A 62-year-old man comes in with a new vesicular rash on his abdomen that has been present for 24 h. He complains of intense pain and tenderness in the same area as the rash. You diagnose herpes zoster. You start an antiviral medication right away, but you wonder what medication you could use to try to alleviate the patient's pain and reduce the incidence of post-herpetic neuralgia. You have seen your colleagues use pregabalin for that purpose, but wonder if there is good evidence to support this practice.
Archives: BETs
Use of corticosteroids in the treatment of septic arthritis in children n
A 3-year-old child presents to the emergency department with High fever and pain in his right knee. You perform a diagnostic arthrocentesis and the stat gram is positive. You start the IV antibiotic treatment and you wonder if the addition of a corticosteroid would be appropriate.
You are a member of a multi disciplinary team (MDT) working on an adult in-patient neurological rehabilitation unit. A patient is admitted with a neurological condition for a period of rehabilitation. The MDT wants to set goals to direct the patient’s intervention. You want to use an outcome measure that will reflect change in functional ability and/or quality of life.
Indication for brain CT in children with mild head injury (2011 UPDATE)
A 6-year-old girl presents to the emergency department with a teacher. She was missing at the end of the lunch break and was found dazed at the base of a climbing frame, and can’t remember what happened. Her examination is normal other than a scalp haematoma, with no evidence of an underlying skull fracture. You are aware of the adverse effects of radiation on the developing brain, but wonder if the history and clinical findings warrant performing a head CT despite the potential risks.
A patient attends A&E with a painful sickle crisis. They have taken oral anlgesia including rescue oramorph with limited effect. You are unable to obtain IV access and wonder if there are any inhaled therapies (apart from oxygen) which could help the patient. You ask your registrar who is uncertain so you decide to check BestBETS
My FY1 who had just seen a patient with a TIA was told by the stroke specialist nurse to prescribe clopidogrel. The FY1 had already given the patient aspirin and asked me whether clopidogrel was better for secondary prevention in this group of patients, and also should she give the clopidogrel as well as the aspirin?
A 28-year-old woman experiencing dizziness, vertigo, nausea, and vomiting after riding a boat is brought to the emergency department. She has no systemic disease or diarrhea and denies being pregnant; her vital signs are normal. Her symptoms improve a lot after resting. She enquires about methods to prevent the motion sickness. You wonder whether natural ginger extracts could help prevent or reduce severity of motion sickness.
A 6 year old attends the emergency department with a moderate exacerbation of his asthma.
Does the ‘Seatbelt Sign’ predict intra-abdominal injury after motor vehicle trauma in children?
A 9-year-old boy presents to the Emergency Department (ED) following a motor vehicle collision. He was a restrained rear seated passenger involved in a head on crash at approximately 45 mph. His physical examination is unremarkable, except for the presence of bruising on the lower abdomen in the distribution of his lap belt, consistent with a ‘seat belt sign,’ (SBS). The boy otherwise looks well. You wonder whether there is evidence to help you decide to discharge the patient, pursue additional imaging, or admit the child for observation/further intervention.
A 2 year old boy is brought to your emergency department after a motor vehicle crash. He was wearing a seatbelt and the parents do not think he lost consciousness. No one else in the car was injured. On exam, the child is quite upset and you are unable to determine whether there is cervical tenderness. You do notice some bruising over his torso. There are no neurologic deficits on exam and he is able to ambulate. Should you obtain cervical spine imaging to rule-out injury?
A 35 year old builder presents to the emergency department having dropped a paving slab on his toes. He has swollen painful great toe on the right foot. An x-ray shows he has sustained a closed fracture of the distal phalanx of the great toe. No other injuries have been sustained.
A 40 year old female arrives to the physiotherapy department with a diagnosed pelvic organ prolapse (POP) from the Gynaecology clinic. She wants to know if pelvic floor muscle exercises alone will help improve her POP symptoms.
You are seeing a 3yr old girl in the ED. She has fever, red tongue and conjunctivitis. Her mother mentions her BCG scar looks more red than usual. You wonder if this is significant.