Emergency medicine journal : EMJ
-
A shortcut review was carried out to establish whether dousing areas of contact with vinegar could relieve the symptoms of Irukandji syndrome. Four studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is there is a lack of evidence for effectiveness and the latest local guidelines should be followed.
-
A short-cut review was carried out to establish whether intravenous tranexamic acid is beneficial in managing acute epistaxis. Seven papers were found in Medline, Embase and the Cochrane Library using the reported searches, but none presented any evidence to answer the clinical question. It is concluded that there is no evidence to support or refute the use of intravenous tranexamic acid in acute epistaxis and that local advice should be followed.
-
A shortcut review was carried out to establish whether ultrasound is an effective diagnostic tool for the diagnosis of sternal fractures. 27 papers were found of which 4 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 patients with blunt thoracic injury and suspected isolated sternal fracture, ultrasound seems superior to conventional radiology to diagnose sternal fracture.
-
To summarise the risk factors for mortality in patients with flail chest based on available evidence in the literature. ⋯ The main independent predictors of mortality in patients with flail chest were reported to be increased age and ISS. More data are needed regarding the association of hospital length of stay, presence of pulmonary contusion and bilateral flail chest.
-
Attempts to resuscitate patients in traumatic cardiac arrest (TCA) have, in the past, been viewed as futile. However, reported outcomes from TCA in the past five years, particularly from military series, are improving. The pathophysiology of TCA is different to medical causes of cardiac arrest, and therefore, treatment priorities may also need to be different. This article reviews recent literature describing the pathophysiology of TCA and describes how the military has challenged the assumption that outcome is universally poor in these patients.