Emergency medicine journal : EMJ
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Case Reports
Vertebral artery dissection and cerebellar infarction following chiropractic manipulation.
Vertebral artery dissection (VAD) associated with chiropractic cervical manipulation is a rare but potentially disabling condition. In this report, we present a young patient manifesting with repeated vertigo. ⋯ A number of cases of VAD associated with chiropractic cervical manipulation have been reported, but rarely in the emergency medicine literature. We present a case of this rare occurrence, and discuss the diagnostic pitfalls.
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A short cut review was carried out to establish whether absorbable sutures offered any benefits over non-absorbable sutures in the treatment of childhood facial lacerations. A total of 31 papers were found, 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. We conclude that absorbable sutures appear to be as good as, and show a trend towards benefit in the treatment of paediatric lacerations.
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Multicenter Study
Effectiveness of measures to reduce emergency department waiting times: a natural experiment.
To determine what measures were introduced by emergency departments in response to the national monitoring week in March 2003, and which, if any, of these were most effective in reducing waiting times. ⋯ Improved waiting time performance may depend, at least in the short term, more on the amount of effort expended than on introducing a single effective change. In addition, those measures most likely to be helpful are likely also to require additional resources.
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Review Meta Analysis
Potential cervical spine injury and difficult airway management for emergency intubation of trauma adults in the emergency department--a systematic review.
Emergency airway management for trauma adults is practised by physicians from a range of training backgrounds and with differing levels of experience. The indications for intubation and technique employed are factors that vary within EDs and between hospitals. ⋯ Full literature search for relevant articles in Medline (1966-2003), EMBASE (1980-2003), and the Cochrane Central Register of Controlled Trials. Relevant articles relating to adults and written in English language were appraised. English language abstracts of foreign articles were included. Studies were critically appraised on a standardised data collection sheet to assess validity and quality of evidence. The level of evidence was allocated using the methods of the Australian National Health and Medical Research Council.