Emergency medicine journal : EMJ
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To determine the incidence of deep vein thrombosis (DVT) in patients diagnosed with superficial thrombophlebitis (STP) after presenting to an outpatient DVT service. ⋯ Although STP is generally considered benign, there is a risk that it may coexist or develop into DVT. The underlying cause of STP should be considered and patients with significant risk factors should be advised to monitor their symptoms closely with regard to potential DVT formation.
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In 1998 'Dubdoc', Ireland's first out-of-hours general practice emergency service, opened in an outpatient suite in St James's Hospital with a separate entrance 300 m from the emergency department (ED). Dubdoc was established with the aim of providing an easy access out-of-hours service for ambulatory patients of those doctors supplying the service. ⋯ Although the presence of the 'Dubdoc' service has resulted in a decrease in ED attendances for triage categories 4 and 5, this is a minor proportion of the overall decrease in attendances in this group of patients.
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Dehydration is a common concern in paediatric emergency care. Limited tools are available to assess reduced urine production, which is commonly cited as a reliable marker of dehydration. ⋯ The hand-held bladder scanner is a convenient, non-invasive and objective adjunct in the assessment and management of children attending the emergency department with suspected dehydration.
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To assess the impact of HIV infection and exposure on survival in critically ill children requiring resuscitation. ⋯ Early and late case death rates are greater in HIV-seropositive than in HIV-uninfected children. 80% of HIV-infected children survived the period most influenced by the process of resuscitation, that is, the first 24 h. HIV status alone should not influence the limitation of intervention decisions in the resuscitation room when faced with a critically ill child.
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To determine the value of abdominal radiography (AXR) for investigating patients attending hospital with a first episode of appendicitis (requiring appendicectomy), acute gallbladder disease or acute pancreatitis, and to identify if early (within 18 h) ultrasound or CT scanning reduces the use of AXR. Setting Two acute teaching hospitals during August-September 2008 and February-March 2009. ⋯ AXR does not aid diagnosis of these conditions but is still performed. Early ultrasound or CT scanning reduces the use of AXR and are more sensitive; methods of providing these should be explored.