Emergency medicine journal : EMJ
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In the UK, recruitment of adequate numbers of doctors to emergency medicine (EM) has been problematic. With this as background, we analysed data about career choice for, and progression in, EM in a large multi-purpose study of doctors' careers. ⋯ Early career choices for EM are less predictive of career destinations than choices for other specialties, and, compared with many other specialties, doctors who pursue it may turn to it relatively late. Training policies on transferable competencies should enable clinical trainees in other related specialties to bank some of their skills if they transfer to EM, rather than necessarily having to start core training in year 1 of EM specialty training.
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A shortcut review was carried out to establish whether intraosseous administration of adenosine was an effective and safe way to terminate supraventricular tachycardia in the paediatric population. Five papers were yielded with the below described search strategies, of which two were directly relevant to the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the papers are tabulated. It was concluded that there is contradicting evidence for the efficacy of intraosseous adenosine, and further studies are needed to answer this question.
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Observational Study
The value of the difference between ED and prehospital vital signs in predicting outcome in trauma.
Traditional vital signs are seen as an important part of trauma assessment, despite their poor predictive value in this regard. ⋯ ΔSBP and ΔRR performed best overall, but ΔSI performed best in the moderate injury group, suggesting earlier identification with ΔSI. Use of Δ values result in good rule-in of 48 h mortality and may supplement trauma treatment decisions.