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Talk or test?
Jane McVicar from Liverpool, UK has carried out a fascinating study that compares (patient recalled) immunisation history and immediate point of care testing in establishing the anti-tetanus status of patients with wounds. Consecutive patients with acute wounds aged 18 and over were recruited and questioned about their tetanus immunisation status. They were categorised as covered, not covered or unsure. Each was then tested with the Protetanus kit for tetanus immunity. Interestingly whatever the patient history suggested there was little actual difference in tetanus immunisation status. Dr McVicar went on to undertake a simple economic analysis which suggest that considerable savings might be made using a testing strategy if this replaced current recommended (as opposed to actual) practice—again the results can be seen in the full paper. Well worth a read and a reflection.
Wrist MR
We have a veritable glut of wrist injury papers this month which is no bad thing as it is a very common presentation to Emergency Departments. The first two of these papers look the management of suspected scaphoid fracture. Nirav Patel and …