General
MHRA: monitoring the safety of seasonal influenza vaccines in children
The MHRA have asked for help monitoring the safety of seasonal influenza vaccines in children. They strongly encourage healthcare professionals to promptly report any cases of febrile convulsion occurring within 72 hours of receiving an influenza vaccine.
Heart attack treatment – primary angioplasty overtakes clot-busting drugs
Figures from the 9th annual MINAP audit show that 63% of eligible patients had primary angioplasty, compared to 44% in 2008/9. Ambulance staff take heart attack patients directly to the catheter laboratory of the nearest heart attack centre, bypassing the Accident and Emergency (A&E) department. This year's results show that 76% of patients that were treated with primary angioplasty were admitted directly to a heart attack centre in England.
Alcohol Related Harms
Young adults are at significant risk of becoming dependent on alcohol or developing advanced liver disease in the future. There is strong evidence that attending an Emergency Department as a result of hazardous drinking creates a “teachable moment” that can be used to modify subsequent behaviour. Every Emergency Department clinician should be able to deliver health advice regarding alcohol consumption at this point.
Evidence-Based Medicine
BestBETS – Best Evidence Topics provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. Five new or modified BETS were added last month.
Non-invasive ventilation in hypercapnic coma
Whole-body CT In trauma patients
Dexamethasone versus prednisolone in asthma
Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults
Intensive insulin vs. conventional treatment for hyperglycaemia in critically ill patients
Cochrane Library
Cochrane Database of Systematic Reviews
Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding
Corticosteroids for acute bacterial meningitis
Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism
Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults
Platelet glycoprotein IIb/IIIa blockers during percutaneous coronary intervention and as the initial medical treatment of non-ST segment elevation acute coronary syndromes
Red cell transfusion for the management of upper gastrointestinal haemorrhage
Short-course antibiotics for acute otitis media
Surgical interventions for treating acute Achilles tendon ruptures
Highlights from the Literature
Emergency Medicine Journal 27(9) September 2010
The additional use of end-tidal alveolar dead space fraction following D-dimer test to improve diagnostic accuracy for pulmonary embolism in the emergency department
Effect of 24-h alcohol licensing on emergency departments: the South Yorkshire experience
Ischaemia modified albumin cannot be used for rapid exclusion of acute coronary syndrome
The role of health and non-health-related factors in repeat emergency department visits in an elderly urban population
Conferences, Study
Emergency Medicine Continuing Education Forum, 10 October, Coventry
UK Team Course, 13-14 October , Edinburgh
ATLS Course, 13-15 October, Croydon
Thoracic Ultrasound course, 19 October, Kettering
Alder Hey Course in Paediatric Emergency Medicine, 21-22 October, Liverpool
Basic Trauma Course, 23 October, Solihull
International Critical Care Symposium, 29 October, London
Adult Sexual Assault Examination and Aftercare course, 13 November, London
CEM Simulation Faculty course, 22 November, Bath
Some Solutions and Emerging Challenges in Encephalitis, 29 November, London
The Black Country Echocardiography Course for Non-Cardiologists, 29-30 November, Dudley
Toxicology: An Update for the Emergency Physician, 30 November 2010, Newcastle
Bi-annual symposium - Paediatric EM covering ST3 competencies, 7 January, Birmingham
Observation Medicine & Ambulatory Care in the Emergency Department 10 January, London
New Medscape Emergency Medicine CME
Graded Symptom Checklist Helps Quantify Symptom Severity in Mild Traumatic Brain Injury
Delaying Appendectomy May Not Be Harmful for Adults With Acute Appendicitis
Imaging of Acute Stroke
Understanding the Etiology and Pathophysiology of Acute Mesenteric Ischemia
This bulletin is brought to you by Library and Knowledge Services. It aims to keep you up-to-date with clinical governance issues. At the beginning of each month, a librarian will update the bulletin with relevant information published in the preceding month. If there are areas you think we also need to cover, please let us know.
This bulletin is brought to you by Library and Knowledge Services. It aims to keep you up-to-date with accident and emergency issues. At the beginning of each month, a librarian will update the bulletin with relevant information published in the preceding month. If there are areas you think we also need to cover, please let us know.
