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Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary
  1. K Mackway-Jones, Professor

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    Best Evidence Topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practicing clinicians. The search strategies used to find the best evidence are reported in detail in order to allow clinicians to update searches whenever necessary. Each BET is based on a clinical scenario and ends with a clinical bottom line which indicates, in the light of the evidence found, what the reporting clinician would do if faced with the same scenario again.

    The BETs published below were first reported at the Critical Appraisal Journal Club at the Manchester Royal Infirmary1 or placed on the BestBETs website. Each BET has been constructed in the four stages that have been described elsewhere.2 The BETs shown here together with those published previously and those currently under construction can be seen at http://www.bestbets.org.3 5 BETs are included in this issue of the journal, the last two of which are negative.

    • Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers

    • Topical analgesia for pain reduction in arterial puncture

    • Antifibrinolytics for the initial management of sub arachnoid haemorrhage

    • Anticoagulation before cardioversion of acute atrial fibrillation in the emergency department

    • Anticoagulation post-cardioversion of acute atrial fibrillation in the emergency department

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