{"title":"Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Low molecular weight heparin or unfractionated heparin in the treatment of patients with uncomplicated deep vein thrombosis.","authors":"B Lane, M Harrison","doi":"10.1136/emj.17.6.402","DOIUrl":"https://doi.org/10.1136/emj.17.6.402","url":null,"abstract":"Report by Beverley Lane, Research Nurse Search checked by Magnus Harrison, Research Fellow \u0000\u0000A 60 year old man presents with a three day history of pain in his left calf. You suspect an above knee deep vein thrombosis (DVT), which is later confirmed by ultrasound. You are …","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"402-3"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21927748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Phrenic nerve injury following blunt trauma.","authors":"D Bell, A Siriwardena","doi":"10.1136/emj.17.6.419","DOIUrl":"https://doi.org/10.1136/emj.17.6.419","url":null,"abstract":"<p><p>Phrenic nerve trauma in the absence of direct injury is unusual and may present diagnostic difficulty. Diaphragmatic paralysis resulting from phrenic nerve injury may closely mimic diaphragmatic rupture. This case highlights the value of magnetic resonance imaging in establishing diaphragmatic integrity and of ultrasonographic assessment during respiratory excursion in confirming diaphragmatic paralysis. In cases of non-contact injury involving torsional injury to the neck, an index of clinical awareness may help to establish the diagnosis of phrenic nerve trauma.</p>","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"419-20"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21927754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Outpatient treatment for patients with uncomplicated above knee deep vein thrombosis.","authors":"B Lane, M Harrison","doi":"10.1136/emj.17.6.403","DOIUrl":"https://doi.org/10.1136/emj.17.6.403","url":null,"abstract":"Report by Beverley Lane, Research Nurse Search checked by Magnus Harrison Clinical Research Fellow \u0000\u0000A 25 year old man presents at the emergency department with a two day history of a swollen and painful right leg. A DVT is suspected and an ultrasound confirms the presence of an extensive clot in the femoral vein. …","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"403-4"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21927749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The laws of violence.","authors":"J Bache","doi":"10.1136/emj.17.6.396","DOIUrl":"https://doi.org/10.1136/emj.17.6.396","url":null,"abstract":"<p><p>Working in an accident and emergency (A&E) department inevitably involves dealing with the consequences of violence, and a knowledge of the laws of violence is a useful adjunct to the clinical practice of A&E medicine. The police and the Crown Prosecution Service decide whether or not to charge a suspect, and which charge is appropriate. All criminal offences are initially considered in the magistrates' court but the more serious offences may be committed to crown court. Specific offences include common assault, actual bodily harm, grievous bodily harm, and grievous bodily harm with intent. If the defendant is found guilty, an appropriate sentence is imposed.</p>","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"396-9"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21927746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Vomiting and serious head injury in children.","authors":"J Barnard, S Carley","doi":"10.1136/emj.17.6.400-a","DOIUrl":"https://doi.org/10.1136/emj.17.6.400-a","url":null,"abstract":"Report by Jim Barnard, Senior House Officer Search checked by Simon Carley, Specialist Registrar \u0000\u0000A 4 year old boy presents to the emergency department after a one metre fall onto a carpeted floor. The child has vomited three times in the past hour but is otherwise well. Clinical examination is unremarkable. You wonder how significant the vomiting is.\u0000\u0000In [a …","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"400-2"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.400-a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21927747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Article 4. An introduction to estimation--1. Starting from Z.","authors":"P Driscoll, F Lecky, M Crosby","doi":"10.1136/emj.17.6.409","DOIUrl":"https://doi.org/10.1136/emj.17.6.409","url":null,"abstract":"In covering these objectives we will introduce the following terms:\u0000\u0000\u0000\u0000\u0000\u0000In the previous article the term inferential statistic was introduced.1 This form of numeric manipulation is often used to estimate a population's parameter from a sample's statistic. For example, inferential statistics would be used to estimate a population's mean from a sample's mean. It can also be used to do the opposite—that is, estimate a sample statistic from a population's parameter. This is not commonly done because it requires the population's mean and standard deviation to be known and this is rarely the case.\u0000\u0000In both calculations the values obtained are only estimations because of the normal variation that occurs. We can however work out the probability of a particular value based upon information from either the sample or population. Central to this is converting the original data to a standard normal distribution so that these estimations can be made.\u0000\u0000A standard normal distribution is a particular type of normal distribution that has the following properties:\u0000\u0000\u0000\u0000\u0000\u0000It is possible to convert any normal distribution to a standard normal distribution by adjusting it such that the population mean becomes zero and the standard deviation is equal to 1. To do this, each of the data points (elements) is modified by:\u0000\u0000\u0000\u0000\u0000\u0000The final value is known as the z statistic. The z statistic is therefore describing the size of the difference between the element (X) and population's mean (μ) …","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"409-15"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21927753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Punchbag machine injuries in a nightclub.","authors":"H Forshaw, J Wyatt","doi":"10.1136/emj.17.6.432","DOIUrl":"https://doi.org/10.1136/emj.17.6.432","url":null,"abstract":"Editor,—Working in accident and emergency (A&E), we are used to patients presenting with injuries sustained during punching. Some of these injuries are sustained by people while in nightclubs, and almost invariably the “punch” is not welcomed by the nightclub management. We wish to …","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"432"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21928930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Prior injection of local anaesthetic and the pain and success of intravenous cannulation.","authors":"R Murphy, S Carley","doi":"10.1136/emj.17.6.406","DOIUrl":"https://doi.org/10.1136/emj.17.6.406","url":null,"abstract":"Report by Ross Murphy Specialist Registrar Search checked by Simon Carley, Specialist Registrar \u0000\u0000A 45 year old woman attends the emergency department with cellulitis. You decide to admit her for intravenous antibiotics. She becomes agitated, distressed and tearful when you explain this to her. On questioning she reveals that she is afraid of the pain of intravenous cannulation. You wonder whether a prior injection of local anaesthetic would lessen the pain …","PeriodicalId":73580,"journal":{"name":"Journal of accident & emergency medicine","volume":"17 6","pages":"406-8"},"PeriodicalIF":0.0,"publicationDate":"2000-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.17.6.406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21927752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}