Life in the Fast Lane Medical Blog Emergency Medicine Update January 2012
This is the third edition of EMU to be modified for LITFL readers. You can download the original pdf version here, which also contains essays on UTIs, pain and acute porphyria. Check out previous editions of EMU on LITFL here.
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Learn about the latest emergency literature by clicking on the show/ hide links below:
BETS- the EBM series from the EMJ – these folks asked: kids that can fully extend their elbow- does that rule significant injury? They claim that it doesn’t but the studies are few and not of great quality, and besides, I would ask- what is considered a significant injury? (EMJ 28(4)334 ).
Even more interesting is their BET number four where they ask how useful bowel sounds are. They claim they have a high specificity for obstruction but low sensitivity meaning hearing normal bowel sounds does not rule out obstruction. (EMJ 28(4)336) This conclusion is based on only one good paper, and in addition, there are many other signs of obstruction that make checking bowel signs less relevant. I personally never check for them, and I think this article brings into question the whole concept of what in the physical exam is really helpful. I am not trashing everything we do, but we do need to question – a little. Isn’t that why you read EMU? (Or is it because you can’t find a Reader’s Digest in the smallest room of the house?)
Life in the Fast Lane Medical Blog - Emergency Medicine education blog
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