eLetters

322 e-Letters

published between 2004 and 2007

  • eletter
    Ron Trussell

    Dear Editor

    Thought provoking as this paper is, it doesn't take account of any 'special awareness' of the problem as percieved by the coronial & reactive health service opinions upon which it is based.

    It might not be the case that Brighton's problems are any greater than any other similar conurbation - only that those reacting to your questions are more specifically looking for, and willing to ident...

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  • Topical anaesthesia in children
    Matt Baker

    Dear Editor

    I read kennedy et al's article regarding the use of topical cocaine and adrenaline with interest.

    I have also seen instillagel (2% lignocaine and 0.25% chlorhexidine)used with good effect when placed on childrens wounds to allow exploration and closure within the emergency department setting.

    The great advantages being that it is easily available within the department and when wo...

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  • Author’s response to ‘futility of nalbuphine’
    Malcolm Woollard

    Dear Editor

    Aruni Sen’s evident distaste for nalbuphine seems to have precipitated a somewhat hasty and inaccurate reading of our paper [1].

    Firstly, we did not claim that nalbuphine is an effective analgesic. We did, however, offer empirical evidence that it is effective for many patients –just under half of those treated had a pain score of three or less (‘mild’ pain) on arrival at hospital. Less tha...

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  • Assessment of cognitive functioning is important but some modification maybe required
    Andrew P Webster

    Dear Editor

    I agree with the comments by Dr Harden that assessment of cognitive function is important in the acutely confused patient.

    However maybe a slight modification is necessary. Knowledge of the start of the first world war is also partly dependent on level of education. As the war started 90 years ago, for the majority of our patients this was a long time before they were born. Perhaps asking when...

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  • LMA use by Warwicksire ambulance service
    Andrew M. Mason

    Dear Editor

    I was interested to read the letter by Pattinson et al [1] reviewing the use of the single-use laryngeal mask airway (LMA-Unique) over a two- year period in the ambulance service in Warwickshire. In their summary, the authors commented that their success rates for LMA insertion were similar to those reported in the literature and that the introduction of LMAs, ‘had achieved the aims that were intended’...

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  • Appropriate analysis and reporting of cluster randomised trials
    Steve Goodacre

    Dear Editor

    Dyson et al [1] use a pragmatic design to address an interesting question, but I am concerned that the statistical analysis may be inappropriate and could have led to erroneous conclusions being drawn. The study is a cluster randomised controlled trial. Instead of randomising individual House Officers (HOs), the authors have randomised groups of HOs (those working at the same hospital). This is entirely...

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  • In need of a PEA?
    Andrew M. Mason

    Dear Editor

    For feeble-minded souls such as myself, the aide mémoire has played a key part in my professional life. Some 30 years ago whilst demonstrating anatomy at Cambridge, I devised numerous mnemonics to assist with teaching. To illustrate their power, whilst I have forgotten the names of virtually all my students and most of my fellow demonstrators, I can recall each and every segment of the right lung, all...

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  • Best Bets, how robust is the review process?
    Adrian A Boyle

    Dear Editor

    The correspondence between Professor Mackway Jones [1] and Dr Locker et al.[2] and Dr Webster [3] raises some interesting points about how Best Bets are developed.

    Best Bets represent an admirable attempt to improve the evidence on which our practice is based and no one should underestimate the hours of work that go into this. Of course, the biggest problem for Best Bets is that the answer...

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  • Topical Anaesthesia in Children – an alternative to cocaine
    Bimal M Mehta

    Dear Editor

    The Emergency Department (ED) at Alder Hey Children’s Hospital, Liverpool has several years experience using topical adrenaline and cocaine gel (topAC) as an anaesthetic for suturing lacerations of head and body in children. We, therefore, read the article by Kennedy et al. with interest.[1]

    An audit conducted within our department showed similar results to Kennedy’s with a high degr...

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  • Risks of Overzelous Adrenalin Administration
    Luigi Gori

    Dear Editor

    In the paper of SGA Brown [1] adrenaline was administered to 19 patients of 21, 3 of which in stage II and 5 in stage I of Muller's grading of systemic allergic reactions, we think that adrenaline administrationat at this stage is excessive and potentially hazardous in respect to signs and symptoms, although the patients were continuously monitored. We think adrenaline administration should be avoided o...

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