169 e-Letters

published between 2011 and 2014

  • Re: An evaluation of echo in life support (ELS): is it feasible? What does it add? Hayhurst et al. Emerg. Med. J. 2011 28:119-121; doi:10.1136/emj.2009.084202
    Michael J. Stewart

    We note the experience of Dr Hayhurst and colleagues in the use of echo in life support (ELS) with interest.[1] Our own anecdotal experience agrees that focused ELS scans can be performed within the 10 second pause in CPR for a pulse check, and provide additional diagnostic information that can guide further resuscitative measures.

    Moreover we have found that it is usually practical to extend the ELS protocol to...

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  • Table 6 Calculation Error
    John Fralick

    Dear Dr. Jones and colleagues,

    I recently came across your paper as I was in need of a power calculation for diagnostic studies and have found your work to be very helpful. I noted, however, a minor but important error in Table 6, that outlines how to calculate sensitivity and specificity. The formula for sensitivity is incorrectly stated as the true positives divided by true positives plus false positives. Thi...

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  • The use of chaperones for intimate examinations is often impractical in primary care
    Deen M Mirza

    I found this article which showed suboptimal use of chaperones in emergency departments to be of great interest. In my clinical work in primary care in the UK, I often struggle with providing a chaperone for intimate examinations. The two main issues I have are who we should bring in, and what should they see.

    Firstly I feel that the person brought in should be someone who is allowed to examine patients themsel...

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  • Methoxy-what?!
    David G.E. Caldicott


    I presume that Dr Fairhurst is referring to a substance used ubiquitously in the Antipodes and more commonly spelled 'methoxyflurANE'.

    It is estimated that over three million doses have been used over the last 25 years in Australia (Jacobs, 2010). It is used by state ambulance services in the pre-hospital environment in most states of Australia, by the Australian Defence Forces, within emergency de...

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  • Comparison of tracheal intubation through intubating laryngeal mask airway and Airtraq? laryngoscope in different non-conventional positions
    Fu Shan Xue

    We read with interest the recent article of Grosomanidis et al.1, who compared applicability and efficacy of the tracheal intubation using an intubating laryngeal mask airway (ILMA) or an Airtraq? laryngoscope (Airtraq) in four non-conventional positions in a manikin study. Their findings that success rates of tracheal intubation using both techniques in an acceptable time period (up to 120 s) are up to 100% appear very...

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  • Reply to: Modelling the effects of the weather on admissions to UK trauma units: a cross-sectional study
    Wouter Stomp

    With great interest we read the report by Parsons et al. regarding the effects of the weather on trauma unit admissions.[1] We would like to bring to the authors attention our study, in which we studied the same effects in an area in the Netherlands geographically and metereologically similar to the United Kingdom over a total period of 36 years, including over 350,000 patients.[2] Although the authors of the present stu...

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  • Treating Hypoglycemia

    Acute Care issues:

    Treating hypoglycaemia in Acute care due to insulin and oral agents create very different challenges. Decrease in blood sugar due to oral agents may be due to skipped meals or exercise. However concurrent illness (dehydration etc), new onset renal dysfunction and drug interactions are major factors that cause oral agents induced hypoglycaemia; such events prolong the half life of sulfonylureas....

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  • Your question and bottom line are too vague
    Mary Hickson

    The question you ask is akin to asking whether drugs can cure a headache. You cannot lump all probiotics together. Probiotics are defined as "live microorganisms that when administered in adequate amounts confer a health benefit on the host"(WHO 2001). Not all micro-organisms will confer a health benefit and the actions of potential probiotics are strain specific. Therefore, your question should be 'Which, if any, probiot...

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  • Lack of evidence, not knowledge, contributes to variability in massive transfusion practice
    Biswadev Mitra

    Milligan, et al. (1) provides valuable insight into the varied management of massive haemorrhage post trauma. However, the conclusions that emergency physicians lacked core knowledge and were unaware of how to prevent and treat early coagulopathy appear unfounded. It would be more prudent to conclude that a paucity of high level of evidence guiding trauma resuscitation was responsible for this varied practice.

    The defin...

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