240 results found
Maconochie I, Baumer H, Stewart MER, 2008, Fluid therapy for acute bacterial meningitis, COCHRANE DATABASE OF SYSTEMATIC REVIEWS, ISSN: 1469-493X
Smart CJ, Maconochie I, 2008, How and why do you declare a major incident?, Prehosp Disaster Med, Vol: 23, Pages: 70-75, ISSN: 1049-023X
INTRODUCTION: The decision to declare a major incident (MI) is not one to be taken lightly, but a delay in doing so may have dire consequences. The aim of this study was to ascertain what factors make specialists from a variety of professional backgrounds in the United Kingdom determine from an initial visual assessment of a scene that a MI should be declared. METHODS: Participants were presented with three different scenarios, which were presented pictorially. Their responses were noted. RESULTS: One hundred seventy-eight professionals took part in this study. For Scenario 1 (a road traffic incident), 101 (57%) declared a MI. For a coach rollover in Scenario 2, a MI was declared by 82 (46%) people, and a MI was declared by 156 (87%) for a rail crash in Scenario 3. Forty-six participants had attended a MI previously. The results for declaring a MI in this group were: (1) Scenario 1, 25 (54%); (2) Scenario 2, 25 (54%); and (3) Scenario 3, 44 (96%). Of this group, 44 had previously had training before experiencing the MI. Those who had > or = 10 years of service in emergency services were more likely to declare a MI in Scenario 2 and 3. CONCLUSIONS: The main problem with the existing system is the interpretation and subjective nature of the word "major". Specialists incorporate many individual factors into using the word. Future research should focus on the development of a system tied to more objective analysis.
Maconochie I, Ross M, 2007, Head injury (moderate to severe)., BMJ Clin Evid, Vol: 2007
INTRODUCTION: Head injury in young adults is often associated with motor vehicle accidents, violence, and sports injuries. In older adults it is often associated with falls. Severe head injury can lead to secondary brain damage from cerebral ischaemia resulting from hypotension, hypercapnia, and raised intracranial pressure. Severity of brain injury is assessed using the GCS. While about a quarter of people with severe brain injury (GCS score less than 8) will make a good recovery, about a third will die, and a fifth will have severe disability or be in a vegetative state. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to reduce complications of moderate to severe head injury as defined by Glasgow Coma Scale? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 17 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, anticonvulsants, corticosteroids, hyperventilation, hypothermia, and mannitol.
Maconochie I, Bingham B, Simpson S, 2007, Teaching children basic life support skills - Improve outcomes but implementation needs to be earlier and more widespread, BMJ-BRITISH MEDICAL JOURNAL, Vol: 334, Pages: 1174-1174, ISSN: 1756-1833
Fayomi O, Maconochie I, Body R, 2007, Is skin turgor reliable as a means of assessing hydration status in children?, EMERGENCY MEDICINE JOURNAL, Vol: 24, Pages: 124-125, ISSN: 1472-0205
Harris D, Patel T, Dunne J, et al., 2007, Implementation of the healthcare recommendations arising from the Victoria Climbie report, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 92, Pages: 71-72, ISSN: 0003-9888
Elliott EJ, Peadon E, Bayreuther J, et al., 2006, Commentaries on ‘Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents’, Evidence-Based Child Health: A Cochrane Review Journal, Vol: 1, Pages: 1233-1237, ISSN: 1557-6272
Pienaar WE, Maconochie IK, 2006, The role of chest x-ray in the diagnosis of community acquired pneumonia in children: A systematic review, Current Pediatric Reviews, Vol: 2, Pages: 331-338, ISSN: 1573-3963
For many years the gold standard in diagnosing pneumonia has been the chest x-ray, both in clinical practice and for research purposes. The objective of this review was to examine the evidence to determine the role of chest x-ray in the diagnosis of pneumonia. A comprehensive literature search was conducted and abstracts were obtained from articles that, judged by their titles, bore relevance to the subject in question. Articles were selected for review based on their abstracts. Articles were subsequently reviewed, appraised and results were presented by grading evidence as Level I, II or III. Even the best available evidence failed to demonstrate improved outcome with the addition of chest radiography in ambulatory acute lower-respiratory infection in children. There is little evidence to justify the routine use of chest radiography in the diagnosis of pneumonia in children, but more research is needed to explore the potential benefit of chest radiography in specific clinical scenarios. © 2006 Bentham Science Publishers Ltd.
Munro A, Maconochie I, 2006, Beta-agonists with or without anti-cholinergics in the treatment of acute childhood asthma?, EMERGENCY MEDICINE JOURNAL, Vol: 23, Pages: 470-471, ISSN: 1472-0205
Treffene S, Paget R, Maconochie I, 2006, Accident and emergency: a gateway to improve the management of atopic disease, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 91, Pages: 544-544, ISSN: 0003-9888
Wallis LA, Maconochie I, 2006, Age related reference ranges of respiratory rate and heart rate for children in South Africa, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 91, Pages: 330-333, ISSN: 0003-9888
Biarent D, Bingham R, Richmond S, et al., 2006, Pediatric life support (PLS): Section 6 of the guidelines for resuscitation 2005 of the European Resuscitation Council, Notfall und Rettungsmedizin, Vol: 9, Pages: 90-122, ISSN: 1434-6222
Baumer JH, Love SJL, Gupta A, et al., 2006, Salicylate for the treatment of Kawasaki disease in children, COCHRANE DATABASE OF SYSTEMATIC REVIEWS, ISSN: 1469-493X
Atkinson M, Bond D, Bonham J, et al., 2006, Management of a child with a decreased level of consciousness: an evidence-based guideline for health professionals, DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, Vol: 48, Pages: 39-39, ISSN: 0012-1622
Cleugh FM, Maconochie IK, 2005, Injury prevention in children, Current Paediatrics, Vol: 15, Pages: 569-574, ISSN: 0957-5839
The scale of childhood injuries in the UK is monumental, accounting for approximately 120,000 hospital admissions and 350 childhood deaths. Financial costs to an already overstretched National Health Service, and societal costs to victims and their families make it an area of priority for prevention. This has been recognised, with government targets set in the "Saving lives: our healthier nation" white paper. The Departments of Heath, Transport, Trade and Industry, and Education and for Skills have responded with strategies to reach these targets by an integrated approach. The British Medical Association works closely with the government, and The Royal College of Paediatrics and Child Health has established a committee for injury prevention. Local hospitals and paediatricians support medical professionals with training for injury management and they are also involved in educating the public about injury prevention, e.g., in conjunction with local groups such as the Injury Minimization Programme for Schools. Various voluntary bodies work towards coordinating roles in injury prevention by providing information and directed interventional support to medical professionals, teachers, parents, carers, and children. These programmes are working, for example, there was a reduction in road-related childhood injuries and deaths in the UK over 5 years preceding 2003. Everyone has a role to ensure injury prevention is effective. © 2005 Elsevier Ltd. All rights reserved.
Jacobs M, Maconochie I, 2005, Headache in paediatric head injury, EMERGENCY MEDICINE JOURNAL, Vol: 22, Pages: 889-889, ISSN: 1472-0205
Biarent D, Bingham R, Richmond S, et al., 2005, European Resuscitation Council Guidelines for Resuscitation 2005 - Section 6. Paediatric life support, RESUSCITATION, Vol: 67, Pages: S97-S133, ISSN: 0300-9572
Jacobs M, Maconochie I, 2005, Best evidence topic report. Headache in paediatric head injury., Emerg Med J, Vol: 22
A short cut review was carried out to establish whether headache was a significant indicator of the severity of head injury in children. 301 papers were found using the reported searches, of which 2 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. It is concluded that headache is not an independent risk factor for intracranial injury in children.
Wallis LA, Healy M, Undy MB, et al., 2005, Age related reference ranges for respiration rate and heart rate from 4 to 16 years, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 90, Pages: 1117-1121, ISSN: 0003-9888
Bhangoo P, Maconochie IK, Batrick N, et al., 2005, Clinicians taking pictures - a survey of current practice in emergency departments and proposed recommendations of best practice, EMERGENCY MEDICINE JOURNAL, Vol: 22, Pages: 761-765, ISSN: 1472-0205
Ninis N, Phillips C, Bailey L, et al., 2005, The role of healthcare delivery in the outcome of meningococcal disease in children: case-control study of fatal and non-fatal cases, BRITISH MEDICAL JOURNAL, Vol: 330, Pages: 1475-1478, ISSN: 0959-8146
Maconochie I, Redhead J, 2005, The National Service Framework: paediatric emergency care, LANCET, Vol: 365, Pages: 1673-1674, ISSN: 0140-6736
Salter R, Maconochie IK, 2005, Implementation of recommendations for the care of children in UK emergency departments: national postal questionnaire survey, BMJ-BRITISH MEDICAL JOURNAL, Vol: 330, Pages: 73-74, ISSN: 1756-1833
Sandell JM, Maconochie IK, 2004, The impact of terrorism on children: a two-year experience., Prehosp Disaster Med, Vol: 19, Pages: 370-371, ISSN: 1049-023X
Maconochie IK, 2004, Kawasaki disease, ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION, Vol: 89, Pages: EP3-EP8, ISSN: 1359-2998
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