Emergency Medicine Journal 2008;25:616
© 2008 BMJ Publishing Group Ltd and the College of Emergency Medicine.
EMQ ANSWERS
EMQ answers
551
| The first 150 words of the full text of this article appear below. |
ANSWER 1
In local anaesthesia...
- False. This is a particularly popular topic for small randomised controlled trials that often show statistical but not clinical significance (a difference on the 100 mm visual analogue scale of more than 20 mm).1 The best studies in adults2 and children3 do not show a benefit of buffering lignocaine.
- True. A review of the historical and trial data shows that low-dose adrenaline (1 : 100 000 or less) reduces the need for tourniquets and does not cause digital infarction.4 Only proprietary local anaesthetic–adrenaline mixtures should be used.
- False. They may hurt more and provide less reliable anaesthesia5 even though they have the advantage of less wound edge distortion.
- True. Note topical anaesthesia is less effective on the trunk and limbs.6
ANSWER 2
Regarding wound infection...
- True.7
- False. There is conflicting evidence from small, heterogeneous trials. A Cochrane review8 concluded that human bites warranted treatment but there was insufficient evidence
. . . [Full text of this article]
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