Potential benefits of incentive spirometry following a rib fracture: a propensity score analysis.

CLINICIAN'S CAPSULEWhat is known about the topic?Literature regarding the impact of incentive spirometry on patients with rib fractures is unclear; there are no recommendations for its use in the emergency department (ED).What did this study ask?The objective of this study was to assess the impact of incentive spirometry on delayed complications in patients with rib fractures in the ED.What did this study find?Unsupervised incentive spirometry use does not have a protective effect against delayed pulmonary complications after a rib fracture.

"One-way-street" streamlined admission of critically ill trauma patients reduces emergency department length of stay.

Emergency department (ED) overcrowding remains a significant problem in many hospitals, and results in multiple negative effects on patient care outcomes and operational metrics. We sought to test whether implementing a quality improvement project could decrease ED LOS for trauma patients requiring an ICU admission from the ED, specifically by directly admitting critically ill trauma patients from the ED CT scanner to an ICU bed. This was a retrospective study comparing patients during the intervention period (2013-2014) to historical controls (2011-2013).

Hypertonic saline in severe traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials.

Objectives: Hypertonic saline solutions are increasingly used to treat increased intracranial pressure following severe traumatic brain injury. However, whether hypertonic saline provides superior management of intracranial pressure and improves outcome is unclear. We thus conducted a systematic review to evaluate the effect of hypertonic saline in patients with severe traumatic brain injury.

Acute minor thoracic injuries: evaluation of practice and follow-up in the emergency department.

Objective: To review the management and follow-up of patients with minor thoracic injuries (MTI) treated by emergency or primary care physicians.

Design: A multicentre, retrospective study.

Setting: Three university-affiliated emergency departments of the metropolitan region of Quebec city, Que.