Emergency medicine journal : EMJ
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The decision by paramedics to alert a receiving hospital to the imminent arrival of a critically ill patient is currently based on the crew's clinical judgement. ⋯ Ambulance crews do not alert hospitals to critically ill patients adequately. The Modified Early Warning Score should be considered to be the basis of a prehospital tool to aid their decision.
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This paper studies the effectiveness of different educational programmes. A number of cohorts of junior doctors received one of two different induction training packages. These programmes differed principally in the length of time over which they were administered. ⋯ There was a noticeable difference in the factual recall between the cohorts depending on what programme they had attended. Those attending the programme delivered over an extended period showed better performance on assessment. The interpretations and implications of these findings are discussed.
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A short-cut review was carried out to establish whether the administration of aspirin before computed tomography scanning improved outcome in patients with symptoms suggestive of stroke. In all, 866 papers were found using the reported searches, two of which presented the best evidence to answer the clinical question. The author group, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. If a computed tomography scan is to be carried out within 48 h of onset of symptoms, then it is prudent to await the result before starting aspirin.
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A short-cut review was carried out to establish whether myringotomy is of value in cases of haemotympanum. In all, 205 papers were found in Medline and 105 in Cochrane using the reported searches. None presented any evidence to answer the clinical question. Hence, it is concluded that there is no evidence available to guide this decision and that local expert advice should be followed.