833 e-Letters

  • The iLMA vs the Airtraq for prehospital airway management
    Andrew M Mason

    I was interested to read the study by Grosomanidis et al., which compared intubation of a manikin using the intubating laryngeal mask airway (iLMA) and Airtraq optical laryngoscope in various non-conventional patient positions [1]. The authors report that those anaesthetists who participated in the study required a significantly greater number of attempts (and time) to achieve intubation via the iLMA when the operator wa...

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  • Assessment of Respiratory Status in the Hot Zone
    Neil Abeysinghe

    Editor, We read with interest the article by M.Malpas [1] which cites the difficulty of assessing respiratory status in triaging those involved in a mass casualty chemical incident resulting from the use of personal protective equipment. However, we are concerned that the use of a calorimetric device to aid this assessment in a mass casualty CBRN incident will prove impractical. It is often difficult to ascertain early ide...

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  • Re:Mephedrone Legislation- Causality or coincidence?
    David M. Wood
    We thank Caldicott and colleagues for their thoughtful and detailed response to our article [1,2]. We agree, as stated in our article, that the results of our findings need to be interpreted with caution and that there may be a number of explanations for the observed decrease in the number of presentations to our Emergency Department with acute mephedrone toxicity subsequent to the UK classification of mephedrone in April 2010....
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  • Consent should not be transitive
    Neal D. Alexander

    Using 'consent' as a transitive verb - such as 'patients will be consented' - is common in clinical trial documents, and extends to journals of the BMJ group[1,2]. Sadly, the online dictionary Wiktionary finds this usage to be specific to medicine, defining it as 'To cause to sign a consent form'[3]. As should be obvious, 'causing' consent would violate the ethical principle of voluntary participation[4]. One assumes...

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  • 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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