eLetters

268 e-Letters

published between 2002 and 2005

  • Prehospital Intubation – Delving deeper into the evidence
    Robert J Dawes

    Dear Editors,

    May I thank Ayan Sen and Raj Nichani for their recent “Best Bet” on prehospital intubation in head injury. It was a pity however, that they neglected to look deeper into the reasons why their conclusion, at least at this point in time, was that there is insufficient evidence to support its use. The very topic of prehospital rapid sequence induction (RSI), was the subject of a panel discussion and p...

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  • Treatment for acute paronychia: Author's response
    Richard Body

    Dear Editor,

    I read with interest the comments regarding the Best Evidence Topic Report (BET) entitled “Incision and drainage preferable to oral antibiotics in acute paronychial nail infection?” and would be delighted to provide justification for the conclusion[1]. Acute paronychia is one of the most common infections of the hand. Far from being a simple digital abscess, acute paronychia represents a dynamic...

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  • IMA - any further benefit?
    Iyad K Azzam

    Dear Editor,

    I read with great interest this article. I believe IMA did not add any benefit over myoglobin in terms of early ruling-out Acute Myocardial Infarction, as the negative predictive value of myoglobin is about 99% in the first 1-3 hours. Moreover, both of them are not specific for Acute MI. Troponins are sensitive in 6-12 hours post symptoms, specific for the heart, especially cardiac troponin I, but both...

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  • Re: Simple technique for paronychia management: aspiration by wide bore needle
    Dr. Rajesh Chauhan

    Dear Editor,

    The technique used by us is quite useful for the superficial collection of pus at any other site as well. This requires simple aspiration. This aspiration technique can be used for hematoma collection also. The simplicity of aspirating rather than incising is readily acceptable to patients and can be easily performed as an OPD procedure.

    With regards.

  • Psychoactive substance misuse in emergency medical care: lessons from psychiatry
    Olive Lynn

    Dear Editor,

    We note with interest findings by Binks et al.[1] that almost 50% of emergency department presenters with direct consequences of “illegal drug” (psychoactive substance) misuse had a psychiatric disorder or emotional difficulties associated with deliberate self-harm.

    Our experience in emergency psychiatry on a Psychiatric Intensive Care Unit (PICU) also identifies very high rates of substance mi...

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  • Preventing inflight medical emergencies by utilising the internet
    Zane Sherif

    Dear Editor,

    As commercial air travel is moving toward an internet driven consumer booking system[1] opportunities exist to remind travellers who may require medications to bring them in their carry on luggage and not to pack them. The first opportunity to do this occurs in the booking process where a flash screen reminding potential travellers that they should carry their medication could be programmed. If ai...

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  • Definition of Relative Analgesia
    Ronald A. Cameron, DMD, MDS(Perio.)

    Dear Editor,

    I could not resist replying, even though time has passed since publication, as I will be conducting continuing education based in part on the classic text, first in the reference list, "Langa's Relative Analgesia in Dental Practice."

    In this text's preface, Langa makes the statement, "The term 'relative analgesia' was introduced by the author many years ago." This would seem to be a credible...

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  • Association does not prove causality
    Brian C Doyle

    Dear Editor,

    I would like to briefly comment on the article entitled "Prehospital endotracheal intubation in adult major trauma patients with head injury" by Ayan Sen and Raj Nichani. In this excellent review, the authors point out that there are no prospective trials that have investigated the prehospital use of endotracheal intubation in adults. I believe it should be stressed that it is very difficult to accou...

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  • All for US and US for all
    Zane Sherif

    Dear Editor,

    Atkinson et al.[1] in their paper highlighted how catheterisation of central venous system for vascular access is an essential skill for emergency physicians. Clinician inexperience has been identified as being associated with a higher number of complications.[2]

    Mansfield did not find that ultrasound usage in his study group, patients requiring chemotherapy, was beneficial. Miller[3] howev...

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  • Best Bets. A call for scrutiny.
    James French

    Dear Editors,

    Best BETS are based on specific clinical scenarios and aim to provide a clinical bottom line which should indicate, in the light of the evidence, what the clinician would do if faced with the same scenario again.[1] The article by Sen and Nechani (EMJ 2005;22:887-889) serves to remind us that unless Best BETS are rigorously conducted their conclusions may be inappropriate.

    Sen and Nechani wond...

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