Emergency medicine journal : EMJ
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A short-cut review was carried out to establish whether the pulmonary embolism rule-out criteria (PERC) can safely exclude the diagnosis of pulmonary embolism (PE) in the emergency department (ED). One recent systematic review was directly relevant to the question and incorporated all the other relevant evidence identified. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 3. The clinical bottom line is that PERC may be safely applied to patients aged 18-49 years presenting to the ED with chest pain and/or dyspnoea providing that the pre-test probability of PE is 7% or less (equivalent to a Wells score of <2).
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Case Reports
BET 1: What is the significance of a 'boggy' (soft) scalp haematoma in head-injured children?
A short-cut review was carried out to establish whether the presence of a soft (boggy) scalp haematoma predicts the presence of intracranial injury in head-injured children. Three studies were directly relevant to the question. ⋯ In the one study that directly addressed the three-part question, it was concluded to warrant CT imaging. Since that time, however, concern regarding the risks associated with irradiation of children may challenge a strategy of imaging otherwise asymptomatic children with no other indication for CT imaging.