Emergency Medicine Journal articles from July 2002

Emergency Medicine Journal archives from July 2002

Emergency analgesia in the paediatric population. Part IV paediatric sedation in the accident and emergency department: pros and cons. (Review).
July 1, 2002... This is the last in a series of four papers on emergency analegesia in the paediatric population. It discusses the use of paediatric sedation in the accident and emergency department. ********** There is currently increased interest...

The role of magnesium in the emergency department. (Review).
July 1, 2002... Magnesium has been advocated for the treatment of a variety of conditions seen in emergency medicine. The authors present a systematic review and advice on appropriate indications for its use. Evidence supports its use in severe asthma,...

Tracheal intubation by novice staff: the direct vision laryngoscope or the lighted stylet (Trachlight)? (Original Article).
July 1, 2002... Objective: To compare the ease of use of the direct vision laryngoscope and the lighted stylet (Trachlight) by novice staff. Methods: Ten novice medical officers (MOs) performed orotracheal intubatjons using either the conventional direct...

Section 136, The Mental Health Act 1983; levels of knowledge among accident and emergency doctors, senior nurses, and police constables. (Original Article).(Statistical Data Included)
July 1, 2002... Objectives: Section 136 of the Mental Health Act 1983 empowers the police to detain those suspected of being mentally ill in public places, and convey them to a place of safety. In practice, accident and emergency (A&E) departments are often...

Being economical with the truth: how to make your idea appear cost effective: the importance of presentation and evaluation of economic data with regard to the cost effectiveness of a health care intervention are discussed. (Original Article).
July 1, 2002... The recognition that the health services, like all other activities, have limited resources available has lead to the widespread adoption of cost effectiveness criteria in the assessment of new health technologies. (1-4) Evidence is required....

Using the internet to coordinate a teaching programme in accident and emergency medicine. (Original Article).
July 1, 2002... The internet permits inexpensive and rapid communication of multiple forms of information across geographical boundaries. The authors describe the development of an internet based mailing list and web site to coordinate the regionwide...

Senior house officer withdrawals from hospital posts: a questionnaire survey. (Original Article).
July 1, 2002... Objectives: To assess the nature and number of unexpected withdrawal by senior house officers (SHOs) after acceptance of a hospital post at interview, and to investigate the reasons and possible solutions. Design: Postal questionnaire...

Whiplash associated disorder in children attending the emergency department. (Original Article).
July 1, 2002... Aims: To determine the incidence, severity, and clinical course of whiplash associated disorder (WAD) in children aged 4-16 years involved as passengers in car crashes. Methods: Prospective surveillance of all paediatric attendances to...

Medicine in the heart of the Antarctic: 1908-2001. (Original Article).
July 1, 2002... Prehospital care in the United Kingdom rarely lasts more than a few hours other than in exceptional circumstances (for example, mountain and cave rescue, oil rigs). In other parts of the world hospitals may be much more distant and in...

Identifying the research question and planning the project: This is the second paper on research in accident and emergency medicine. It discusses the potential for research in A&E medicine and how to identify a good research question. (Research Series).
July 1, 2002... This paper has the following objectives: * to discuss the role of research in A&E medicine * to propose the advantages of doing A&E research * to explore which areas and types of study the A&E researcher is best placed to tackle...

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. (Best Evidence Topic Reports).
July 1, 2002... 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 practising...

Article 9. Change, committees, and the press want to speak to you: this article in the series on management within the emergency department focuses on the importance of meetings and how to instigate change. (Simulated Interactive Management Series).
July 1, 2002... FEEDBACK Underperforming SpR Dr Ireland is not doing well. Evidence is mounting that he is having problems in coping with ill children. The amount of written evidence from within the department and from other departments along with...

Impact of NHS Direct on other services: the characteristics and origins of its nurses. (Prehospital Care).(Statistical Data Included)
July 1, 2002... Objective: To characterise the NHS Direct nurse workforce and estimate the impact of NHS Direct on the staffing of other NHS nursing specialties. Method: A postal survey of NHS Direct nurses in all 17 NHS Direct call centres operating in...

An email audit of prehospital doctor activity in an area of the West Midlands. (Prehospital Care).
July 1, 2002... Objectives: To describe the nature and extent of prehospital doctor activity in an area of the West Midlands by review of group email. To explore the use of email as a means of data collection among a group of prehospital doctors. ...

Recognition of death and termination of cardiac resuscitation attempts by UK ambulance personnel. (Prehospital Care).
July 1, 2002... Objectives: To identify whether the practice of the UK ambulance trusts comply with national recommendations with respect to when ambulance personnel are allowed to recognise death and/or terminate resuscitation attempts in the adult,...

Triage decisions of Prehospital emergency health care providers, using a multiple casualty scenario paper exercise.
July 1, 2002... Objective: To examine the accuracy of theoretical triage decision making among emergency prehospital health care professionals, using a multiple casualty paper exercise. Methods: A standardised 20 casualty paper exercise requiring each...

A solution to the non-deflating balloon of a suprapubic catheter. (Case Reports).
July 1, 2002... A case report describes the successful aspiration of a non-deflating suprapubic urinary catheter by passing a cannula directly down the fistula tract. It is a relatively safe and simple procedure that can be performed in an accident and...

Delayed asystolic cardiac arrest after diltiazem overdose; resuscitation with high dose intravenous calcium.
July 1, 2002... A 51 year old man took a mixed overdose including 1.8-3.6 g of diltiazem, paracetamol, aspirin, isosarbide nitrate, and alcohol. He initially presented to hospital after six hours with mild hypotension and was treated with activated charcoal...

An unusual case of paralytic ileus after jellyfish envenomation.
July 1, 2002... A 31 year old tourist presented with paralytic ileus after jellyfish sting. This unusual presentation after jellyfish envenomation is reported and the literature reviewed for jellyfish envenomation syndromes. ********** Jellyfish...

Cardioversion by venepuncture in sustained stable supraventricular tachycardia.
July 1, 2002... Two cases are described of cardioversion from stable supraventricular tachycardia after venepuncture. In both cases usual vagal manoeuvres at home and in the casualty department were unsuccessful. However, attempts to site intravenous...

Beware the tooth fairy.
July 1, 2002... After a period of stability, trauma patients can unexpectedly deteriorate. If this happens it is important to follow a systematic approach, if necessary repeating the primary survey. The following is an unusual case of airway obstruction not...

Pharyngeal foreign body in a child persisting for three years.
July 1, 2002... Foreign body ingestions are common in children. They can pose a diagnostic problem if the foreign body is embedded in the soft tissues of pharynx. A 4 year old girl presented with halitosis for two years. A pharyngeal foreign body, a metallic...

Respiratory papillomatosis: a rare cause of collapse in a young adult presenting to the emergency department.
July 1, 2002... Treating patients with rapidly deteriorating respiratory compromise in the emergency room is difficult and stressful. The patient in front of you is rapidly progressing towards total cardiorespiratory collapse and you may have no idea why. A...

Haemorrhage into an arachnoid cyst: a serious complication of minor head trauma.
July 1, 2002... Arachnoid cysts are infra-arachnoidal cerebrospinal fluid collections that are usually asymptomatic. However, they can become acutely symptomatic because of haemorrhage and cyst enlargement, which may result from minor head trauma. The range...

Acute appendicitis after a fall from a ladder: a traumatic aetiology?
July 1, 2002... A cute appendicitis is the commonest emergency condition requiring surgery in the United Kingdom. Its precise aetiology, however, remains unproven: dietary, genetic factors, and infectious agents have been implicated. (1) Trauma has also been...

Anterior shoulder dislocation: an unusual complication. (Case Reports).(Brief Article)
July 1, 2002... A case of transection of anterior circumference humeral artery, a branch of the 3rd part of the axillary artery is reported, after a simple anterior shoulder dislocation. This complication though rare could potentially result in catastrophic...

Focal lingual dystonia, urinary incontinence, and sensory deficits secondary to low voltage electrocution: case report and literature review. (Case Reports).
July 1, 2002... Electrocution injuries are well reported in review articles and cases of high voltage electrocution injury are abundant. However, reports of low voltage electrocution injury are few. A case is presented of low voltage shock from a 120 volt AC...

Letters.
July 1, 2002... Diagnostic errors in an accident and emergency department I commend the author for comprehensively investigating a complex area but found some important pieces of information missing in the study. (1) Firstly, there is no information...

Correction.(Correction Notice)
July 1, 2002... An editorial error occurred in this article by Dr Wallace and other (2002;19;202-5). In the flowchart, along the staggered overdose pathway, all doses should be described on a dose/kg/day and not a dose/kg basis. Also, patients who present...