Joëlla H Hopman, Juliette A L Santing, Kelly A Foks, Rolf J Verheul, Christien M van der Linden, Crispijn L van den Brand, Korné Jellema
INTRODUCTION: A computerized tomography (CT) scan is an effective test for detecting traumatic intracranial findings after mild traumatic brain injury (mTBI). However, a head CT is costly, and can only be performed in a hospital. OBJECTIVE: To determine if the addition of plasma S100B to clinical guidelines could lead to a more selective scanning strategy without compromising safety. METHODS: We conducted a single center prospective cohort study at the emergency department...
November 17, 2022: Brain Injury
Gabrielle Trépanier, Guylaine Laguë, Marie Victoria Dorimain
OBJECTIVES: Patients leaving against medical advice (AMA) can be distressing for emergency physicians trying to navigate the medical, social, psychological, and legal ramifications of the situation in a fast-paced and chaotic environment. To guide physicians in fulfilling their obligation of care, we aimed to synthesize the best approaches to patients leaving AMA. METHODS: We conducted a scoping review across various fields of work, research context and methodology to synthesize the most relevant strategies for emergency physicians attending patients leaving AMA...
October 31, 2022: CJEM
Jeffrey J Perry, David E Newman-Toker, Robert Ohle
No abstract text is available yet for this article.
October 24, 2022: CJEM
A O'Connor, J R Abbas, H McNeill
The One Minute Preceptor (OMP) model of teaching has an important role to play during the COVID-19 pandemic. It's quick and easy to learn and can be applied to any clinical setting. By responding directly to a student's needs, and building on the knowledge they already hold, the OMP is able to offer relevant and opportunistic teaching that the learner can immediately apply. Finally, the OMP can be taught in under two hours meaning medical staff not used to regularly teaching can develop the confidence to offer high quality educational interventions...
2022: Acute Medicine
Ariel Hendin, Erin Rosenberg, Hans Rosenberg
No abstract text is available yet for this article.
June 2022: CJEM
Volker Musahl, Ian D Engler, Ehab M Nazzal, Jonathan F Dalton, Gian Andrea Lucidi, Jonathan D Hughes, Stefano Zaffagnini, Francesco Della Villa, James J Irrgang, Freddie H Fu, Jon Karlsson
Clinical evaluation and management of anterior cruciate ligament (ACL) injury is one of the most widely researched topics in orthopedic sports medicine, giving providers ample data on which to base their practices. The ACL is also the most commonly treated knee ligament. This study reports on current topics and research in clinical management of ACL injury, starting with evaluation, operative versus nonoperative management, and considerations in unique populations. Discussion of graft selection and associated procedures follows...
January 2022: Knee Surgery, Sports Traumatology, Arthroscopy
Sophie Ramsden, Lauren Beals
A short-cut review of the available medical literature was carried out to establish whether elbow immobilisation is required after closed reduction of a distal radial fracture. After abstract review, six papers were found to answer this clinical question using the detailed search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that elbow immobilisation is not required.
March 2022: Emergency Medicine Journal: EMJ
George Mastoras, Sara H Gray
No abstract text is available yet for this article.
September 2021: CJEM
Kevin H Phan, John G Anderson, Donald R Bohay
Outpatient orthopedic surgery is gradually becoming the standard across the country, as it has been found to significantly lower costs without compromising patient care. Peripheral nerve blocks (PNBs) are largely what have made this transition possible by providing patients excellent pain control in the immediate postoperative period. However, with the increasing use of PNBs, it is important to recognize that they are not without complications. Although rare, these complications can cause patients a significant amount of morbidity...
July 2021: Orthopedic Clinics of North America
Kamel S Kamel, Mitchell L Halperin
We discuss the use of urine electrolytes and urine osmolality in the clinical diagnosis of patients with fluid, electrolytes, and acid-base disorders, emphasizing their physiological basis, their utility, and the caveats and limitations in their use. While our focus is on information obtained from measurements in the urine, clinical diagnosis in these patients must integrate information obtained from the history, the physical examination, and other laboratory data.
May 2021: KI Reports
Kathryn Hawk, Jason Hoppe, Eric Ketcham, Alexis LaPietra, Aimee Moulin, Lewis Nelson, Evan Schwarz, Sam Shahid, Donald Stader, Michael P Wilson, Gail D'Onofrio
The treatment of opioid use disorder with buprenorphine and methadone reduces morbidity and mortality in patients with opioid use disorder. The initiation of buprenorphine in the emergency department (ED) has been associated with increased rates of outpatient treatment linkage and decreased drug use when compared to patients randomized to receive standard ED referral. As such, the ED has been increasingly recognized as a venue for the identification and initiation of treatment for opioid use disorder, but no formal American College of Emergency Physicians (ACEP) recommendations on the topic have previously been published...
September 2021: Annals of Emergency Medicine
Aleksandar Trajkovski, Eddy Lang
No abstract text is available yet for this article.
May 2021: CJEM
Derek K Chu, Paul Oykhman, Gordon L Sussman
No abstract text is available yet for this article.
April 6, 2021: Canadian Medical Association Journal: CMAJ
Dexter Seow, Youichi Yasui, James D F Calder, John G Kennedy, Christopher J Pearce
BACKGROUND: An acute Achilles tendon rupture (AATR) is a common injury. The controversy that has surrounded the optimal treatment options for AATRs warrants an updated meta-analysis that is comprehensive, accounts for loss to follow-up, and utilizes the now greater number of available studies for data pooling. PURPOSE: To meta-analyze the rates of all complications after the treatment of AATRs with a "best-case scenario" and "worst-case scenario" analysis for rerupture rates that assumes that all patients lost to follow-up did not or did experience a rerupture, respectively...
November 2021: American Journal of Sports Medicine
Gillian R Schmitz, Michael Gottlieb
No abstract text is available yet for this article.
July 2021: Annals of Emergency Medicine
Myla E Moretti, Wendy J Ungar, Stephen B Freedman, Suzanne Schuh
BACKGROUND: While electrolyte maintenance solution is recommended and commonly used in pediatric gastroenteritis, it can be more costly and less palatable than preferred fluids such as apple juice. OBJECTIVE: To assess the incremental cost-effectiveness of apple juice/preferred fluids versus electrolyte maintenance solution in reducing treatment failures in children in an emergency department from societal and health care perspectives. METHODS: A probabilistic cost-effectiveness analysis was performed using clinical trial and chart data...
March 21, 2021: CJEM
Michael Gottlieb, Brit Long
No abstract text is available yet for this article.
October 2021: Academic Emergency Medicine
Amber E Hoek, Marieke Joosten, Diederik W J Dippel, Ed F van Beeck, Leandra van den Hengel, Björn Dijkstra, Dafni Papathanasiou, Daphne van Rijssel, Maaike van den Hamer, Stephanie C E Schuit, Alex Burdorf, Juanita A Haagsma, Pleunie P M Rood
STUDY OBJECTIVE: We measure the effect of video discharge instructions on postconcussion symptoms in patients with mild traumatic brain injury in the emergency department. METHODS: A multicenter randomized controlled trial was conducted in which patients with mild traumatic brain injury were randomly assigned to either intervention (verbal, written, and video discharge information) or control (verbal and written discharge information only). All patients were interviewed 1 week and 3 months from randomization...
March 2021: Annals of Emergency Medicine
Adam Reuben, Andrew Appelboam, Kara N Stevens, Jane Vickery, Paul Ewings, Wendy Ingram, Alison N Jeffery, Richard Body, Malcolm Hilton, Jason Coppell, Brian Wainman, Andy Barton
STUDY OBJECTIVE: Epistaxis is a common emergency department (ED) presentation and, if simple first aid measures fail, can lead to a need for anterior nasal packing. Tranexamic acid is an agent that contributes to blood clot stability. The aim of this study is to investigate the effectiveness of topical intranasal tranexamic acid in adult patients presenting to the ED with persistent epistaxis, and whether it reduces the need for anterior nasal packing. METHODS: From May 5, 2017, to March 31, 2019, a double-blind, placebo-controlled, multicenter, 1:1, randomized controlled trial was conducted across 26 EDs in the United Kingdom...
June 2021: Annals of Emergency Medicine
Kyle C McKenzie, Cecil D Hahn, Jeremy N Friedman
This guideline addresses the emergency management of convulsive status epilepticus (CSE) in children and infants older than 1 month of age. It replaces a previous position statement from 2011, and includes a new treatment algorithm and table of recommended medications based on new evidence and reflecting the evolution of clinical practice over the past several years. This statement emphasizes the importance of timely pharmacological management of CSE, and includes some guidance for diagnostic approach and supportive care...
February 2021: Paediatrics & Child Health
2021-02-18 15:28:26
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