Emergency medicine journal : EMJ
-
Mobile apps are increasingly being used at the bedside as a part of clinical care. With almost 300 emergency medicine-related apps available in the Apple App Store, it can be overwhelming deciding which are most useful for emergency department providers. A Top 10 list of apps is highlighted which illustrate the many ways that quality apps can positively impact the care of emergency department patients.
-
Review Case Reports
BET 1: Ambulatory care in well adults diagnosed with malaria in the emergency department.
A short-cut review was carried out to establish whether patients with malaria can be safely treated as outpatients. Thirty-six papers were found, of which four 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. The clinical bottom line is that in selected patients with Plasmodium falciparum malaria ambulatory management may be a safe alternative to inpatient management, although the current UK guidance advocates initial admission for all patients.
-
Review Case Reports
BET 3: Topical intranasal tranexamic acid for spontaneous epistaxis.
A short-cut review was carried out to establish whether topical tranexamic acid can be used to treat spontaneous epistaxis. Thirty-three papers were found, 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 these best papers are tabulated. The clinical bottom line is that there is insufficient evidence to support the use of topical intranasal tranexamic acid in the management of spontaneous epistaxis in haemodynamically stable patients presenting to the emergency department.
-
Review Case Reports
BET 2: Are patients who have used chewing gum at an increased risk of aspiration during sedation?
A short-cut review was carried out to establish whether patients who have chewed gum are at increased risk of aspiration during sedation. Twenty-nine papers were found, of which six presented the best evidence to answer the clinical question. ⋯ The clinical bottom line is that patients who have chewed gum in the past 6 h may theoretically be at increased risk of aspiration. This should be considered when making a balanced decision about the use of procedural sedation.
-
Traumatic hip dislocations (THD) are uncommon in children. They constitute true emergencies because unrecognised THD leads to avascular necrosis (AVN) of the femoral head. This review presents the evidence for best practice for the diagnosis and treatment of THD in the emergency department (ED) of children under the age of 7 years. ⋯ THD in this age group mainly occurs with low-energy trauma and leads to posterior dislocations. Urgent closed reduction of acute cases are done in the OR, or the ED. ED reduction appears to be safe. Neglected THDs need open reduction.