Emergency medicine journal : EMJ
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A short-cut review was carried out to establish whether icatibant is effective in the treatment of hereditary angioedema. A total of 168 papers were found using the reported search, of which one represented 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 this best paper are tabulated. The clinical bottom line is there is promising evidence for the use of the bradykinin receptor antagonist icatibant for the treatment of acute attacks of hereditary angioedema.
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Anterior cruciate ligament (ACL) disruptions are common injuries that currently hold a fearsome reputation among athletes of all abilities and disciplines. Indeed, if the diagnosis is missed at first presentation, it is difficult to attribute ongoing instability and recurrent injury to an ACL tear. Classically, patients then often improve shortly before repeatedly reinjuring their knee. ⋯ Once diagnosed, the responsibility of advising and further counselling of patients with ACL injuries is best left to the orthopaedic knee specialist. Family practitioners and emergency room doctors should not feel pressured to offer advice on specialist areas such as return to sports without reconstruction or indeed the need for reconstruction. Indeed, decisions to return to sports with ACL-deficient knees have all too often led to disastrous reinjury events to the articular cartilage and/or the menisci.
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Comparative Study
Bedside ultrasonography for the detection of small bowel obstruction in the emergency department.
Plain film radiography (x-ray) is often the initial study in patients with suspected small bowel obstruction (SBO) to expedite patient care. ⋯ EP-performed US compares favourably to x-ray in the diagnosis of SBO.
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Multicenter Study
The C-MAC videolaryngoscope for prehospital emergency intubation: a prospective, multicentre, observational study.
In this preliminary prospective observational study at four physician-led air rescue centres, the efficacy of the C-MAC (Karl Storz, Tuttlingen, Germany), a new portable videolaryngoscope, was evaluated during prehospital emergency endotracheal intubations. ⋯ The C-MAC videolaryngoscope was suitable for prehospital emergency endotracheal intubations with complicated airway conditions, such as maxillo-facial trauma. The option to perform direct laryngoscopy and videolaryngoscopy with the same device appears to be exceptionally important in the prehospital setting.
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A short cut review was carried out to establish which intraosseous device is best for use in the prehospital environment. A total of 2100 papers were found using the reported search, of which 2 represented 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. The clinical bottom line is that traditional manual intraosseous infusion devices have better success rates and faster insertion times compared with semi-automatic intraosseous infusion devices in the prehospital setting.