Craig Ferguson

Topical anaesthetic versus lidocaine infiltration to allow closure of skin wounds in children

A short cut review was carried out to establish whether topical anaesthetics are an acceptable alternative to lidocaine infiltration in children. A total of 54 papers were found using the reported search, of which seven represented 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.

Procedural sedation for cardioversion

A short-cut review was conducted to establish whether any of the available drugs used for procedural sedation in patients with tachydysrhythmias are safer or more effective than the alternatives. In all, 135 papers were found using the reported searches, of which 7 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. It is concluded that propofol, methohexital, thiopentone and etomidate all seem to be good choices.

Should a child with preseptal periorbital cellulitis be treated with intravenous or oral antibiotics

Report by Shafic Al-Nammari, Junior Clinical Research Fellow Search checked by Benjamin Roberton/Craig Ferguson Moorfields Eye Hospital & St George’s Hospital A short cut review was carried out to establish whether there was any evidence to show whether children with preseptal periorbital cellulitis should be treated with intravenous or oral antibiotics. 395 papers were found using the reported searches of which none presented any evidence to answer the clinical question. It is concluded that there is no evidence to determine whether intravenous antibiotics are better than oral antibiotics in the management of simple …

Early mobilisation for volar plate avulsion fractures

Report by Richard Body, Clinical Research Fellow Checked by Craig J Ferguson, Clinical Research Fellow A short cut review was carried out to establish whether rest or mobilisation is best for volar plate avulsion fractures. A total of 73 papers were found using the reported search, of which two represented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, …

Delivery of bronchodilators in acute asthma in children

### Abstract A short cut review was carried out to establish whether delivery of bronchodilators to children was better by spacer device or nebuliser. 1456 papers were found using the reported searches, 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. It is concluded that in most cases where a child presents with moderate to severe asthma beta-2-agonists could be delivered via a spacer device in place of a nebuliser. ### Clinical scenario A seven year old child with a known history of asthma presents with a 24 hour history of exacerbation of wheeze. He has been using his salbutamol inhaler with little benefit. You prescribe a s-agonist by nebuliser but wonder if it …

BET 1: ASSESSING THE SIZE OF BURNS: WHICH METHOD WORKS BEST?

Report by: Saiqa Hussain , Medical Student Search checked by: Craig Ferguson , SpR Emergency Medicine Institution: Manchester Royal Infirmary, Manchester, UK A short-cut review was carried out to establish whether there is one assessment method that is the most accurate at estimating the surface area of a burn. Over 1500 papers were found using the reported searches, of which five 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 shown in table 1. It is concluded that there is no evidence to show benefit of one form of estimation over another in clinical practice. View this table: Table 1 Relevant papers ### CLINICAL SCENARIO A 30-year-old woman is brought to the emergency department with extensive burns after having been trapped in a burning car. After initial resuscitation of the patient you attempt to assess the surface area of skin affected by the burn in order to guide the volume of fluid required for resuscitation. You wonder which method of surface area assessment is the best tool for assessing the surface area of her burns. ### THREE-PART QUESTION In a [patient with a burn] is there one [method of assessment of size] that is most [accurate to assess surface area of the wound]? ### SEARCH STRATEGY Medline using the OVID interface 1966 to May 2009:[burn

Aspirin in the treatment of acute pulmonary embolism

.mp OR exp Burns OR heat injur

Pregnancy-associated plasma protein A: a novel cardiac marker with promise

.mp OR thermal injur

BET 2: SHOULD WE BE MEASURING TROPONINS IN PATIENTS WITH ACUTE PERICARDITIS?

.mp OR scald.mp] AND [assess

BET 2: Is early chemical thromboprophylaxis safe in patients with blunt trauma solid organ injury (SOI) undergoing non-operative management (NOM)?

.mp …