Emergency medicine journal : EMJ
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To describe the emergency department (ED) management of isolated mild traumatic brain injury (TBI) in the USA and to examine variation in care across age and insurance types. ⋯ Substantial ED resources are devoted to the care of isolated mild TBI. The present study identified deficiencies in and variation around several important aspects of ED care. The development of guidelines specific for mild TBI could reduce variation and improve emergency care for this injury.
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A short cut review was carried out to establish whether steroids are indicated in children presenting with Bell's palsy. A total of 60 papers were found using the reported search, of which three represented 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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Case Reports
Delayed presentation of traumatic ventricular septal defect and mitral leaflet perforation.
A case of intracardiac stabbing is reported. The victim sustained injuries disproportionate to his initial presentation. ⋯ The need for immediate referral to a cardiothoracic unit and the importance of the use of echocardiography is stressed. This enables the safest and most appropriate management of potentially lethal injuries.
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To collect data on the consultation frequency and demographic profile of victims of violence attending an emergency department (ED) in Switzerland. ⋯ Based on this monthly prevalence rate, we estimate that over 3000 adults affected by violence consult our ED per annum. This underlines the importance of the problem and the need to address it. Health services organisations should establish measures to improve quality of care for victims. Guidelines and educational programmes for nurses and physicians should be developed in order to enhance providers' skills and basic knowledge of all types of violence, how to recognise and interact appropriately with victims, and where to refer these patients for follow up care in their local networks.
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Myocardial contusion injury (MCI) is a complication of blunt thoracic trauma, which may occur at relatively low velocities. MCI may also occur from chest compressions during cardiopulmonary resuscitation. We review the clinical pathology, diagnostic tools, and treatment for MCI.