European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Review
Is the management of dog bite wounds evidence based? A postal survey and review of the literature.
To determine current practice in the management of dog bite wounds with regard to the use of prophylactic antibiotics and primary closure and to compare the available evidence. ⋯ The management of recent dog bite wounds is not entirely evidence based in many A and E departments in the UK.
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A 69-year-old patient with a new-onset generalized epileptiform tonic-clonic seizure was successfully diagnosed with pulmonary thromboembolism in the prehospital setting even though the clinical picture suggested an unknown, primarily neurological, problem. Prehospital diagnostic procedures also included capnometry and D-dimer assay. The former showed lower than normal end-tidal carbon dioxide pressure values, and a value of the latter proved to be highly pathological. In the intensive care unit the diagnosis of massive pulmonary thromboembolism was confirmed.
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The incidence of drug and alcohol use is unknown among Danish trauma patients, and has not been thoroughly investigated in Europe. ⋯ The rate of trauma patients with a blood serum level of alcohol greater than 100 mg/dl was similar to a previous European study and to US studies. The prevalence of drugs was less, and benzodiazepines were the most used group of drugs in our study. The routine screening of Danish trauma patients in order to implement preventative measures may be beneficial.
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Clinical Trial
Administration of analgesia for acute abdominal pain sufferers in the accident and emergency setting.
Recent trials suggest that the early administration of analgesia in patients with acute abdominal pain facilitates examination and does not delay diagnosis. We investigated current practice regarding analgesia for these patients. ⋯ This study shows the need for standardized protocols for analgesia usage in patients presenting with acute abdominal pain.
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Hip fracture is a significant injury for older persons. Little has been reported about emergency department (ED) care of these patients. ⋯ The ED visit presents a largely untapped opportunity for focused efforts in fall and hip fracture prevention, especially in countries with comprehensive geriatric services and well integrated healthcare delivery systems. Despite the high likelihood of pain, the administration of analgesics appears to be low and may be a worthy focus for practice improvement.