Emergency medicine journal : EMJ
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A short cut review was performed to seek the evidence for use of intravenous lipid emulsion in the treatment of overdose with β-receptor antagonists. Eight case reports and one case series with a total of 10 patients were found. The authors, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are tabulated. The clinical bottom line is that there is only anecdotal evidence of effectiveness for this treatment.
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A short cut review was performed to assess the effect of the presence of family members on the efficiency of paediatric trauma resuscitation. Two studies with a total of 999 patients were included. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are tabulated. The clinical bottom line is that the presence of the patient's family does not adversely affect the outcome of paediatric trauma resuscitation.
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A short cut review was performed to assess the utility of a skeletal survey in patients with suspected non-accidental injury. Three studies including a total of 983 patients were found. The authors, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are tabulated. The clinical bottom line is that skeletal surveys are useful in children who are suspected to have non-accidental injury, particularly in those aged under 1 year.
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The authors report the case of a 4-year-old boy who presented to the emergency department with acute post-traumatic winging of right scapula following a fall onto his back. The x-ray of his right shoulder showed no fracture. An MRI Scan of cervical spine and brachial plexus did not reveal any abnormalities. ⋯ At 2 years follow-up, there was no improvement in the winging of his right scapula. He was asymptomatic at rest but complains of pain in the right scapular and shoulder region during swimming limiting his swimming activity. Currently he was being evaluated by the orthopaedic team for corrective surgery.
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Increasingly emergency departments (ED) and other acute services in the hospital provide first access care, especially out of hours and for poorer families. Studies of detection of child maltreatment in the hospital have focused on children presenting with injury, although maltreatment may be suspected when parents present to the hospital with problems related to violent behaviour, drug abuse or mental health problems. ⋯ Clinicians need to be aware that half the vulnerable children in hospital are identified through one or other parent. It is hypothesised that the availability of an experienced child protection advisor on-site, combined with child protection training, makes it possible for clinicians caring for adults with problems related to violence, drug abuse or acute mental illness, to take action to address the potential vulnerability of their children.