomy without cardiopulmonary bypass. (Source: Emergency Medicine Journal) Emergency Medicine Journal journals http://www.medworm.com/rss/comments.php?id=2917803 Thu, 22 Oct 2009 17:01:24 +0100 2917803