Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 498
Filter
1.
Emerg Med J ; 39(3): 237-238, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35190394

ABSTRACT

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.


Subject(s)
Colles' Fracture , Evidence-Based Emergency Medicine , Humans
2.
Washington, D.C.; PAHO; 2022-01-26. (PAHO/IMS/EIH/COVID-19/22-0010).
Non-conventional in English | PAHO-IRIS | ID: phr-52719

ABSTRACT

This document includes the results of a rapid systematic review of current available literature. The information included in this review reflects the evidence as of the date posted in the document. In recognition of the fact that there are numerous ongoing clinical studies, PAHO will periodically update this review and corresponding recommendations as new evidence becomes available.


Subject(s)
COVID-19 , Coronavirus , Coronavirus Infections , Betacoronavirus , Pandemics , Evidence-Based Emergency Medicine
3.
Emerg Med J ; 39(2): 157-158, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35058292

ABSTRACT

A short-cut review of the available medical literature was carried out to establish whether CT scanning can rule out cerebellar infarction. After abstract review, two 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 there is insufficient evidence to draw a conclusion.


Subject(s)
Emergency Service, Hospital , Evidence-Based Emergency Medicine , Humans , Infarction , Tomography, X-Ray Computed
5.
Emerg Med J ; 38(5): 401-403, 2021 May.
Article in English | MEDLINE | ID: mdl-34449416

ABSTRACT

A short-cut review of the available medical literature was carried out to establish whether homemade or cloth face masks can prevent respiratory virus transmission or clinical illness. After abstract review, twelve 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 there is currently no direct evidence to support the use of homemade or cloth masks by the general public for protection against viral infections.


Subject(s)
Masks/statistics & numerical data , Respiratory Tract Infections/prevention & control , Virus Diseases/prevention & control , Evidence-Based Emergency Medicine , Humans
6.
Emerg Med J ; 38(8): 653-655, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34449435

ABSTRACT

A short-cut review of the literature was carried out to examine the diagnostic test characteristics and potential patient benefits through the use of the Ottawa Subarachnoid Haemorrhage Clinical Decision Rule. Nine papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that the Ottawa Clinical Decision Rule has a high sensitivity for the diagnosis of subarachnoid haemorrhage; however, there is limited robust evidence of international generalisability and no evidence of improved patient outcomes following implementation. Further prospective research is required in populations with variable prevalence to evaluate the safety and effectiveness of this intervention, compared with routine evaluation strategies.


Subject(s)
Clinical Decision Rules , Subarachnoid Hemorrhage/diagnosis , Diagnosis, Differential , Evidence-Based Emergency Medicine , Humans , Sensitivity and Specificity
7.
Emerg Med J ; 38(8): 655-656, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34449436

ABSTRACT

A short-cut review of the literature was carried out to examine the benefits of caffeine as an analgesic adjunct in tension-type and migraine-type headache. Six papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that caffeine provides effective analgesia as an adjunctive treatment in the management of secondary headache syndromes.


Subject(s)
Caffeine/therapeutic use , Migraine Disorders/drug therapy , Pain Management/methods , Tension-Type Headache/drug therapy , Evidence-Based Emergency Medicine , Humans
8.
CMAJ Open ; 9(1): E261-E270, 2021.
Article in English | MEDLINE | ID: mdl-33731427

ABSTRACT

BACKGROUND: Emergency physicians lack high-quality evidence for many diagnostic and treatment decisions made for patients with suspected or confirmed coronavirus disease 2019 (COVID-19). Our objective is to describe the methods used to collect and ensure the data quality of a multicentre registry of patients presenting to the emergency department with suspected or confirmed COVID-19. METHODS: This methodology study describes a population-based registry that has been enrolling consecutive patients presenting to the emergency department with suspected or confirmed COVID-19 since Mar. 1, 2020. Most data are collected from retrospective chart review. Phone follow-up with patients at 30 days captures the World Health Organization clinical improvement scale and contextual, social and cultural variables. Phone follow-up also captures patient-reported quality of life using the Veterans Rand 12-Item Health Survey at 30 days, 60 days, 6 months and 12 months. Fifty participating emergency departments from 8 provinces in Canada currently enrol patients into the registry. INTERPRETATION: Data from the registry of the Canadian COVID-19 Emergency Department Rapid Response Network will be used to derive and validate clinical decision rules to inform clinical decision-making, describe the natural history of the disease, evaluate COVID-19 diagnostic tests and establish the real-world effectiveness of treatments and vaccines, including in populations that are excluded or underrepresented in clinical trials. This registry has the potential to generate scientific evidence to inform our pandemic response, and to serve as a model for the rapid implementation of population-based data collection protocols for future public health emergencies. TRIAL REGISTRATION: Clinicaltrials.gov, no. NCT04702945.


Subject(s)
COVID-19 , Emergency Medicine , Registries , COVID-19/diagnosis , COVID-19/therapy , Canada , Data Accuracy , Data Collection , Data Management , Emergency Service, Hospital , Evidence-Based Emergency Medicine , Follow-Up Studies , Humans , Information Storage and Retrieval , Patient Reported Outcome Measures , Prospective Studies , Quality of Life , Retrospective Studies , SARS-CoV-2 , Telephone
9.
Emerg Med Pract ; 23(2): 1-24, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33476506

ABSTRACT

As recommendations for the diagnosis, treatment, and disposition of patients with community-acquired pneumonia continue to evolve, this issue reviews the current evidence and guidelines for managing these patients in the emergency department. The various clinical decision aids are compared, as they assist in determining the level of inpatient care required and allow for a greater proportion of patients to be treated successfully as outpatients. A clinical pathway for emergency department management delineates optimal antibiotic regimens based on severity, comorbidities, and risk factors.


Subject(s)
Community-Acquired Infections/diagnosis , Community-Acquired Infections/therapy , Emergency Service, Hospital , Evidence-Based Emergency Medicine , Pneumonia/diagnosis , Pneumonia/therapy , Humans
10.
Emerg Med J ; 38(1): 78-79, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33372045

ABSTRACT

A shortcut review was carried out to see whether the hook test is sensitive enough for a negative result to exclude complete distal biceps tendon rupture (DBTR) in adults. 3 papers 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 papers are tabulated. It is concluded that the hook test is moderately sensitive at detecting complete DBTR when carried out by skilled clinicians in specialist upper limb clinics. As a single test, it is not sensitive enough to be used to exclude complete DBTR.


Subject(s)
Arm Injuries/diagnosis , Physical Examination/methods , Tendon Injuries/diagnosis , Diagnosis, Differential , Evidence-Based Emergency Medicine , Humans , Rupture , Sensitivity and Specificity
11.
Emerg Med J ; 38(1): 79-80, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33372046

ABSTRACT

A shortcut review was carried out to investigate whether avulsion fractures of the base of the fifth metatarsal were best treated with tubular bandage, a walking boot or a short leg plaster cast. One paper presented the only evidence to answer one of the clinical questions (plaster cast or walking boot) but no evidence was found comparing tubular bandage and a walking boot. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. It is concluded that while the only evidence available shows marginal benefit of walking boot over short plaster cast during recovery, there is no benefit to final outcome. Further research comparing tubular bandage and walking boot is required.


Subject(s)
Bandages , Casts, Surgical , Foot Orthoses , Fractures, Avulsion/therapy , Metatarsal Bones/injuries , Evidence-Based Emergency Medicine , Humans
12.
J Emerg Nurs ; 47(1): 113-122, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33221035

ABSTRACT

INTRODUCTION: ED visits for gastrostomy tube-related complications are common, and many are related to tube displacement. Evidence-based practices can provide standardized care. METHODS: This study was an evidence-based project to develop and implement an algorithm for the care of patients with a displaced gastrostomy tube in the emergency department. Providers were educated on the algorithm, and clinical practice change was evaluated. Provider knowledge was assessed using pretest and posttest; analyses included paired t test. Descriptive statistics of electronic medical record data on confirmation method, documentation, and referral were reported. RESULTS: Provider knowledge was improved after the education (n = 22; t(21) = -3.80; P = 0.001). After the education, procedure notes were used and completed in 95% of the cases. Appropriate use of the confirmation method was present in 95% of the cases, and all cases were referred to the gastrostomy/specialty clinic. DISCUSSION: Educating providers regarding care for displaced gastrostomy tubes increased their knowledge. A standardized algorithm improved care by decreasing the use of contrast studies, improving documentation, and referring patients to the gastrostomy/specialty clinic. This evidence-based algorithm offered health care providers a protocol to ensure consistent care for children in the emergency department and support for families.


Subject(s)
Algorithms , Emergency Service, Hospital , Evidence-Based Emergency Medicine/education , Gastrostomy/adverse effects , Quality Improvement , Child , Educational Measurement , Hospitals, Community , Humans
13.
Emerg Med Pract ; 22(Suppl 12): 1-43, 2020 Dec 15.
Article in English | MEDLINE | ID: mdl-33320488

ABSTRACT

Blunt cerebrovascular injuries include cervical carotid dissections and vertebral artery dissections that are due to blunt trauma. Although the overall incidence is low, dissections remain a common cause of stroke in children, young adults, and trauma patients. Symptoms of dissection, such as headache, neck pain, and dizziness, are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient or may not be recognized as being due to a dissection. A missed diagnosis of cervical artery dissection can result in devastating neurologic sequelae, and emergency clinicians must act quickly to recognize this diagnosis and begin treatment as soon as possible. This supplement reviews the application of advanced screening criteria, imaging options, and antithrombotic treatment for patients with blunt cerebrovascular injuries, with a focus on reducing the occurrence of ischemic stroke.


Subject(s)
Craniocerebral Trauma/complications , Emergency Service, Hospital , Stroke/etiology , Stroke/prevention & control , Wounds, Nonpenetrating/complications , Anticoagulants/therapeutic use , Carotid Artery, Internal, Dissection/complications , Carotid Artery, Internal, Dissection/diagnosis , Carotid Artery, Internal, Dissection/drug therapy , Craniocerebral Trauma/diagnosis , Craniocerebral Trauma/drug therapy , Diagnosis, Differential , Diagnostic Imaging , Early Diagnosis , Evidence-Based Emergency Medicine , Humans , Medical History Taking , Physical Examination , Risk Factors , Vertebral Artery Dissection/complications , Vertebral Artery Dissection/diagnosis , Vertebral Artery Dissection/drug therapy , Wounds, Nonpenetrating/diagnosis , Wounds, Nonpenetrating/drug therapy
15.
Emerg Med Pract ; 22(12): 1-20, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33211443

ABSTRACT

Rhabdomyolysis is a life-threatening pathological process that must be treated as early as possible to avoid potentially life-threatening sequelae. Much of the evidence that informs the management of rhabdomyolysis is retrospective research, often reported from mass disasters, and many practices that have been implemented as standard treatment are based on small studies published more than 30 years ago. This issue reviews the current literature on rhabdomyolysis and provides recommendations for each phase of care, from the prehospital setting through disposition. The evidence is examined regarding the variety of therapies that are used to manage rhabdomyolysis, the potential for recognizing a genetic predisposition for the condition, and therapeutic recommendations that improve patient outcomes.


Subject(s)
Emergency Service, Hospital , Evidence-Based Emergency Medicine , Rhabdomyolysis/diagnosis , Rhabdomyolysis/therapy , Diagnosis, Differential , Humans
18.
Emerg Med Pract ; 22(10): CD1-CD2, 2020 Oct 01.
Article in English | MEDLINE | ID: mdl-33080128
20.
Emerg Med J ; 37(11): 725-728, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33097554

ABSTRACT

A short cut review was carried out to establish whether intra-articular injection of local anaesthetic is an effective alternative to intravenous analgesia with or without sedation to facilitate reduction of acute shoulder dislocations. Eleven studies were considered relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these studies are tabulated. The clinical bottom line is that intra-articular injection of local anaesthetic is a safe and effective method of providing procedural analgesia for the reduction of acute shoulder dislocations.


Subject(s)
Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Conscious Sedation , Pain Management/methods , Shoulder Dislocation/therapy , Evidence-Based Emergency Medicine , Humans , Injections, Intra-Articular
SELECTION OF CITATIONS
SEARCH DETAIL
...