Russell Boyd

Perimortem caesarean section

A short cut review was carried out to establish whether there is any evidence to show that perimortem caesarean section in the third trimester can save the life of the child or mother. Altogether 1210 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 paper are tabulated. A clinical bottom line is stated

Corticosteroids in the management of near-drowning

Report by Bernard A Foex, Specialist Registrar Checked by Russell Boyd, Consultant (Adelaide, Australia) A 15 year old boy was playing in the local canal. He jumped off a small bridge and got his foot caught in an old shopping trolley on the bottom. He was pulled out but he was unconscious and apnoeic. He was given BLS by the paramedics so that when he arrived in accident and emergency he was conscious, tachypnoeic, and centrally cyanosed. He …

EMLA or amethocaine (tetracaine) for topical analgesia in children

Report by Russell Boyd, Consultant Search checked by Michelle Jacobs, Specialist Registrar A 5 year old child is to undergo venepuncture for a diagnostic blood test. You wonder if the application of Ametop (4% amethocaine gel) or EMLA …

Journal clubs in clinical medicine

Journal clubs in clinical medicine have long been recognised as a useful tool for keeping up to date with new developments.1 More recently they have been used as a tool for the teaching of critical appraisal,2 which for emergency medicine trainees in the UK is an important part of …

Glucose or glucagon for hypoglycaemia

Report by Russell Boyd, Specialist Registrar Search checked by Bernard Foex, Specialist Registrar An insulin dependent diabetic adult is brought into the emergency department uncooperative and acutely confused. A blood glucose stick test confirms hypoglycaemia. You wonder whether parenteral glucose or …

Leucovorin (calcium folinate) in “antifreeze” poisoning

A short cut review was carried out to establish whether the addition of intravenous calcium folinate to standard (ethanol) therapy reduced the visual complications of antifreeze (methanol and ethyleny glycol). Altogether 12 papers were found using the reported search, of which one animal study 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.

IL D-dimer test in the diagnosis of pulmonary embolism

A short cut review was carried out to establish whether a negative IL D-dimer test alone could be used to rule out a diagnosis of pulmonary embolus. Six 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.

Accuracy of combining clinical probability score and simpliRED d-dimer for diagnosis of pulmonary embolism

A short cut review was carried out to establish whether bedside clinical examination and simpliRED d-dimer are sufficiently sensitive to rule out pulmonary embolus. A total of 272 papers were found using the reported search, 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 tabulated. A clinical bottom line is stated.

Intramuscular piroxicam or intramuscular diclofenac for renal colic

Report by Russell Boyd, Consultant in Emergency Medicine Checked by Polly Terry, Specialist Registrar in Emergency Medicine A 35 year old man presents to the emergency department with acute renal colic proven on urine dipstick analysis and urgent IVU. His pain is severe and you would like …

Erythrocyte sedimentation rate and septic arthritis in children

Report by Russell Boyd, Consultant Search checked by Bruce Martin, Specialist Registrar A 3 year old child presents to the emergency department with a short history of limp, temperature and difficulty in weight bearing on the left leg. The pain is principally located at the hip joint and you fear this …