174 e-Letters

published between 2009 and 2012

  • White coat effect: heart rate, blood pressure... and shock index in minimally injured patients
    Pierre Pasquier

    We read with interest the article by Bruijns et al. comparing the relationship between heart rate (HR) and systolic blood pressure (SBP) in non-haemorrhagic, minimally injured patients with that of a non-injured control group.1 There was a statistically significant difference between the groups for both HR and SBP (p<0.001), demonstrating that as far as mild to moderate injury is concerned, HR tends to be higher than...

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  • Learning Ophthalmology in a Hurry
    Vipul Ramjiani

    I am glad to see Eye Know How featured in the Emergency Medicine Journal. As someone who has worked in accident and emergency and now a starter in the ophthalmology world, this book has proved invaluable. I feel the need to reiterate the symptom led approach highlighted in this b...

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  • A mnemonic to remember the sepsis six bundle
    Santosh Bongale

    I am a specialty registrar in Emergency Medicine presently working at CrossHouse Hospital, Kilmarnock, Scotland.

    I have prepared a mnemonic to help remember the sepsis six bundle which I thought, I might share it with you.

    "Give 3, Take 2 and Monitor 1"

    Give 3 ( Oxygen + IV fluids + Antibiotics) Take 2 ( Blood Cultures + Hb/Lactate) Monitor 1 ( urine output)

    I have found the use of thi...

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  • Response to EMJ article comment:
    Fiona Jayne Togher

    We would like to thank Brooks Walsh for his comments and agree that it is important to understand the rich and mostly ignored perspectives of prehospital clinicians and their patients.

    Whilst it is true that patients were drawing upon a singular concrete experience they usually reported this in the context of their broader experiences and expectations of interactions with health services. Similarly, although cl...

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  • The cognitive burden of Higher Speciality Trainees in Emergency Medicine: the hidden workload?
    Carl McQueen

    As an Emergency Medicine Higher Speciality Trainee taking time out of training to complete a research post I read the recent article by Allard and colleagues (1) regarding interruptions on the ED shop floor with great interest. During my ST4 post in Emergency Medicine at a large teaching hospital in the United Kingdom I undertook my own self- observational audit study similar to that performed by Allard. During a total o...

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  • Glaucoma definition and relevant pharmacology
    Vipul Ramjiani

    The most recent letter(1) published in response to the article 'Short answer question case series: diagnosis and management of glaucoma'(2) highlighted important errors within the article. Some further points need to be clarified.

    Iopidine and brimonidine are primarily alpha-2-adrenoreceptor agonists. Subsequently they have no pharmacodynamic effect on pupillary action as sympathetic innervation to the pupillar...

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  • Device for nebulised bronchodilator delivery to supine patients
    Matt Pepper

    Currently in Australia a number of ambulance services utilise the "T- piece" to deliver nebulised medications to supine patients.1 The device is used in conjunction with a bag valve mask, and could have been effective for the patient in this case study. It's great to see good innovation in adapting to the circumstances that paramedics are faced with in the field.


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  • Elderly Patients and the Emergency Department
    James E France

    Dear Sir, We read with interest the editorial by Hughes [1] regarding the Emergency and Urgent care needs of elderly patients presenting to the emergency department (ED). We have been aware of the steadily increasing numbers of elderly patients attending the ED. We recently undertook some retrospective work looking at all over 65year attendees for a one week period in November 2011 to a medium sized DGH.


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  • Out-of- hospital non-invasive mechanical ventilation: discovering a new setting.
    Antonio Esquinas

    Title: Out-of- hospital non-invasive mechanical ventilation: discovering a new setting.

    Antonio M. Esquinas MD, PhD, FCCP International Fellow AARC Intensive Care Unit Hospital Morales Meseguer Avenida Marques de los velez s/n Murcia, 3008 Spain Phone:+34609321966 FAX:+34968232484 E-mail: antmesquinas@gmail.com

    Key words: non invasive mechanical ventilation; out-of-hospital.

    To editor:...

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  • Experiences versus opinions
    Brooks M. Walsh

    I applaud Togher et al. for tackling the rich, and mostly ignored, perspectives of the prehospital clinicians and of the patients during the short but relatively intense transport from home to the hospital.

    I would offer one comment on the different nature of the responses given by the clinicians and by the patients. The patients were generally describing a singular concrete experience, and whatever opinions or...

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