ABSTRACT
A short cut review was carried out to establish whether nasal erythema in a reindeer might be a useful navigational aid on Christmas Eve. From a search of nine papers, five presented evidence relevant to the question. The author, date and country of publication, "subjects" studied, study type, relevant outcomes, results and study weaknesses of these papers are presented in table 3. The clinical bottom line is that a reindeer with a red nose at rest at the North Pole would not inspire confidence.
Subject(s)
Erythema/veterinary , Nose Diseases/veterinary , Reindeer , Travel , Wit and Humor as Topic , Animals , WeatherSubject(s)
Myocardial Ischemia/diagnosis , Aged , Antineoplastic Agents, Phytogenic/therapeutic use , Blood Vessel Prosthesis Implantation , Body Surface Potential Mapping , Coated Materials, Biocompatible/therapeutic use , Coronary Stenosis/diagnosis , Coronary Stenosis/therapy , Humans , Image Processing, Computer-Assisted , Male , Myocardial Ischemia/therapy , Myocardial Reperfusion , Paclitaxel/therapeutic use , StentsABSTRACT
A short cut review was carried out to establish whether serial x rays were necessary in cases of battery ingestion where the battery has passed through the oesophagus. A total of 104 papers were found using the reported search, of which none presented any evidence to answer the clinical question. It is concluded that there is no evidence available to answer this question. Further research is needed.
Subject(s)
Electric Power Supplies , Foreign Bodies/diagnostic imaging , Radiography, Abdominal , Deglutition , Emergency Service, Hospital , Evidence-Based Medicine , Humans , Long-Term Care/methodsABSTRACT
A short cut review was carried out to establish whether a torn frenulum in a child is indicative of non-accidental injury. Altogether 104 papers were found using the reported search, of which none presented any evidence to answer the clinical question. It is concluded that there is no evidence available to answer this question. Further research is needed.
Subject(s)
Child Abuse/diagnosis , Labial Frenum/injuries , Accidental Falls , Child, Preschool , Emergency Service, Hospital , Evidence-Based Medicine , Humans , InfantABSTRACT
A short cut review was carried out to establish the published evidence for gastric lavage in lithium overdose. Altogether 20 papers were found using the reported search, of which none presented the best evidence to answer the clinical question. A clinical bottom line is stated.
Subject(s)
Antimanic Agents/poisoning , Gastric Lavage , Lithium Carbonate/poisoning , Adult , Drug Overdose , Emergency Medicine , Evidence-Based Medicine , Humans , MaleABSTRACT
A short cut review was carried out to establish whether the insertion of a femoral central venous pressure line causes more thrombotic complications than insertion of a jugular line. Altogether 90 papers were found using the reported search, of which eight 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)
Catheterization, Central Venous/adverse effects , Femoral Vein , Thrombosis/etiology , Aged , Emergencies , Fractures, Bone/complications , Fractures, Bone/therapy , Humans , Male , Pulmonary Edema/complications , Pulmonary Edema/therapyABSTRACT
A short cut review was carried out to establish whether the absence of a clinical pulse deficit can be used to exclude dissecting thoracic aneurysm in patients with chest pain. Altogether 89 papers were found using the reported search, of which one was a previous systematic literature review. A further two papers published since the review were also found. These three 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 best papers are tabulated. A clinical bottom line is stated.
Subject(s)
Aortic Aneurysm, Thoracic/diagnosis , Aortic Dissection/diagnosis , Pulse , Chest Pain/etiology , Emergencies , Evidence-Based Medicine , Humans , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
A short cut review was carried out to establish whether gastric lavage was better than activated charcoal alone at reducing toxicity after aspirin or other non-steroidal anti-inflammatory drug (NSAID) overdose. Altogether 72 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. A further relevant paper was found on scanning the references of papers identified. 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)
Anti-Inflammatory Agents, Non-Steroidal/poisoning , Aspirin/poisoning , Gastric Lavage , Charcoal/therapeutic use , Drug Interactions , Drug Overdose/therapy , Emergencies , Evidence-Based Medicine , Female , Humans , Middle Aged , Suicide, AttemptedABSTRACT
A short cut review was carried out to establish whether parenteral thiamine was more effective than an oral preparation at replacing thiamine in alcoholics without encephalopathy. Twenty five 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)
Alcoholism/complications , Thiamine Deficiency/drug therapy , Thiamine/administration & dosage , Administration, Oral , Emergency Service, Hospital , Evidence-Based Medicine , Humans , Infusions, Intravenous , Thiamine Deficiency/etiologyABSTRACT
A short cut review was carried out to establish whether prophylactic antibiotics reduce infections and other complications in elderly patients with pretibial haematomas. Altogether 65 papers were found using the reported search, of which none presented any evidence to answer the clinical question. It is concluded that there is no evidence available to answer this question. Further research is needed.
Subject(s)
Antibiotic Prophylaxis , Hematoma/complications , Leg Injuries/complications , Wound Infection/prevention & control , Aged , Aged, 80 and over , Emergency Service, Hospital , Evidence-Based Medicine , HumansABSTRACT
A short cut review was carried out to establish the sensitivity of a normal chest radiograph as a rule out test for aortic aneurysm. Altogether 557 papers were found using the reported search, of which four 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)
Aortic Aneurysm/diagnostic imaging , Aortography , Humans , Male , Mediastinum/diagnostic imaging , Middle Aged , Sensitivity and SpecificityABSTRACT
A short cut review was carried out to establish whether gastric lavage is better than activated charcoal in cases of poisoning with paracetamol. Altogether 63 papers were found using the reported search, of which four 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)
Acetaminophen/poisoning , Analgesics, Non-Narcotic/poisoning , Gastric Lavage , Suicide, Attempted , Charcoal/therapeutic use , HumansABSTRACT
A short cut review was carried out to establish which of the ice glove technique, the multiple puncture technique, or the application of sugar was the best approach for paraphimosis reduction. Thirty three papers were found using the reported search, of which three 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)
Paraphimosis/therapy , Dietary Carbohydrates/therapeutic use , Humans , Ice , Male , PuncturesABSTRACT
AIM: To assess the ability of nurses using the Manchester Triage System (MTS) to identify those patients with chest pain requiring immediate electrocardiogram (ECG) and physician assessment within ten minutes. METHOD: A four-week prospective cohort of all patients attending with chest pain compared detection of risk by nurses using the MTS to that of researchers using best available evidence-based prognostic indicators from history. RESULTS: The study of 167 patients showed that nurses using MTS had a sensitivity of 86.8 per cent (95 per cent confidence interval (CI), 78.4-92.3 per cent) and a specificity of 72.4 per cent (95 per cent CI, 61.4-81.2 per cent) when identifying high risk cardiac chest pain. CONCLUSION: Nurses using the MTS are a sensitive tool for identifying high risk cardiac chest pain but further work is required to assess whether additional training can improve sensitivity.
Subject(s)
Angina Pectoris/diagnosis , Chest Pain/classification , Chest Pain/nursing , Electrocardiography/nursing , Emergency Nursing/methods , Triage/methods , Chest Pain/diagnosis , Cohort Studies , Diagnosis, Differential , False Negative Reactions , Humans , Prospective Studies , Risk Assessment , Sensitivity and SpecificityABSTRACT
A short cut review was carried out to establish whether negative dipstick urine analysis is sensitive enough to rule out urinary tract infection (UTI) in adults with urinary symptoms. Altogether 75 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)
Reagent Strips , Urinary Tract Infections/diagnosis , Adult , Evidence-Based Medicine , Female , Humans , Sensitivity and Specificity , Urinalysis/methodsABSTRACT
A short cut review was carried out to establish whether antacids can be used as a diagnostic test in atypical chest pain. Altogether 374 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)
Antacids , Chest Pain/etiology , Angina Pectoris/diagnosis , Diagnosis, Differential , Gastroesophageal Reflux/diagnosis , Humans , Male , Middle AgedABSTRACT
A short cut review was carried out to establish whether gastric lavage is indicated after tricyclic antidepressant overdose. Altogether 82 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)
Amitriptyline/poisoning , Antidepressive Agents, Tricyclic/poisoning , Adult , Drug Overdose/therapy , Female , Gastric Lavage , HumansABSTRACT
A short cut review was carried out to establish what level of INR was a contraindication to thrombolysis in patients taking warfarins. Altogether 296 papers were found using the reported search, but none presented any evidence to answer the clinical question. More research is needed in this area and, in the mean time, local advice should be followed.
Subject(s)
Anticoagulants/therapeutic use , Coumarins/therapeutic use , Thrombolytic Therapy , Aged , Contraindications , Female , Humans , International Normalized RatioABSTRACT
A short cut review was carried out to establish whether CT scans of the upper cervical spine are necessary in trauma patients with altered mental status and normal plain radiographs. A total of 572 papers were found using the reported search, of which six 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.
