eLetters

329 e-Letters

published between 2005 and 2008

  • Management of Cocaine Associated Chest Pain
    Olu Fayomi

    Dear Sir,

    I read with great interest the article by Liddler et al on the appropriate use and administration of antidotes for recreational drug toxicity. I would however like to seek clarification from the authors for their justification in the use of iv Metoprolol in scenario 4 ( 42 – Year old man with ingestion of two lines of cocaine presenting with ischaemic chest pain, ECG changes-ST depression and a BP of...

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  • Cricothyrotomy Pig Model Flawed
    Nikhil V Kulkarni

    EDITOR, As an anaesthesiologist, I must respectfully disagree with the conclusion reached by Cho et al. that “[t]he porcine model is a more useful training tool than the manikin model for cricothyrotomy with PCK [Portex cricothyrotomy kit] because of its reality and similarity to human anatomy.”(1)

    Animal models have been shown previously to produce poor cricothyrotomy placement accuracy by students.(2) Manikin...

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  • Salbutamol worth trying
    Paul Walsh

    I read with interest the BET ‘Is nebulized salbutamol indicated in bronchiolitis?

    Perhaps this is the wrong question. As emergency physicians(EP) perhaps the more pertinent question is 'Does salbutamol decrease need for hospital admission?'

    We have addressed this question in an RCT which compared adrenaline to salbutamol.1 We found that salbutamol decreased the need for admission. This decrease was su...

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  • GCP is for all health professionals involved
    Tom Quinn

    I enjoyed reading the commentary on Good Clinical Practice and welcome the efforts of the College of Emergency Medicine to make training in this important area available to emergency physicians.

    I think, however, it is important to recognise the imnportance of other disciplines - nurses and paramedics being key examples- in emergency care research, and perhaps to foster collaboration with relevant partner Colleg...

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  • Nitrous oxide can be made more effective and predictable using a closed breathing circuit
    Faye Weinberg

    Dear Sir,

    We read with interest the study by Babl et al “limited analgesia efficacy of nitrous oxide for painful procedures in children” published in the EMJ November 2008 Vol 25 No 11.

    Central to the protocol and management is the use of clinical assessment to determine adequacy and depth of analgesia/ sedation. We agree with this wholeheartedly and support this method as it emphasises the importanc...

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  • viva potatoes [ a sonopleardo models]
    Mahamoud M Gabal

    Dear Editor

    Several models had been suggested for ultrasonographic training for intervention {1,2}.

    The main criteria of the models should be more or less simulate the human body organs, cost no much and easily prepared, {3}.

    For three years of trying in this field in my radiology laboratory the potatoes models were on the top of all ,{4}.

    After boiling of the potatoes the trai...

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  • In Support of observational Pain Tools for Emergency Medicine Triage in Children
    Briar Stewart

    PLEASE NOTE THIS IS A RESUBMISSION FOR PRINTING PURPOSES WITH THE NECESSARY PERMISSIONS AS REQUESTED EMERMED/2008/069971 - Notify Author Re: Deficiencies

    We read with interest this article by Shavit et al comparing the Alder Hey Triage Pain Score with a subjective scoring tool. The finding of a discrepancy in scoring between the tools, with the AHTPS scoring lower, is entirely consistent with the similar finding...

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  • nitrous oxide can be made more effective and predictable using a closed breathing circuit
    Faye Weinberg

    Dear Sir,

    We read with interest the study by Babl et al “limited analgesia efficacy of nitrous oxide for painful procedures in children” published in the EMJ November 2008 Vol 25 No 11.

    Central to the protocol and management is the use of clinical assessment to determine adequacy and depth of analgesia/ sedation. We agree with this wholeheartedly and support this method as it emphasises the importance...

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  • The PAWS score and the need to consider oxygen requirement
    Lynn Sinitsky

    We read with interest the study by Egdell et al (1).

    In a busy Paediatric Emergency Department, there is a need for a tool to help determine those children who are critically ill or deteriorating and need intervention to prevent morbidity and mortality.

    Recent NICE guidance on the initial assessment and management of feverish illness in children under 5 years suggests the use of a traffic light system...

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  • Nitrous is not enough
    Andrew Appelboam

    Dear Sir

    RE: The Efficacy of N2O

    We read with interest the recent article by Babl et al but feel the paper, its provocative title and accompanying editorial comment could be misleading and potentially damaging to the use of this useful agent.

    In our experience, ‘intra procedural’ pain scoring by the patient during adequately administered 70% nitrous would in most cases be impossible. Indeed...

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