191 e-Letters

published between 2008 and 2011

  • Emergency management of minor head injury in anticoagulated patients
    Henry G. Watson

    Letter to the Editor Henry G Watson* & James Ferguson *Department of Haematology Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland AB25 2ZN Email: henrywatson@nhs.net Tel 00-44-1224-553394

    Department of Emergency Medicine Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland Email: j.ferguson@nhs.net Tel 00-44-1224-550506 Keywords: Intracranial haemorrhage, warfarin, prothrombin complex concentr...

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  • Early Rule-Out using High-Sensitivity Troponin
    Edward W. Carlton

    We read with interest the study published in this month's EMJ by Aldous et al. High-Sensitivity troponin T for early rule-out of myocardial infarction in recent onset chest pain. (1) This study adds to the growing body of published evidence that points to the safe use of new high-sensitivity troponin assays earlier in the patient journey.(2,3,4) The authors quite rightly point out that further prospective testing is...

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  • A complication of the use of an intra-osseous needle
    Alan Moloff

    I have recently read the case report "A complication of the use of an intra-osseous needle" by Helm, Goller, Hackenbroch and Hossfeld published online in your Emergency Medicine Journal June 2, 2011. This is a well written and informative article that discusses the uses and potential complications of intra-osseous infusion.

    I am concerned about the actual FAST1 device that was used in this case report. This wa...

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  • Mephedrone Legislation- Causality or coincidence?
    David G.E. Caldicott
    We read with interest the short report by Wood et al[1], and support the idea of the Emergency Department as an observatory for emerging licit/illicit novel substances. We would caution however, against the assumption that legislation has a significant impact on the consumption patterns of young drug users. For that assumption, one would require significantly more data, from a much wider range of EDs than the relatively...
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  • Re:Acute cyanide poisoning from apricot kernels
    Davide Cigolini

    Dear Collegues,

    We were very glad to reply your letter posted online on the emj website in october, 6 2011. We read very carefully your concerns regarding the verifiability of cyanide as the poisoning agent. Certainly You can agree with us that, in a brief report with a fixed length, it is very difficult to give all the information and in some case you have to choose what you consider more important . In this c...

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  • Left-without-being-seen patients and nurse counselling
    Benoit Bailey

    Left-without-being-seen patients and nurse counselling

    It is with great interest that we acknowledge the recent publication concerning improvements that could prevent departures of patients that left-without-being seen (LWBS) (1). Children who LWBS are an important concern in our emergency department (ED) and we have previously reported a proportion of LWBS of 17% during the year 2008 (2). With the implementatio...

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  • Best BETS: A further call for scrutiny.
    Alistair Steel

    Dear Sirs,

    We have previously expressed concerns about the validity of the "clinical bottom line" published alongside the popular Best BETS. (1) Best BETS should be based on specific clinical scenarios and should aim to provide a clinical bottom line which indicates, in the light of the evidence, what the clinician would do if faced with the same scenario again. (2) The report by Olaussen and Williams serves to...

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  • Acute cyanide poisoning from apricot kernels
    Vikhyat S. Bebarta

    We congratulate Cigolini and colleagues on their case report of apparent cyanide poisoning from apricot kernels[1]. However, we have several concerns regarding the verifiability of cyanide as the poisoning agent. These concerns were not addressed in the case description or in a limitations section.

    First, while the patient was surrounded by apricot kernels, ingestion of the kernels was not verified visually (...

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  • Age-based paediatric weight estimation is imprecise
    Giles N Cattermole

    Dear Editor,

    Luscombe et al [1] are to be congratulated for developing a more accurate age-based paediatric weight estimation tool than that previously commonly used in the UK. Perhaps modesty prevented them mentioning that their formula has also been incorporated into the 5th edition of the Advanced Paediatric Life Support manual, for 6-12 year olds [2]. It is important for readers to realise that in their art...

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  • Insufficient detail sadly means that this case remains not proven
    Kit Byatt

    We read this intriguing case report with great interest. However, it contained two specific weaknesses which undermined its strength, leaving it inconclusive. The critical point is not whether caffeine excess might cause seizures (this is known), or the theoretical pathophysiology (comprehensively discussed in the article), but whether it was the definitive cause of seizures in this case.

    Firstly, without meas...

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