Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether routine nasogastric decompression with a nasogastric tube improved the process and outcome of care in adults with small bowel occlusion. 211 papers were found using the reported searches, of which 1 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 this paper is tabulated. It is concluded that there is no scientific evidence for the routine use of nasogastric tubes in these patients.
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In the Netherlands, screening for child maltreatment is mandatory in all emergency departments but it is unclear which screening methods are being used. As a first step towards implementation of a universal screening method across all emergency departments, we assessed the currently used screening methods. ⋯ Large variations in screening methods exist across emergency departments in the Netherlands, most of which are not based on empirical evidence.
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Biomarkers have been developed in emergency medicine to improve decision at bedside using Bayesian approach. We intend to determine the cognitive process actually utilised by emergency physicians to incorporate biomarkers in clinical reasoning. ⋯ Although biomarkers have been developed to be used in a Bayesian approach, emergency physicians mainly use other analytical and non-analytical cognitive processes to introduce these tools in their clinical reasoning.
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Although there has been some research on the impact of extreme weather on the number of ambulance call-out incidents, especially heat waves, there has been very little research on the impact of cold weather on ambulance call-outs and response times. In the UK, there is a target response rate of 75% of life threatening incidents (Category A) that must be responded to within 8 min. This paper compares daily air temperature data with ambulance call-out data for Birmingham over a 5-year period (2007-2011). ⋯ For every reduction of air temperature by 1°C there was a reduction of 1.3% in performance. Improved weather forecasting and the take up of adaptation measures, such as the use of winter tyres, are suggested for consideration as management tools to improve ambulance response resilience during extreme weather. Also it is suggested that ambulance response times could be used as part of the syndromic surveillance system at the Health Protection Agency.