Emergency medicine journal : EMJ
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Use of specialist healthcare services is increasing. ⋯ The use of specialist care hospital admission can be reduced if appropriate alternatives are available.
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Review Meta Analysis
Pulmonary embolism rule-out criteria (PERC) in pulmonary embolism--revisited: A systematic review and meta-analysis.
To perform a systematic review and meta-analysis including all the current studies to assess the accuracy of pulmonary embolism rule-out criteria (PERC) in ruling out pulmonary embolism (PE). ⋯ Because of the high sensitivity and low negative likelihood ratio, PERC rule can be used confidently in clinically low probability population settings.
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A short-cut review was carried out to determine whether intranasal lidocaine was an effective treatment for patients with acute cluster headaches. Two hundred and seventy-two papers were found using the reported search, of which four were considered relevant to the three-part question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are shown in table 2. Although the included studies all found some degree of symptomatic relief with this treatment, the methodological weaknesses of the studies compromised the validity of this finding, and the authors concluded that there was insufficient evidence to support this treatment in clinical practice.
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Pelvic fractures are among the most devastating traumatic injuries accompanied by high morbidity and mortality rate leading to catastrophic outcomes and haemodynamic consequences. Although Advanced Trauma Life Support (ATLS) recommends performing pelvic radiography in all major blunt trauma patients, several lines of evidence recommend that it can be limited to those blunt trauma patients who are haemodynamically unstable or have positive pelvic physical examination. Thus, we performed this study in order to evaluate the efficacy of routine pelvic radiography in haemodynamically stable, high-energy, blunt trauma patients. ⋯ Pelvic radiography could be eliminated from the primary survey protocol of the patients with high-energy blunt trauma who are haemodynamically stable and have negative pelvic physical examination.