Emergency medicine journal : EMJ
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Comparative Study
Childhood falls: characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score.
The aim of this study was to determine the general characteristics of childhood falls, factors affecting on mortality, and to compare the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) as predictors of mortality and length of hospital stay in childhood falls. ⋯ In our series, the head was the most frequent site of injury, and the most common type of fall was from balconies. Scores on the GCS, NISS, and ISS are significantly associated with mortality. The performance of the NISS and ISS in predicting mortality in childhood falls was similar.
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Pregnancy tests are often performed routinely for female emergency department (ED) patients of reproductive age. One major reason is a perception that patients are unreliable in predicting their own pregnancy status. We hypothesised that patients could reliably predict that they were not pregnant. ⋯ Sexual history and self assessment can be used as a highly effective predictor of a patient not being pregnant. Given the risks of missed pregnancy in the ED, and low monetary and time cost of pregnancy tests, frequent testing is still recommended in most instances.
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Envenomation by marine creatures is common. As more people dive and snorkel for leisure, the incidence of envenomation injuries presenting to emergency departments has increased. Although most serious envenomations occur in the temperate or tropical waters of the Indo-Pacific region, North American and European waters also provide a habitat for many stinging creatures. ⋯ Various other treatments such as vinegar, fig juice, boiled cactus, heated stones, hot urine, hot water, and ice have been proposed, although many have little scientific basis. The use of heat therapies, previously reserved for penetrating fish spine injuries, has been suggested as treatment for an increasing variety of marine envenomation. This paper reviews the evidence for the effectiveness of hot water immersion (HWI) and other heat therapies in the management of patients presenting with pain due to marine envenomation.
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A short cut review was carried out to establish whether loop diuretics are useful for critically ill patients with renal failure. A total of 1017 citations were reviewed of which two answered the three part question. The clinical bottom line is that in critically ill patients with acute renal failure, there is no evidence to suggest that the use of loop diuretics reduces mortality, reduces length of ITU/hospital stay, or increases the recovery of renal function.