Emergency medicine journal : EMJ
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Review Meta Analysis
Systematic review and meta-analysis of routine total body CT compared with selective CT in trauma patients.
Full-body CT scanning is increasingly being used in the initial evaluation of severely injured patients. We sought to analyse the literature to determine the benefits of full-body scanning in terms of mortality and length of time spent in the emergency department (ED). ⋯ We eagerly await the results of randomised controlled trials. Firm clinical outcome data are expected to emerge in the near future, though data on cost and radiation exposure will be needed before definitive conclusions can be made.
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Multicenter Study
Traumatic lacerations: what are the risks for infection and has the 'golden period' of laceration care disappeared?
To determine risk factors associated with infection and traumatic lacerations and to see if a relationship exists between infection and time to wound closure after injury. ⋯ Diabetes, wound contamination, length greater than 5 cm and location on the lower extremity are important risk factors for wound infection. Time from injury to wound closure is not as important as previously thought. Improvements in irrigation and decontamination over the past 30 years may have led to this change in outcome.
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A short cut review was carried out to establish whether ultrasound was better than x-ray at detecting fractured ribs after minor chest trauma. Two papers 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 tabulated. It is concluded that while current studies suggest ultrasonography is better than x-ray at detecting rib fractures, further studies with a well-established gold standard should be completed before ultrasonography is used routinely.
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To measure the performance characteristics of an immunochromatographic rapid antigen test for respiratory syncytial virus (RSV) and determine how its interpretation should be contextualised in patients presenting to the emergency department (ED) with bronchiolitis. ⋯ The RSV antigen test we examined had modest performance characteristics. The results of the antigen test should be interpreted in the context of the results of previous tests.