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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A short cut review was carried out to establish whether the risk of thoracic aortic aneurysm can be assessed clinically at the bedside. 393 papers were found using the reported searches, of which two 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 those best papers are tabulated. It is concluded that there are no prospectively tested rules to risk stratify chest pain for the risk of dissecting aortic aneurysm. The aortic dissection detection score might be useful but requires prospective validation in an emergency department cohort of patients with chest pain.
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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 over the counter cough and cold medicines were associated with unexpected deaths in childhood. 115 papers were found using the reported searches, of which three 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 those best papers are tabulated. It is concluded that while over the counter cough and cold medications may be associated with unexpected paediatric deaths, the degree of risk is not clear.