Journal of accident & emergency medicine
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To examine the use of thrombolytic treatment in patients with suspected acute myocardial infarction (AMI) and left bundle branch block (LBBB). To evaluate electrocardiographic criteria for the identification of AMI in the presence of LBBB, and examine the implications of using these criteria in the clinical setting. ⋯ Currently, thrombolytic treatment is under-utilised in patients with LBBB and AMI, and those who are thrombolysed endure lengthy delays before treatment. Patients with any of the predictive criteria should be thrombolysed immediately. When the diagnosis is in doubt, serial ECGs may demonstrate evolving ischaemic change.
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Clinical Trial Controlled Clinical Trial
Validation of the Ottawa ankle rules in children.
To assess whether the Ottawa ankle rules can be used to accurately predict which children with ankle and midfoot injuries need radiography. ⋯ The Ottawa ankle rules can be applied in children to determine the need for radiography in ankle and midfoot injuries. Their implementation leads to a reduction in the radiography rate without leading to an increase in the number of missed fractures.