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  1. Malcolm Woollard, Associate Editor

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Establishing a prehospital emergency care service in Pakistan

This paper gives a fascinating insight into the challenges of establishing a quality-conscious government run prehospital emergency service in a developing country. In Punjab none of the major medical educational institutions include emergency medicine as part of their curriculum, and emergency admissions have, in the past, been largely via private vehicles or ambulances with little more equipment than a stretcher and a siren. The authors describe the process of setting up a system from scratch, from the establishment of enabling legislation, to training, and building infrastructure. This process has also had a significant positive impact on the modernisation of other emergency services and provides an excellent example of what can be achieved given the political will (see page 513).

Liquid ecstasy

Galicia and colleagues describe the presentation of 505 patients admitted to their emergency department in Spain following GHB (liquid ecstasy) intoxication. They note that more than three-quarters had taken at least one other drug, including alcohol, and that this increases the proportion requiring prolonged admission, ventilation and other interventions, although no patient responded …

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