Emergency medicine journal : EMJ
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Female participants are underrepresented in randomised control trials conducted in urgent care settings. Although sex and gender are frequently reported within demographic data, it is less common for primary outcomes to be disaggregated by sex or gender. The aim of this review is to report sex and gender of participants in the primary papers published on research listed on the National Institute of Health and Care Research (NIHR) Trauma and Emergency Care (TEC) portfolio and how these data are presented. ⋯ Fewer females than males were included in TEC trials from 2010 to 2023. One trial reported the primary outcome stratified by sex. There is significant scope to increase the scientific value of TEC trials to females by funders.
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A short systematic review was undertaken to assess whether intradermal sterile water injections (ISWI) provide effective pain relief in adult patients presenting to the Emergency Department (ED) with renal colic. MEDLINE, Embase, Cochrane and Google Scholar databases were searched, identifying seven relevant studies. ⋯ The short follow-up periods, exclusion of more comorbid patients and variability in study design limit the generalisability of the findings. Further research is needed to establish the long-term effectiveness of ISWI in the management of renal colic in the ED.
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A short systematic review was undertaken to assess whether intradermal sterile water injections (ISWI) provide effective pain relief in adult patients presenting to the Emergency Department (ED) with renal colic. MEDLINE, Embase, Cochrane and Google Scholar databases were searched, identifying seven relevant studies. ⋯ The short follow-up periods, exclusion of more comorbid patients and variability in study design limit the generalisability of the findings. Further research is needed to establish the long-term effectiveness of ISWI in the management of renal colic in the ED.
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Trauma and emergency care is a national priority in Uganda due to the high burden of injury, impacting a primarily young and rural population. With a significant gap in qualified emergency medicine professionals, a need exists to rapidly upskill the current health workforce and to strengthen access to learning for non-specialist emergency care providers nationally. This review was completed in partnership with the Ugandan Ministry of Health and a consortium of UK partners to support national emergency workforce capacity building in Uganda and East Africa. ⋯ Findings included (1) the identification of local technology expertise and experience, in direct contrast to literature and global perceptions of low-resource environments, (2) high and broad levels of national engagement with digital solutions, (3) existing ambition and infrastructure available to feasibly deliver training at scale and (4) delivery implications for comparable contexts. The review concludes that these emerging technologies should be considered a practical option in the design and delivery of health workforce training at scale. A series of recommendations are proposed for the policy and practice of health professional education and training in Uganda and for comparable contexts.
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A short-cut systematic review was conducted using a described protocol. The three-part question addressed was: In adult patients presenting to the ED with diabetes-related visual symptoms, how effective is using a portable handheld fundus camera in diagnosing diabetic retinopathy?MEDLINE, Embase and Cochrane databases were searched for relevant evidence. Altogether, 237 papers were found using the search strategy developed. 12 provided the best evidence to answer the three-part question. ⋯ Jin et al (2017) demonstrated high-quality images with 63% rated as excellent, showing a comparable efficacy to a traditional tabletop camera. Das et al (2022) found that Remidio and Pictor handheld cameras had high success rates and image quality, with sensitivities of 77.5% (95% CI: 65.9% to 89.0%) and 78.1% (95% CI: 66.6% to 89.5%), respectively, comparable to the Zeiss tabletop camera's sensitivity of 84.9% (95% CI: 78.2% to 91.5%). The clinical bottom line is that the best available evidence supports the effectiveness of portable handheld fundus cameras for diagnosing diabetic retinopathy in emergency settings.