Emergency medicine journal : EMJ
-
Observational Study
Ultrasound-guided intravenous catheter survival impacted by amount of catheter residing in the vein.
Ultrasound (US)-guided peripheral IVs have a high failure rate. We explore the relationship between the quantity of catheter residing within the vein and the functionality of the catheter over time. ⋯ The quantity of catheter residing in the vein is a key predictor of long-term functionality of US-guided IVs and is strongly associated with the hazard of failure within 72 hours. Catheter failure is high when <30% of the catheter resided in the vein. Optimum catheter survival occurs when ≥65% of the catheter is placed in the vein.
-
A shortcut review of the literature was carried out to establish whether the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score was reliable and accurate enough to rule out testicular torsion in the paediatric population. Four papers were found to be relevant to the clinical question following the below-described search strategies. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are tabulated. It is concluded that based on the currently available evidence, a low-risk TWIST score has a high sensitivity and can be used in line with clinical judgement to rule out testicular torsion.
-
A shortcut review of the literature was carried out to establish whether prehospital point of care (POC) troponin tests are reliable and accurate enough to detect acute coronary syndrome (ACS) in adult patients. Nine papers were found to be relevant to the clinical question following the below-described search strategies. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are tabulated. It is concluded that based on the currently available evidence, POC troponin assays are insufficiently sensitive to 'rule out' ACS in the prehospital environment.
-
An 89-year-old female patient presented to the ED with mild abdominal pain and a history of vomiting for 3 days. Because of dementia, further history was unclear. Vital signs were normal. ⋯ There was no episode of vomiting during the ED consultation. A supine AXR was performed (figure 1).emermed;35/9/576/F1F1F1Figure 1Supine AXR. WHAT IS THE DIAGNOSIS?: Foreign bodyGallstone ileusColon obstructionIntestinal volvulus.
-
A 59-year-old man with no medical history presented to the ED with abdominal distension, vomiting and diffuse abdominal pain after drinking seven cups of white gourd drink (an authentic Asian drink composed mainly of white gourd). A chest radiograph was performed (figure 1).emermed;35/9/571/F1F1F1Figure 1Chest radiograph. AP, anteroposterior. ⋯ What is the most likely diagnosis?Crescent in doughnut sign, intussusceptionFalciform ligament sign, pneumoperitoneumStepladder sign, small bowel obstructionCoffee-bean sign, sigmoid colon volvulus.