eLetters

277 e-Letters

published between 2003 and 2006

  • Spinal Boards Do NOT Work
    Aidan E. Tasker-Lynch

    Dear Editor

    Your study states that spinal boards are the gold standard - they are not!. Numerous studies have shown that they do not achieve an acceptable level of immobilization, cause additional discomfort, pain and indeed pressure damage. They should be baned from pre-hospital use, let alone consideration for in-hospital use.

    The Gold standard here is the vacuum mattress, an altogether better piece of...

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  • Critical cases direct our needs and skills
    Mahamoud M Gabal

    Dear Editor

    The interest in use of ultrasonography had been increased in the last decade in the interventional procedures both in emergency and in ICU patients .. the question of {to use or not to use }is frequently asked in straight forward cases . and the fair of the suspected complication and cost benefit studies are the most frequent in this field . but the real need is in that cases in which the ultrasonog...

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  • Law amended
    Timothy J Coats

    Dear Editor

    An amendment to the Medicines Regulations 2004 was published this week. Essentially it brings these regulations (governing medicines research) more into line with the Mental Capacity Act 2005 (governing all non-medicines research). This will allow pre-hospital and early in-hospital research where it it not practical to obtain Professional Legal Adviser consent. The amendment says that if it is impossi...
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  • Ultrasonography as an alternative to the diagnostic exploration
    Mahamoud M Gabal

    Dear Editor

    I read with interest this work .. indeed careful examination is so important in detection of peripheral nerve injury as it can predict the exact affected nerve and it may suspect the site of the injury even in blunt trauma to the limb . but to shift from the clinical examination to the exploration directly may be insufficient for proper guide to management . ultrasonography is a alternative to the dia...
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  • Confidence comes with experience
    Sam Al-Jafari

    Dear Editor

    It is with interest that I note the findings of the study conducted by Croft et al. At the authors' institution, junior doctors were 'considerably less confident in managing minor injuries compared with other conditions'.

    Whilst it is rightly pointed out that 'there is no substitute for hands-on experience', the authors have not discussed the previous employment history of the juniors questioned....

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  • Tissue pH
    Richard G Fiddian-Green

    Dear Editor

    "Although haemodynamic and oxygenation profiles were initially similar, non-survivors had substantially reduced [sublingual] microcirculatory changes and small-vessel perfusion"(1,2). Why? Because the interstitial pH was lower in non-survivors than survivors and so their relative need for blood flow was reduced by the up-regulation of oxidative phosphorylation presumably achieved by increasing the prot...

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  • Excellence in Analgesia
    JOHN J CRONIN

    Dear Editor,

    What are / should we be excellent at as emergency medicine physicians? I found this discussion very stimulating and a topic definitely worth considering. I would disagree, however, with the placement of Analgesia down the list at Number7. I feel that pain management should be one of the first priorities when we deal with our patients. Sometimes this may be forgotten in the pursuit of the underlyin...

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  • Blunt ocular trauma from egg-throwing - not an unusual phenomenon?
    JOHN J CRONIN

    Dear Editor,

    On first reading the October edition of the EMJ, I questioned the value of publishing an article dealing with the unusual phenomenon of blunt ocular trauma from egg-throwing. However, the first patient that I saw the very next day in the emergency department had suffered this exact injury. The patient was a young male and presented one day after the assault. The egg was thrown by his "friend" whil...

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  • Time for Emergency Physicians to all become experts in sedation
    Paul A Jennings

    Dear Editor,

    I welcome this reivew by Duncan et al (1) that adds further support to the use of sedation by emergency physicians (EPs) when performed according to safe sedation guidelines. I have previously completed a systematic review of the use of midazolam and propofol by non- anaesthetists for procedural sedation with similar conclusions to the review by Symington and Thakore (2) published in the EMJ earlier...

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  • Ambu Bag – Basic Life Support Saves the Day.
    Vikas Suri

    Dear Editor

    With reference to the article by Agarwal et al, [1] we would like to bring to your notice a patient of neuroparalytic snake bite who was managed with basic life support and manual ambu-bag ventilation. A 30-year old male was brought to our ER in a gasping state. Due to shallow breathing efforts, immediate endotracheal intubation was carried out and manual ambu-bag ventilations started. The pulse and...

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