Emergency medicine journal : EMJ
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Clinical trials are required to strengthen the evidence base for prehospital care. This questionnaire study aimed to explore paramedics' perceptions of prehospital research and barriers to conducting prehospital clinical trials. ⋯ Paramedics reported interest and understanding of research, but a number of practical and ethical barriers were recognised that need to be addressed if prehospital clinical trials are to increase.
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A shortcut review was carried out to establish whether steroids prevent biphasic anaphylactic reactions in children. Seven papers were directly relevant to the question. ⋯ The clinical bottom line is that there are no trials to show that steroids prevent biphasic reactions. However, there are other grounds for using them in anaphylactic reactions and they are still recommended in guidelines.
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This subjective review is based on a presentation made at the College of Emergency Medicine Scientific Conference in September 2013. My theme was that there are certain features of the critically ill which cause understandable anxiety, namely hypoxia, haemorrhage and hypotension. So, I have selected papers relevant to the management of these frightening situations.
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Cranial CT is the gold standard for the investigation of intracranial emergencies. The aim of this pilot study was to audit whether senior emergency physicians were able to report CT head scans accurately and reliably having attended structured teaching. ⋯ In conclusion, we feel that this model can be employed as a safe and long-term alternative provided that the radiology department are committed to providing ongoing teaching and that a database is maintained to highlight problem areas. Emergency physicians need to remember that the clinical status of the patient must never be ignored, irrespective of their CT head findings.