Emergency medicine journal : EMJ
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A short-cut review was carried out to establish whether honey provides significant symptom relief of cough in children with an upper respiratory tract infection (URTI). Only one paper presented a trial addressing the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are shown in table 1. The clinical bottom line is that honey does appear to be effective in relieving some of the symptoms of URTI.
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Biphasic waveform defibrillation results in higher rates of termination of fibrillation than monophasic waveform defibrillation but has not been shown to improve survival outcomes. ⋯ Treatment with biphasic AED shocks improved the likelihood of ROSC and neurologically favourable 1-month survival after witnessed VF compared with monophasic AED shocks. In addition to waveform differences, a shorter time interval from the first shock to the second shock could account for the better outcomes with biphasic AED.
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Prehospital staff have made a significant contribution in recent years to improving care for patients with acute coronary syndrome, multiple trauma and stroke. There is, however, another group of patients that is not currently being targeted, with a similar time-critical condition. This group of patients is those with severe sepsis and septic shock and they could also benefit greatly from timely prehospital care. This article will consider how prehospital staff can improve the outcome of patients with severe sepsis, and in particular how they can aid emergency departments in identifying and initiating treatment in patients with severe sepsis.
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Pathways to guide clinical care are well accepted and used in many emergency departments. We wanted to introduce a number ("bundle") over a short space of time and involve the whole patient stay in the pathway. It was hypothesised that a more efficient process would result with an overall reduction in length of stay (LoS). ⋯ The introduction of a bundle of evidence-based care pathways can modestly reduce LoS for certain types of acute medical patients in a DGH setting.
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Head injury outcome is influenced by the initial insult and the various pathophysiological changes that take place in the posttraumatic phase, some of which may be amenable to intervention. Appropriate measures taken during initial emergency department management and subsequently in the intensive therapy unit can significantly improve outcome. ⋯ Early imaging, rather than admission and observation for neurological deterioration, reduces the time to the detection of life-threatening complications. This paper discusses the current management of severe head injury, some prognostic indicators and methods used to rule out an associated spinal injury.