Subject(s)
Acetaminophen/administration & dosage , Acetaminophen/poisoning , Databases, Factual , Drug Overdose , Female , Humans , Toxicology , Young AdultSubject(s)
Casts, Surgical , Humeral Fractures/therapy , Orthotic Devices , Aged , Evidence-Based Medicine , Humans , Middle AgedSubject(s)
Esophageal Diseases/etiology , Hernia, Hiatal/complications , Respiratory Sounds/etiology , Stomach Volvulus/complications , Aged , Dilatation, Pathologic/diagnostic imaging , Dilatation, Pathologic/etiology , Dilatation, Pathologic/surgery , Esophageal Diseases/diagnostic imaging , Esophageal Diseases/surgery , Female , Hernia, Hiatal/diagnostic imaging , Hernia, Hiatal/surgery , Humans , Radiography , Respiratory Sounds/diagnosis , Stomach Volvulus/diagnosis , Stomach Volvulus/surgeryABSTRACT
Transient Global Amnesia (TGA) is a benign and temporary loss of anterograde memory with the preservation of remote memories and immediate recall. TGA was first described in 1956 and since then epilepsy, transient ischaemic attacks (TIA), migraine and now intracranial venous stasis have been implicated in its aetiology. Precipitants of TGA include physical exertion and valsalva-like manoeuvres. In order to diagnose TGA the criteria created by Hodge and Warlow in 1990 can be used. This requires the episode of memory loss to be witnessed and involve anterograde amnesia. The patient must not have any evidence of neurological signs or deficits, features of epilepsy, active epilepsy or recent head injury. Finally the episode must have resolved within 24 h. In this case study the patient's symptoms are mistakenly attributed to a TIA. There is no increased risk of TIA or CVA in patients who have had TGA and there are no increased levels of mortality amongst these patients. In this article we aim to help doctors working in the emergency department to diagnose and manage TGA.
Subject(s)
Amnesia, Transient Global/diagnosis , Amnesia, Transient Global/therapy , Diagnosis, Differential , Emergency Medicine/methods , Emergency Service, Hospital , Female , Humans , Ischemic Attack, Transient/diagnosis , Treatment OutcomeABSTRACT
A short-cut review was carried out to establish whether myringotomy is of value in cases of haemotympanum. In all, 205 papers were found in Medline and 105 in Cochrane using the reported searches. None presented any evidence to answer the clinical question. Hence, it is concluded that there is no evidence available to guide this decision and that local expert advice should be followed.
Subject(s)
Hemorrhage/surgery , Tympanic Membrane/injuries , Tympanic Membrane/surgery , Adult , Emergencies , Evidence-Based Medicine , Hemorrhage/etiology , Humans , MaleABSTRACT
A short cut review was carried out to establish how long after onset of headache a lumbar puncture should be carried out to rule out subarachnoid haemorrhage. Altogether 142 papers were found using the reported search, of which one 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 this best paper are tabulated. A clinical bottom line is stated.
Subject(s)
Spinal Puncture/methods , Subarachnoid Hemorrhage/diagnosis , Evidence-Based Medicine , Headache/etiology , Humans , Subarachnoid Hemorrhage/complications , Time FactorsABSTRACT
A short cut review was carried out to establish whether intubation is always required in patients presenting with a decreased conscious level after gamma-hydroxybutyrate ingestion. Altogether 95 papers were found using the reported search, of which two 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. A clinical bottom line is stated.
Subject(s)
Anesthetics/poisoning , Intubation, Intratracheal , Sodium Oxybate/poisoning , Adult , Coma/chemically induced , Coma/therapy , Drug Overdose , Emergency Medicine , Evidence-Based Medicine , Humans , MaleABSTRACT
A short cut review was carried out to establish whether CT scans are better than tangential skull radiographs at detecting depressed skull fractures. No papers answering this question were found using the reported search.
Subject(s)
Skull Fracture, Depressed/diagnostic imaging , Skull/diagnostic imaging , Tomography, X-Ray Computed , Adult , Evidence-Based Medicine , Humans , MaleABSTRACT
A short cut review was carried out to establish whether antibiotics reduce infective complications after puncture wounds to the foot. A total of 29 papers were found using the reported search, of which none answered the question posed. Further research is needed in this area.
