Emergency medicine journal : EMJ
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A short-cut review was carried out to establish whether the parents of children with anaphylaxis are proficient in the use of autoinjectors. Seven hundred and three papers were found of which nine 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 shown in table 2. The clinical bottom line is that competence varies widely and that further efforts are required to train and monitor training outcomes.
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Randomized Controlled Trial
Comparison of clinical outcomes between intermittent and continuous monitoring of central venous oxygen saturation (ScvO2) in patients with severe sepsis and septic shock: a pilot study.
The Surviving Sepsis Campaign (SSC) to improve patient outcomes in severe sepsis and septic shock contains recommendations for protocolised resuscitation including early goal-directed therapy (EGDT) resuscitation. In EGDT, central venous oxygen saturation (ScvO2) is measured as the target monitoring value. The objective of this study was to determine whether intermittent measurement of ScvO2 is as clinically effective as continuous monitoring in EGDT implementation. ⋯ During EGDT, intermittent ScvO2 monitoring was not inferior to continuous ScvO2 monitoring when delivered within the first 6 h of intervention.
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The authors report a case of a 10-year-old boy who presented to the emergency department following an episode of syncope. While on telemetry, the child was found to have runs biventricular tachycardia. Catecholaminergic polymorphic ventricular tachycardia was diagnosed, and the case report discusses this rare but important diagnosis that should be considered in children presenting with syncope.