Thiopentone sedation for sedation of acutely agitated, violent, intoxicated patients: evaluation of 2 cases.

Two cases of violent, drug-intoxicated patients who presented considerable problems in management, and were resistant to standard sedative agents, are described. Effective and safe sedation, without the need for full anaesthesia and endotracheal intubation, was achieved using titrated doses of thiopentone. The merits of selecting this agent in these circumstances are discussed.

State of play: clearing the thoracolumbar spine in blunt trauma victims.

Introduction: The present article reviews the clinical and imaging clearance of the thoracic and lumbar spines of blunt trauma victims and the evolution of these strategies with the use of new imaging technologies.

Methods: A comprehensive literature search was performed, and articles identified were critically appraised

Results: Twenty papers were identified, 12 directly comparing computed tomography screening with plain X-rays. Evidence-based protocols are presented.

Best evidence topic report. Nebulised magnesium in asthma.

A short cut review was carried out to establish whether the addition of nebulised magnesium sulphate to beta agonist therapy improves outcome in acute asthma. Altogether 69 papers were found using the reported search, of which five 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 best papers are tabulated.

Best evidence topic report. Prophylactic antibiotics for subungual haematoma.

A short cut review was carried out to establish whether antibiotic prophylaxis is indicated after trephining of a subungual haematoma. Two papers were found using the reported search, of which neither presented any evidence to answer the clinical question. It is concluded that there is no evidence available to answer this question.