Emergency medicine journal : EMJ
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A 31-year-old man purchased the legal high Energy-1 (NRG-1) over the internet; this was advertised as containing the compound naphthylpyrovalerone (NPV), which at the time was currently legally available in the UK. He ingested 1 g of this substance and developed a prolonged high associated with palpitations, sweating and insomnia. ⋯ Users of legal highs need to be aware that legal highs purchased over the internet may contain illegal substances and therefore they may be liable for prosecution if found in possession of these substances. Future educational campaigns aimed at recreational drug and legal high users should include reference to the potential legal implications of buying these substances.
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Multicenter Study
Validation of the Taiwan triage and acuity scale: a new computerised five-level triage system.
An ideal emergency department (ED) triage system accurately prioritises patients on the basis of the urgency of interventions required to avoid under- or over-triage. The objective of this study was to develop and validate a five-level Taiwan triage and acuity scale (TTAS) with an electronic decision support tool. ⋯ The TTAS was found to be a reliable triage system that accurately prioritises the treatment needed to avoid overtriage, more efficiently deploying the appropriate resources to ED patients.
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A short cut review was carried out to establish whether intranasal fentanyl is better than parenteral morphine for managing acute severe pain in children. 51 papers were found using the reported searches, of which 4 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 tabulated. It is concluded that intranasal fentanyl is an effective and safe alternative to IV or IM morphine for managing acute pain in children presenting to the Emergency Department.
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A short cut review was carried out to establish whether prophylactic antibiotics should be given to prevent Weil's disease after a fall into standing water. 30 papers were found using the reported searches, of which 4 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 tabulated. It is concluded that if there is immersion in an endemic area for leptospirosis, or if there is higher risk of water contamination such as standing water, known rat infestation, drainage channels then doxycycline would have to be recommended. Other scenarios are not as clear.