eLetters

183 e-Letters

published between 2010 and 2013

  • Facebook pages about junior doctors in the UK.
    Mohammed A. Rashid

    Lulic and Kovic are to be congratulated for an innovative and captivating article exploring the use of Twitter in emergency physicians1.

    As they mention, Facebook is another popular social media site that highly engages all members of the public, including doctors. A number of pages have emerged on the site that represent quintessential figures in UK hospitals. Popular pages include 'The Medical Registrar', 'The...

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  • Improper Use of Troponin Assay
    Nancy Lutwak

    The publication authored by Macdonald, et al. focused on the accuracy of a 2 hour serial multiple biomarker protocol for exclusion of myocardial infarction in the Emergency Department1. Correct use of biomarkers to exclude MI is essential.

    I recently observed a case in the emergency department which demonstrated improper use of the troponin assay.

    The patient, a man in his 60's with history of diabete...

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  • Re:Pre-intervention data and paramedic intubation
    Adam Chesters

    Mr Mallinson makes three pertinent points. A doctor-paramedic team attends all patients. Each member of the team has a specific role to play and while some of these skills are theoretically interchangeable, it is local policy that the doctor performs the intubation. This is because we recognise that these patients are a high-risk group who should have intubation carried out with the maximum chance of success at the first...

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  • Re:Out-of- hospital non-invasive mechanical ventilation: discovering a new setting.
    Markus Soren Roessler

    We thank Antonio Esquinas for his response to our article. Our rationale for NIV in the prehospital setting is based on the pathophysiology of acute respiratory failure. In acute hypoxic respiratory failure shunt is the primary underlying problem. While the application of Oxygen (+ specific medication, e.g. diuretics) may improve SpO2, the paO2/FiO2- Index will not improve, as there is no alveolar recruitment. NIV immedia...

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  • Re:The importance of accurate identification of drugs of abuse in emergency departments
    Danielle Horyniak

    We thank Polesel and colleagues for raising some important points regarding the accurate identification of ecstasy and related drugs (ERDs) in emergency departments. While testing of biological samples to accurately identify what drugs have been consumed is ideal, these resources may not always be available and, given the time required to conduct analysis and obtain test results, decisions regarding patient management m...

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  • electrocardiographic differential diagnosis of ST segment depression
    Linda O'Connor

    Case examples were succinct and very user friendly to follow.

    Thanks, Linda O'Connor RN

    Conflict of Interest:

    None declared

  • Driver obesity and the risk of fatal injury during traffic collisions - the view from Europe
    Diarmuid De Faoite

    Dear Sir,

    The excellent article by Rice and Zhu on driver obesity and the risk of fatal injury during traffic collisions attracted our attention. We represent a collaborative research group which is involved in similar research in Europe. As part of our work, we are currently analyzing the data of over 20,000 passengers collected in the largest German accident register across a range of variables, including wei...

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  • Lidocaine in intravenous regional anaesthesia.
    Matthew J Dunn

    I congratulate the authors on an interesting paper. They mention in their conclusions that a non inferiority study comparing Lidocaine to Prilocaine would be appropriate. I note that Bartholomew and Sloan's paper reviewed around 45000 cases of Prilocaine intravenous regional anaesthesia (IVRA) with no serious side effects including cases where the cuff either failed or was not inflated. A non inferiority study designed t...

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  • Femoral nerve blocks should be performed in the modern Emergency Department in patients with fractured femurs
    Liam D. Quinn

    Dear Editor,

    We read with some dismay the results of the survey of current practice of the administration of femoral nerve blocks in the emergency department (ED), reported by Mittal and Vermani.[1] The survey response rate of 230 EDs out of a possible 252, is to be commended. We are concerned though that of the EDs that responded, only 55% regularly gave femoral nerve blocks to patients with fractured femurs....

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  • Tetanus Vaccination in ED
    Rajesh Vasiraju

    Tetanus Vaccination is actually one of the many grey areas so far. Which wounds need booster dose and which one will need immunoglobulin. If 10 physicians are asked probably there will be 10 different explanations. If the wounds are major no one will have any doubts. The small wounds are the tricky ones in the minor side of ED. Yes the pro tetanus kit tool will be very good to assess who needs booster doses and do the rig...

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