Emergency medicine journal : EMJ
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The aim of this study was to determine whether a normal range of elbow movement can be used as a rule out tool for significant injury after blunt trauma in the paediatric population. ⋯ In the setting of blunt trauma resulting in elbow injury in children, a normal ROM does not rule out a significant injury and should not be used as a screening tool.
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Multicenter Study
Impact of the Surviving Sepsis Campaign on the recognition and management of severe sepsis in the emergency department: are we failing?
Severe sepsis/septic shock (SS/SS) has a high mortality. The past decade lays witness to a concerted international effort to tackle this problem through the Surviving Sepsis Campaign (SSC). However, bundle delivery remains problematic. In 2009, the College of Emergency Medicine (CEM) set out guidelines for the management of SS/SS. These set the standards for this audit. ⋯ The SSC has had some impact; however, there is still a long way to go. It is assumed that the picture is similar in EDs across the UK and recommendations are made based on these local findings.
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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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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.