Emergency medicine journal : EMJ
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To review, firstly, published studies comparing classic antipsychotics, benzodiazepines, and/or combination of both; and secondly, available data on the use of atypical antipsychotic medications in controlling agitation and aggressive behaviour seen in psychiatric patients in emergency. ⋯ Atypical antipsychotics such as risperidone, ziprasidone, and olanzapine with or without benzodiazepines should be considered first in the treatment of acute agitation. If these agents are not available the combination of a classic antipsychotic and a benzodiazepine would be a reasonable alternative. An oral treatment should always be offered first for building up an alliance with the patient and suggesting an internal rather than external locus of control.
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Review Meta Analysis
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. IL D-dimer test in the diagnosis of pulmonary embolism.
A short cut review was carried out to establish whether a negative IL D-dimer test alone could be used to rule out a diagnosis of pulmonary embolus. Six papers were found using the reported search, 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 tabulated. A clinical bottom line is stated.
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Multicenter Study
Management of whiplash injuries presenting to accident and emergency departments in Wales.
To assess the use of soft collars for whiplash injuries presenting to Welsh accident and emergency departments and compare with recommended treatment as suggested by other literature. ⋯ The study recommends treatment protocols for whiplash injuries prescribing regular analgesia, early home exercises with the help of an advice sheet, and physiotherapy if symptoms persist.
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To determine the clinical impact of positive results from blood cultures sent from a busy paediatric accident and emergency department. ⋯ Blood cultures sent from an accident and emergency department rarely influence clinical management. A more focused approach to bacteriological investigation is recommended.
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Review Meta Analysis
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Outpatient investigation of pulmonary embolism.
A short cut review was carried out to establish whether outpatient investigation of suspected pulmonary embolus is a safe strategy. A total of 198 papers were found using the reported search, of which one 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 this best paper are tabulated. A clinical bottom line is stated.