eLetters

322 e-Letters

published between 2004 and 2007

  • Re: Regurgitation of Best Evidence?
    Stewart Teece

    Dear Editor

    I would like to thank Drs Glazebrook and Probst for pointing out a potential source of confusion. I also considered gastric lavage innapropriate management of overdose for multiple reasons, which gave me cause to review the evidence. The fact it's use is still occasionally suggested in clinical practice remains a personal concern.

    At the time of the initial authorship of the BET concerned, g...

    Show More
  • ED RSI in the UK - the growing evidence base is not inconsistent
    Cliff Reid

    Dear Editor

    We would like to thank Dr Oglesby and colleagues for their helpful comments [1], and for highlighting their data on complication rates for ED RSI [2] which were published subsequent to the submission of our paper [3].

    We share entirely their reservations regarding propofol as an induction agent in ED patients. It is our observation that it is associated with a greater incidence of hypotens...

    Show More
  • Ice, Pins and Sugar: Are they meant for reducing paraphimosis
    Raveenthiran Venkatachalam

    Dear Editor,

    I read, with interest, the article by Jones and Teece [1]. The authors have attempted to find the best out of three procedures, which more or less resemble home remedy. They should not be offered in a modern scientific emergency department because they are based on misunderstood pathophysiology of paraphimosis [2].

    In paraphimosis, as soon as the constricting ring of prepuce gets stuck...

    Show More
  • Head injury transfers
    Peter J Hutchinson

    Dear Editor

    The letter by C D Okereke [1] “Head injury transfers: arm of greatest delay” confirms that considerable delays persist in the transfer of patients with traumatic brain injury from district general hospitals to regional neurosurgical units. Our own data indicates that emergency craniotomy for traumatic brain injury was achieved in only 1 out of 24 patients [2] within the recommended four hour target [...

    Show More
  • Regurgitation of Best Evidence?
    William Glazebrook

    Dear Editor

    While I normally find the Best BETs both informative and useful, I was surprised at the publishing of one concerning gastric lavage in drug overdose [1].

    Gastric lavage is both dangerous and without benefit in all but a few overdoses. The 1997 Joint Position Statement made by the American Academy of Clinical Toxicology, and the European Association of Poisons Centres stated that gastric lavage s...

    Show More
  • Back to the future-superspecialisation in ED
    Dilip Menon

    Dear Editor

    I think the model the Israeli medical services had adopted in the development of emergency medicine is brilliant and something we should deliberate adopting as modelling for the future of emergency medicine. It's not a new idea as the Casualty Surgeons in the UK and countries affiliated to this model in other parts of the world did way back in the 1960's develop as a group of specialist orthopaedic sur...

    Show More
  • EMERGENCY DEPARTMENT, WEEKENDS, AND TEMPORAL PATTERN OF OCCURRENCE OF ACUTE MEDICAL DISEASES.
    Roberto Manfredini

    Dear Editor

    We read the interesting paper by Mirò et al [1], who found that in the emergency department (ED) weekends are not characterized by a loss of effectiveness compared to workdays. The possible reduction in staff and loss of attention on weekends is a topic still under debate. A recent study [2] analyzed the six more common urgent procedures usually utilized in acute care hospitals, and found that only 5...

    Show More
  • Convincing senior doctors to train in EM
    Mohamed Gaber

    Dear Editor

    Dr Halpern's article about the development of EM training in Israel is quite informative and can be relevant to many other countries in the middle east.

    However, I would like to enquire about how senior physicians who are already trained in their respective specialties and run their own private clinics were persuaded to leave all that and enter another 2.5 years of EM specialist training - th...

    Show More
  • Jelly on the Belly
    Dilip Menon

    Dear Editor

    I read with interest Brooks audit of FAST in a 100 Blunt Abdominal Trauma and 10 penetrating abdominal injuries done by 3 non-radiologists members of of the emergency department. Ultrasound imaging as a diagnostic modality is unique for us in A&E as it requires skills in both image acquisition and interpretation where we have traditionally had only to deal with the latter for plain films or CT/MRI...

    Show More
  • Fast food medicine for thought
    Dilip Menon

    Dear Editor

    The paper by Terris [1] on reducing waiting times in the ED using consultant/Senior Nurse triage and subsequent papers by Subash on team triage and Mitchell on Senior House Officer time-motion study in this month's EMJ is giving me serious concerns we have missed the woods for the trees. Our core activity of giving high quality emergency care to those who truly need it is being diluted by the increasin...

    Show More

Pages