European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The relatively simple technique of administering a femoral nerve block is known to be quick, safe and effective in providing prolonged analgesia to children with femoral shaft fracture. Although medical literature supports its use in the emergency setting, no studies have been conducted on how this is undertaken in practice. ⋯ There is unnecessary delay in carrying out this procedure for children with fractures to the femoral shaft. A significant degree of reliance on staff external to the Emergency Department was reported. This paper supports increased training and supervision to promote the more widespread and prompt use of femoral nerve blocks as an important standard of care for the Emergency Department.
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To obtain information about patient, staff and organization characteristics of Emergency Departments in the Netherlands, and evaluate the changes between 1996 and 1999. ⋯ Almost all hospitals in the Netherlands reported an increase in the number of patients visiting the Emergency Department, especially in the number of self-referred patients. A majority of the Emergency Departments are now staffed by emergency physicians instead of surgical residents. Developing specific training programmes for emergency physicians should be a priority for the Netherlands in the future.
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A case of open irreducible dislocation of the interphalangeal joint of the thumb with interposed flexor pollicis longus tendon and palmar plate with sesamoid bone is described.
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To compare patient, guardian and professional assessment of acute pain in children presenting to an Emergency Department, and to examine whether there was a correlation between the scores obtained using the Faces and linear scales for each group. ⋯ Professionals score pain lower than do children or guardians. Similar pain scores are obtained using both a Faces and a linear scale. This study offers no support for the introduction of a uniform pain assessment tool in a paediatric Emergency Department setting.
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Comparative Study
The role of the emergency medicine resident using the Alvarado score in the diagnosis of acute appendicitis compared with the general surgery resident.
To compare the accuracy of diagnosing appendicitis between emergency medicine residents using the Alvarado score and general surgery residents using ultrasonography and their clinical provision. ⋯ There was no statistical difference between the emergency medicine residents using the Alvarado score and the general surgery residents in terms of suspecting the diagnosis of appendicitis.