Evidence Update (May 2015)

Evidence Update (May 2015)

For abstracts of the reviews below please click on the titles. There may be a link to the full text in the top right hand corner of the webpage. You may have to log in using your NHS Athens username and password, if you don’t have one go to Register for Athens and register for free.

If full text is not available then please email us to request a copy, directly quoting the number(s) of the articles you would like.

NICE Guidance

There are no new NICE guidelines published this issue.

Practice changing research, sourced from Dynamed

1) Sepsis treatment in adults

Updated 2015 Apr 27 06:56:00 AM: protocol-based early goal-directed therapy is similar to usual care for mortality in patients with early septic shock (N Engl J Med 2015 Apr 2)

2) Endovascular therapy for acute stroke

Updated 2015 Apr 26 08:55:00 AM: addition of stent retriever within 6 hours of stroke onset following IV alteplase for stroke with confirmed occlusion of intracranial internal carotid artery and/or first segment of middle cerebral artery reduces disability at 90 days (N Engl J Med 2015 Apr 17 early online)

3) Intracerebral haemorrhage

Updated 2015 Apr 24 03:15:00 PM: perihematomal edema volume growth associated with increased risk of death or dependency at 90 days in patients with intracerebral hemorrhage (Stroke 2015 Apr)

New and Updated Cochrane Systematic Reviews

There are no new Cochrane systematic reviews this issue.

Good Quality Systematic Reviews

4) Predicting geriatric falls following an episode of emergency department care: a systematic review

5) Efficacy of the Manchester Triage System: a systematic review

6) Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis

7) A systematic review of outcomes following emergency transfer to hospital for residents of aged care facilities

8) Performance of the high-sensitivity troponin assay in diagnosing acute myocardial infarction: systematic review and meta-analysis

9) Use of a full-body digital X-ray imaging system in acute medical emergencies: a systematic review

10) Prehospital noninvasive ventilation for acute respiratory failure: systematic review, network meta-analysis, and individual patient data meta-analysis

11) The prehospital management of suspected spinal cord injury: an update

12) Coronary computed tomographic angiography for detection of coronary artery disease in patients presenting to the emergency department with chest pain: a meta-analysis of randomised clinical trials

13) Does pre-hospital endotracheal intubation improve survival in adults with non-traumatic out-of-hospital cardiac arrest? A systematic review

14) Does topical Amethocaine cream increase first-time successful cannulation in children compared with a eutectic mixture of local anaesthetics (EMLA) cream? A systematic review and meta-analysis of randomised controlled trials

15) Use of serum procalcitonin in evaluation of febrile infants: a meta-analysis of 2317 patients

16) Opioid analgesia for acute abdominal pain in children: a systematic review and meta-analysis

17) A systematic review of vapocoolants for reducing pain from venipuncture and venous cannulation in children and adults

18) Comparison of whole-body computed tomography vs selective radiological imaging on outcomes in major trauma patients: a meta-analysis

19) Continuous positive airway pressure and noninvasive ventilation in prehospital treatment of patients with acute respiratory failure: a systematic review of controlled studies

20) Does pre-hospital endotracheal intubation improve survival in adults with non-traumatic out-of-hospital cardiac arrest? A systematic review

21) Heparin therapy reduces 28-day mortality in adult severe sepsis patients: a systematic review and meta-analysis

22) Comparison of the effects of albumin and crystalloid on mortality in adult patients with severe sepsis and septic shock: a meta-analysis of randomised clinical trials

23) Albumin versus other fluids for fluid resuscitation in patients with sepsis: a meta-analysis

24) The effect of goal-directed therapy on mortality in patients with sepsis ? earlier is better: a meta-analysis of randomised controlled trials

25) Biomarkers predicting sepsis in polytrauma patients: current evidence

26) The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis

Economic Evaluations

27) Randomised clinical trial of an emergency department observation syncope protocol versus routine inpatient admission

28) Cost-effectiveness of the PECARN rules in children with minor head trauma

29) Cost-effectiveness analysis of endoscopic sphenopalatine artery ligation vs arterial embolisation for intractable epistaxis

30) Is prehospital treatment of acute stroke too expensive? An economic evaluation based on the first trial

31) The cost-effectiveness ratio of a managed protocol for severe sepsis

32) Intravenous immunoglobulin for severe sepsis and septic shock: clinical effectiveness, cost effectiveness and value of a further randomised controlled trial

Reports/Statistics on UK Emergency Medicine

33) The NHS Confederation has published a series of a case studies relating to urgent care:

34) Alcohol return on investment tool

As part of its savings and productivity collection, NICE has published Alcohol return on investment tool. The tool has been developed to help decision making on interventions and strategies to prevent and reduce alcohol use at local and sub-national levels. The tool enables the user to evaluate a portfolio of interventions in their geographical area and models the economic returns that can be expected in different payback timescales. The different interventions included in the tool can be mixed and matched to see which intervention portfolio or package provides the best 'value for money', compared with 'no package of interventions' or any other specified package.

35) Cost of binge drinking

The University of Bath Institute for Policy Research has published The cost of binge drinking in the UK. This study focuses on the estimates of the additional cost to the economy generated by binge drinking by examining its effects on accident and emergency admissions, road accidents, arrests and the number of police officers on duty.  This estimate is then used to assess the likely effectiveness of policies designed to discourage binge drinking and mitigate its effects and costs. The three potential policy interventions considered are minimum unit pricing, alcohol excise taxes and a higher minimum legal drinking age (MLDA).

36) Delivering effective treatment to people affected by drug and alcohol

NHS Confederation has published a case study Delivering effective treatment to people affected by drug and alcohol misuse in Thanet.  The case study describes out a programme of proactive cooperation between Turning Point and other organisations working in the local area.  Turning Point's strategy is to focus on the specific challenges faced by each individual, including their family and household circumstances in conjunction with several organisations, including local NHS services, the probation service, housing officers, the police, JobCentre Plus, community mental health services, homeless projects, the carer support group, the local hospital, and staff at the council’s gateway centre.  Turning Point shares information, trains staff to refer clients to them, places outreach workers in their premises and attend meetings both bilaterally, and as part of the local authority’s Margate Task Force anti-poverty group.

Latest Journal Table of Contents

37) Academic Emergency Medicine

38) Annals of Emergency Medicine

39) Emergency Medicine Journal

40) European Journal of Emergency Medicine

41) Journal of Emergency Nursing

42) The Lancet

43) BMJ

44) New England Journal of Medicine

45) Paediatrics

46) Archives of Disease in Childhood

Evidence Update (June 2015)

Evidence Update (June 2015)