MSF Blog Surprise trauma Trauma basics Trauma skills Blunt trauma Penetrating trauma Evidence reviews Compendium Cardiology Infectious disease Paediatrics Neurology Pharmacology Toxicology/electrolytes Respiratory Best of FOAM Websites Journals Podcasts Ultrasound Anaesthetics French About A review of some of the latest low-resourcs emergency medicine evidence Implementing WHO guidelines for unwell newborns. Management of possible serious bacterial infection in young infants where referral is not possible in the context of existing health system structure in Ibadan, South-west Nigeria Ayede A et al. Aim To test the feasibility of implementing an outpatient protocol for suspected neonatal sepsis when referral isn’t possible. Rationale The WHO has developed guidelines that recommend a simplified outpatient antibiotic…
This week I learnt – 6
That we may not have to use sterile gloves for suturing Magnesium can help to rate control Atrial fibrillation (but interestingly not cardioversion). There is concern that high dose naloxone will lead to rebound agitation; however this did not seem the case in this observational study. The continued utility of TXA is demonstrated in this paper looking specifically at the low acuity injuries and still demonstrates a survival benefit (if given early).
Can we use non-sterile gloves for suturing?
MSF Blog Surprise trauma Trauma basics Trauma skills Blunt trauma Penetrating trauma Evidence reviews Compendium Cardiology Infectious disease Paediatrics Neurology Pharmacology Toxicology/electrolytes Respiratory Best of FOAM Websites Journals Podcasts Ultrasound Anaesthetics French About A review of some of the latest low-resourcs emergency medicine evidence Use of non-sterile gloves for suturing Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial Juliette J M Zwaans ,Wouter Raven , Arthur V Rosendaal, Esther M M Van Lieshout, Geesje Van Woerden ,Peter Patka ,Juanita A Haagsma , Pleunie P M Rood Aim To assess if the use of…
This week I learnt- 5
Controlling fever doesn’t seem to have any effect on serious outcomes or death. Controlling fever could be harmful but of course can be provided for comfort. It is probably safe to skip thrombolysis and go straight to thrombectomy. Beware winter’s morphology as STEMI mimic In kids with buckle fracture unlikely matters much what type of immobilisation is offered. That saying “quiet” in an emergency department does not make it busier (but leads to perception it is!)
That the biggest decrease in a patient’s angina symptoms come form telling them the lesion they have isn’t going to cause a problem. Explored more; apparently about a third had symptoms completely improved. Clinical prediction tools are much better validated to “rule out” than “rule in” the need for intervention. The “weekend effect” is more likely due to lack of community services than inadequate hospital services. In low-resources environments (in this case South Africa) a (Free) emergency department visit could cost them about a third of their monthly income.