eLetters

126 e-Letters

published between 2000 and 2003

  • Routine thrombolysis for all non-traumatic cardiac arrests?
    Ranjit Sinharay

    Dear Editor

    I read with interest the letter publication by Knowles on routine use of thrombolysis during all non-traumatic cardiac arrests, whether caused by pulmonary embolism ( PE ) or by myocardial infarction (MI).[1] His comment was based in relation to a case report by MacCarthy P et al (Emerg Med J 2002; 19: 178 -79.)

    BTS guidelines mention performing urgent echocardiography for massive PE with...

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  • Chest pain obervation unit (CPOU) - A road to a cost effective management of Acute Coronary Syndrome
    Ranjit Sinharay

    Dear Editor

    I read with interest the paper by Goodacre and Calvert.[1] I agree with the authors that as most patients of undifferentiated chest pain have a benign disorder, admission represents a considerable waste of resources. Nevertheless, it is worrying to note that in UK 6% of patients discharged from emergency departments after attendance with acute chest pain were found to have prognostically significant myo...

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  • What is "relative analgesia"? Reply
    Gary J Browne

    Dear Editor

    Howes [1] concern about the term !%relative analgesia!& pertaining to our recent description of nitrous oxide analgesia in children is noted.[2] This is actually a term that has been used to describe nitrous oxide analgesia for many years. It first appeared in the dental literature and was used originally to describe situations where continuous flow / variable concentration nitrous oxide was administ...

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  • Authors' Reply
    Yamni Nigam

    Dear Editor

    With reference to the comments made by Dr Simmons [1] concerning 'A preliminary investigation into bacterial contamination of Welsh emergency ambulances'.[2] We fully accept that the methods used were not rigorous enough to accurately quantify numbers of bacteria for any given measured area. However, our work was simply described as a preliminary investigation and this pilot study did identify short...

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  • Vasopressin and adrenaline in cardiac resuscitation - the BET.
    Kerstin Hogg

    Dear Editor

    We read with interest the comments on our best evidence topic review on Vasopressin or adrenaline in cardiac resuscitation and are happy to explain the process involved in producing the BET.

    This literature search was first conducted in March 2002. Our initial and specific question was:
    Is vasopressin more effective than adrenaline in achieving return of circulation and longte...

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  • Vasopressin or adrenaline in cardiac resuscitation
    Thomas E Locker

    Dear Editor

    The best evidence topic report (BET) by Hogg and Mahu [1] raises a number of concerns, both with the article itself and the BETs process as a whole. The relative efficacy of adrenaline and vasopressin in the management of cardiac arrest is an important subject of relevance to all who work in Emergency Medicine. For this BET to only include those papers directly comparing vasopressin and adrenaline is to...

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  • Emergency Department overcrowding
    Richard M Makower

    Dear Editor

    The articles on the problems of Emergency Department (ED) overcrowding make interesting reading, as the problems outlined are familiar to us in the UK, and I am sure that we would all identify similar causes and both short and long term solutions.[1]

    The list of stopgap measures, in the article by Fatovich and Hirsch [1] is also familiar to us all. Ambulance diversion is difficult outside larg...

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  • Emergency Department overcrowding - a universal problem
    Ian A Sammy

    Dear EDitor

    I read with interest the article by Schull.[1] Having recently moved back to Trinidad from the UK, I had thought that the problems encountered by Emergency Departments in developing countries were different from those in the developed world. Unfortunately, they are all too familiar: overcrowding, long waiting times, lack of inpatient facilities, and lack of trained staff. Each of these problems differ in d...

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  • Diagnostic decision support in the ED: practical considerations
    Padmanabhan Ramnarayan

    Dear Editor

    Graber's article raises several valid points about the provision of diagnostic decision support in the ED.[1] The Emergency Depertment (ED) is one setting where reaching the correct diagnosis - for simple clinical problems and unusual ones - may reduce the burden of diagnostic error and its costly adverse consequences.[2]

    In Graber's study, QMR and ILIAD were tested for their diagnostic accu...

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  • What is "relative analgesia?"
    Marten C Howes

    Dear Editor

    I welcome the paper by Frampton et al.[1] describing their experiences of nurse-administered nitrous oxide, which adds further evidence to the literature [2] supporting this technique as a useful and safe method of easing the suffering of children during their attendance at an Emergency Department.

    I feel that the use of the term “relative analgesia” is somewhat confusing; this is not...

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