Emergency medicine journal : EMJ
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Review Comparative Study
Ultrasound to detect haemothorax after chest injury.
A short cut review was carried out to establish whether ultrasonography is as sensitive and specific as chest x ray or computed tomography (CT) scan in detecting haemothorax after chest trauma. Thirty-nine papers were found using the reported searches, of which six 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 shown in table 3. It is concluded that ultrasonography is more sensitive and as specific as chest x ray at detecting haemothorax in patients with chest trauma.
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Randomized Controlled Trial Comparative Study
Tracheal intubation by non-anaesthetist physicians using the Airway Scope.
To evaluate the performance of the Airway Scope for tracheal intubation by non-anaesthetist physicians. ⋯ The Airway Scope may reduce the time to secure the airway and the incidence of failed tracheal intubation in novice laryngoscopists.
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A short cut review was carried out to establish whether aminophylline improved return of spontaneous circulation rates and eventual outcome in bradyasystolic cardiac arrest. A total of 1154 papers were found using the reported searches, 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 four papers are summarised in table 4. It is concluded that aminophylline offers no benefit in this situation.
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Gastric perforation in association with incarceration of a hiatus hernia rarely features on a list of differential diagnoses of acute chest pain. A patient presented to the emergency department with acute chest pain characteristic of myocardial ischaemia. Several risk factors for ischaemic heart disease (IHD) were present. ⋯ Her postoperative course was complicated by pulmonary and intra-abdominal sepsis necessitating admission to the intensive care unit where she remained for 23 days. This case highlights the challenge that non-cardiac chest pain presents to the acute care physician. Patients who present with risk factors for and symptoms consistent with a diagnosis of IHD may have non-cardiogenic pathology which can be life-threatening.
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Case Reports
Chest compressions for a patient in cardiac arrest after penetrating trauma with a knife still in situ.
A 45-year-old man was brought by ambulance to the emergency department. He was in shock, with a knife handle protruding from his abdomen. ⋯ Resuscitation and haemostasis were achieved and the patient was eventually discharged from hospital. This case report discusses the risks of chest compressions for trauma patients with a penetrating weapon still in situ.