BET 2: Does topical lidocaine improve oral intake in children with painful mouth ulcers?

2020 ◽  
Vol 37 (2) ◽  
pp. 113-114
Author(s):  
Ritter M D Daniel ◽  
Seamon D O Jason ◽  
S Jones Jeffrey
Keyword(s):  
Pain Relief ◽  
Patient Group ◽  
Oral Intake ◽  
Oral Lesions ◽  
Clinical Question ◽  
Oral Ulcers ◽  
Paediatric Patients ◽  
Topical Lidocaine ◽  
Study Type

A shortcut review was carried out to establish whether topical lidocaine was effective at reducing pain and improving oral intake in children with painful oral lesions. 34 papers were found using the reported searches, of which two presented the best available 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 two papers are tabulated. It is concluded that in otherwise healthy paediatric patients with painful oral ulcers, treatment with viscous lidocaine does not improve oral intake, although it may provide some pain relief.

BET 1: Is routine irrigation of a cutaneous abscess necessary?

2018 ◽  
Vol 35 (2) ◽  
pp. 126.2-127 ◽  
Author(s):  
Joshua Badour ◽  
Matt Singh ◽  
Jeffrey Jones
Keyword(s):  
Clinical Outcomes ◽  
Patient Group ◽  
Adult Patients ◽  
Abscess Cavity ◽  
Clinical Question ◽  
Incision And Drainage ◽  
Improved Outcomes ◽  
Study Type

A short cut review was carried out to establish whether the addition of irrigation of the abscess cavity improved outcomes after incision and drainage of a cutaneous abscess. One paper 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. It is concluded that in adult patients with cutaneous abscesses routine irrigation during incision and drainage does not improve clinical outcomes.

Towards evidence-based emergency medicine: best BETs from the Manchester Royal InfirmaryBET 1: Can hands-on defibrillation be performed safely?BET 2: FAST or ROSIER to identify suspected stroke in the prehospital setting?

2020 ◽  
pp. emermed-2020-210497
Author(s):  
Kevin Mackway-Jones ◽  
David Adler ◽  
Ian Gibbons ◽  
Andrew Helming ◽  
Joshua Lupton ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Patient Group ◽  
Safety Profile ◽  
Prehospital Setting ◽  
Evidence Based ◽  
Clinical Question ◽  
Hands On ◽  
Class 1 ◽  
Suspected Stroke ◽  
Study Type

A review was carried out to see whether hands-on defibrillation could be performed safely. 6 papers 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 papers are tabulated. It is concluded that hands-on defibrillation has the potential to be performed safely if the rescuer uses appropriate electrical insulating barriers such as polyethylene gloves or class 1 electrical insulating gloves. The safety profile of nitrile gloves is unclear. Since detection of shock was used as a proxy for safety, additional investigation is warranted before hands-on defibrillation becomes common practice.

BET 1: Does inhaled tranexamic acid reduce morbidity in adults with haemoptysis?

2019 ◽  
Vol 37 (1) ◽  
pp. 45.2-46
Author(s):  
Jennifer Mervau ◽  
Seamon Jason ◽  
Jeffrey S Jones
Keyword(s):  
Tranexamic Acid ◽  
Patient Group ◽  
Clinical Question ◽  
Massive Haemoptysis ◽  
Fast Resolution ◽  
Study Type

A short cut review was carried out to establish whether inhaled tranexamic acid is more effective than placebo at controlling bleeding in patients with haemoptysis. Thirty-four papers were found using the reported searches, of which one presented the best available 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 is tabulated. It is concluded that in patients with non-massive haemoptysis, management with nebulised TXA leads to fast resolution.

Inability of a negative faecal occult blood test to rule out intussusception in children

2017 ◽  
Vol 34 (7) ◽  
pp. 489-490
Author(s):  
Alvin Chin ◽  
Kerstin De Wit
Keyword(s):  
Patient Group ◽  
Blood Test ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Clinical Question ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Faecal Occult ◽  
Study Type ◽  
Rule Out

A short cut review was carried out to establish whether a negative faecal occult blood test was sufficiently sensitive to rule out a diagnosis of intussusception in children. 5 papers 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 papers are tabulated. It is concluded that a negative faecal occult blood test cannot reliably rule out the diagnosis of intussusception .

BET 2: FAST or ROSIER to identify suspected stroke in the prehospital setting?

2020 ◽  
Vol 37 (9) ◽  
pp. 587-588
Author(s):  
Ian Gibbons ◽  
Owen Williams
Keyword(s):  
Patient Group ◽  
Screening Tool ◽  
Prehospital Setting ◽  
Clinical Question ◽  
Fast Screening ◽  
Suspected Stroke ◽  
Study Type

A short cut review was carried out to whether the FAST screening tool is more accurate than the ROSIER tool at correctly identifying those with stroke in the prehospital setting. 9 papers 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 papers are tabulated. It is concluded that FAST and ROSIER have similar sensitivities in the recognition of stroke, with ROSIER demonstrating a higher specificity in the prehospital setting.

BET 2: Predicting the need for endotracheal intubation in poisoned patients

2019 ◽  
Vol 36 (9) ◽  
pp. 573-575 ◽  
Author(s):  
Luke Buswell ◽  
Alaistair Hayes ◽  
Janos Baombe
Keyword(s):  
Risk Factors ◽  
Endotracheal Intubation ◽  
Patient Group ◽  
Adult Patients ◽  
Clinical Question ◽  
Review Of The Literature ◽  
Difficult Question ◽  
Unknown Substance ◽  
Study Type

A short cut review of the literature was carried out to establish whether any risk factors would predict the need for endotracheal intubation in undifferentiated adult patients presenting with poisoning/overdose with unknown substance. Five papers 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 papers are tabulated. It is concluded that further robust studies of large cohorts are needed to answer this difficult question.

Paediatric major incident triage tools for identifying those in need of life-saving interventions

Trauma ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 237-245
Author(s):  
Andrew Follows ◽  
Jamie Vassallo
Keyword(s):  
Patient Group ◽  
Major Incident ◽  
Clinical Question ◽  
Limited Evidence ◽  
Life Saving ◽  
Study Type

A short cut review was carried out to establish whether existing paediatric major incident triage tools identify patients requiring life-saving interventions. Sixteen papers 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 papers are tabulated. In summary, there is limited evidence for the validity of existing paediatric major incident triage tools.

BET 2: Is keeping the eyes shut while fitting predictive of a psychogenic cause for seizures?

2019 ◽  
Vol 37 (1) ◽  
pp. 46-47
Author(s):  
Anna Mackway-Jones RN ◽  
Laura Howard
Keyword(s):  
Patient Group ◽  
Final Diagnosis ◽  
Clinical Question ◽  
Psychogenic Seizures ◽  
Epileptic Patients ◽  
Eyes Open ◽  
Eye Closure ◽  
Study Type

A short cut review was carried out to establish whether the presence of eye closure in a patient that appears to be fitting is useful in determining whether the fit is epileptic or non-epileptic 497 papers were found using the reported searches, of which nine presented the best available 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 eight of these papers are tabulated. It is concluded that if a patient has their eyes shut during a fit then it is likely that the fit is psychogenic. However, some epileptic patients do have their eyes shut during seizures and many patients with psychogenic seizures have their eyes open so eye closure alone cannot be used for final diagnosis.

BET 1: is the patient’s perception of shortness of breath a useful triage tool in exacerbations of COPD?

2020 ◽  
Vol 37 (2) ◽  
pp. 112.2-113
Author(s):  
R N Anna Mackway-Jones ◽  
Laura Howard
Keyword(s):  
Acute Exacerbation ◽  
Patient Group ◽  
Clinical Question ◽  
Shortness Of Breath ◽  
Acute Exacerbation Of Copd ◽  
Acute Exacerbations ◽  
Exacerbation Of Copd ◽  
Patient’S Perception ◽  
Study Type ◽  
Worse Prognosis

A shortcut review was carried out to establish whether the degree of breathlessness in patients with an acute exacerbation of COPD is indicative of the severity of the exacerbation. Three hundred and forty-seven papers were found using the reported searches, of which five presented the best available 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 five papers are tabulated. It is concluded that increased shortness of breath is associated with a worse prognosis in patients with acute exacerbations of COPD. Dyspnoea assessment should be included in the triage process.

BET 1: High-flow nasal oxygen therapy in bronchiolitis

2019 ◽  
Vol 36 (4) ◽  
pp. 248.2-249
Author(s):  
Tom Jaconelli ◽  
Fatemah Rajah
Keyword(s):  
Patient Group ◽  
Oxygen Therapy ◽  
Signs And Symptoms ◽  
High Flow ◽  
Clinical Question ◽  
Study Type ◽  
Better Than

A shortcut review was carried out to establish whether high-flow nasal oxygen was better than standard oxygen therapy in infants with signs and symptoms of bronchiolitis at reducing the need for escalation of therapy. Three papers 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 papers are tabulated. It is concluded that high-flow nasal oxygen has a role in the management of bronchiolitis and may reduce the need for escalation of therapy with patients with bronchiolitis under the age of 1 year.

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