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Primary Survey
  1. Geoff Hughes, Editor

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    THE BREADTH OF THE JOURNAL IS SPREADING

    We live in a globalised, instantly communicating world, with booming economies in the sub-continent and China. Traditional world orders are being challenged. This journal is receiving an increasing number of submissions from countries that we do not normally hear from, countries that are starting to recognise and invest in prehospital and hospital emergency services. We welcome this development, both the investment and the submitted articles. The editorial team are also witnessing an improvement in the quality of the papers submitted from these countries; we have published many in the past and we publish some more this month, as well as papers from more traditional sources. Malaysia, Thailand, and Pakistan are amongst other countries represented this month.

    POST WAR AND DISASTER EMERGENCY SERVICES

    A team from New York looked at issues related to emergency care in post-war Kosovo. Their conclusions may not be too surprising but it is surely good that such surveys are conducted. Are any similar studies being done, have been done or being planned in other war stricken countries? How does the work of humanitarian government and non-government agencies get transcribed into the post-war domestic political infrastructure? Many readers of this journal will have exposure to working in and an expertise in such scenarios. Please write to us and let us know your thoughts and experiences.

    Mujeeb and Jaffery from Pakistan report on emergency blood transfusion services in their country after the large earthquake of 2005, in which an estimated 73,000 people were killed.
 See page 18and 22

    A CERTAIN PART OF SE ASIA

    We have a report from Thailand on experience learned from the introduction of head injury guidleines in a trauma referral system. A useful and unexpected benefit was the improvement in the doctor-nurse relationship. Maybe we need to report this to NICE in the UK. A team from neighbouring Malaysia describe their experiences of classroom and simulation based disaster training and a group from Taiwan report on problems with post -traumatic stress disorder in health workers in the SARS outbreak in 2003. Are there any lessons here which can be applied to planning for the predicted bird flu pandemic with the avian influenza A (H5N1) virus?
 See pages 25, 7 and 12

    A BRACE OF ISSUES

    Closer to home Walker and a team from Scotland report their findings about sick-notes and GP waiting times and we have a review of injuries from baseball bats, (the modern day cudgel -eggs being the modern day missile for eye injuries).
 See page 31

    MEA CUPLA

    Foex and colleagues from Manchester write a robust commentary and challenge to a paper published here that studied rectal fluid replacement in animal models. They take us to task for publishing the original paper and then take the authors to task for doing the study described in the paper. Read it and you will learn plenty about rabbit colonic physiology, maybe more than you ever want to know.
 See page 3

    A POTPOURRI

    Clements et al review the traditional dogma of using (or not) cuffed endotracheal tubes in children; we have a correspondent who highlights the difficulties of implementing sepsis guidelines in a district general hospital; there is evidence from Teeside that the presence of doctors does not prolong prehospital scene times and finally we see the return of the SOCRATES series of Cochrane reviews; we know that Socrates the Greek philospher was executed by swallowing hemlock but we are delighted that this SOCRATES is alive and kicking. Welcome back.
 See 57 and 37

    A happy and prosperous new year to all our readers. May it bring everything you think you want.

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