Author Archives: MJEM ONLINE

Bed rest is associated with more post-dural puncture headache

SOURCE Arevalo-Rodriguez I, Ciapponi A, Roqué I, et al. (2016). Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev 3:CD009199 CONTEXT Post-dural puncture headache (PDPH) complicates up to 30% of lumbar punctures (LP). Bed rest and supplementary fluids administration are common preventative practices after a LP. CLINICAL QUESTION Does bed rest and/or additional fluids administration decrease the ...

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Supraventricular tachycardia: adenosine and calcium channel antagonist are equivalent

SOURCE Alabed S, Sabouni A, Providencia R, et al. (2017). Adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia. Cochrane Database of Syst Rev 10:CD005154. CONTEXT Supraventricular tachycardia (SVT) is a common arrhythmia. Vagal maneuvres are often unsuccessful and drugs are required to terminate SVT.  Despite limited evidence, current guidelines recommend using adenosine as first-line treatment. CLINICAL QUESTION Should adenosine ...

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The bedside clinical tests to detect difficult airway management have a limited efficiency

SOURCE Roth D, Pace NL, Lee A, et al.(2018). Airway physical examination tests for detection of difficult airway management in apparently normal adult patients. Cochrane Database Syst Rev5:CD008874 CONTEXT The airway is a crucial component in the management of unconscious, anaesthetised or sedated patients.Insufficient ventilation or difficult intubation are detriments to health and difficult to predict, even in patients without ...

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Intravenous magnesium sulfate reduces hospital admission of children with moderate to severe acute asthma in the emergency department

SOURCE Griffiths B, Kew KM. (2016). Intravenous magnesium sulfate for treating children with acute asthma in the emergency department. Cochrane Database Syst Rev 29:CD011050 CONTEXT Intravenous magnesium sulfate(IV MgSO4)is recommended by various guidelines for children with acute asthma that have not responded to first-line treatment with bronchodilators and steroids. CLINICAL QUESTION Is intravenous administration of magnesium sulfate for treating children ...

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Half as much post-dural puncture headache with atraumatic needles

SOURCE Arevalo-Rodriguez I, Muñoz L, Godoy-Casasbuenas N, et al. (2017). Needle gauge and tip designs for preventing post-dural puncture headache (PDPH). Cochrane Database Syst Rev 4:CD008874 CONTEXT Post-dural puncture headache (PDPH) is defined as a postural headache occurring within 3 days of a lumbar puncture (LP). It happens less than 15 minutes after sitting or standing and resolves within 15 ...

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Intravenous magnesium sulfate administration reduces the frequency of hospitalization in adults presenting refractory asthma attacks resistant to conventional treatment in the emergency department

SOURCE Kew KM, Kirtchuk L, Michell CI. (2014). Intravenous magnesium sulfate for treating adults with acute asthma. Cochrane Database Syst Rev 5:CD010909 CONTEXT In asthma attacks resistant to conventional treatment (inhaled beta-2-mimetics and ipratropium), magnesium sulfate (MgSO4) is often used without any validated data in the literature. CLINICAL QUESTION Is the use of MgSO4 intravenously to treat an asthma attack ...

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Snakebite in Lebanon: The painful reality

Jabbour E. Snakebite in Lebanon: The painful reality. Med Emergency, MJEM 2020; 28 DOI: 10.26738/MJEM.2017/MJEM28.2020/CT.CEE.140319 Keywords: antivenom, emergencies, emergency department, Lebanon, Middle East, snake, species

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Insufficient data concerning therapeutic management of necrotizing soft-tissue infections

SOURCE Hua C, Bosc R, Sbidian E, et al. (2018). Interventions for necrotizing soft tissue infections in adults.  Cochrane Database Syst Rev5:CD011680 CONTEXT The necrotizing soft-tissue infection is a rare pathology of bacterial origin with high morbidity and mortality, which requires multidisciplinary management. Standard management includes empiric intravenous antibiotic therapy, early surgical debridement of necrotic tissues, intensive care support and ...

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Modest benefit of inhaled magnesium sulfate for acute asthma in the emergency department

SOURCE Knightly R, Milan SJ, Hughes R, et al.(2017). Inhaled magnesium sulfate in the treatmentof acute asthma. Cochrane Database SystRev 11:CD003898 CONTEXT Acute asthma is a reason for frequent use of Emergency Department (ED). Despite effective therapies, some crises remain difficult to control. Magnesium sulfate (MgSO4) works by increasing the response of beta-receptors to beta-2-mimetics as well as by a ...

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Splenic rupture after colonoscopy diagnosed by bedside ultrasonography

El Asmar A, Traboulsy S, El Tawil Ch. Splenic rupture after colonoscopy diagnosed by bedside ultrasonography. Med Emergency, MJEM 2020;28 DOI: 10.26738/MJEM.2017/MJEM28.2020/CT.CRE.180219 Keywords: colonoscopy, spleen, ultrasonography

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