169 e-Letters

published between 2011 and 2014

  • Public Hospital Reform Underway in Beijing, China
    Haijiang Zhou

    We read with interest the article by Shamini et al[1], in which he suggested that primary care services should be more responsive to needs of the older adolescent age. Here we intend to introduce some new policies recently implemented in hospitals in Beijing, China.

    Beijing has begun implementing its public hospital reform programs since July 1, 2012 [2]. Patients are charged a medical care service fee which va...

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    Luca Roncati

    We have read with great interest the article by Rickard et al. [1] concerning with the management of raised intracranial pressure in course of traumatic brain injury. More in detail, the sugar alcohol mannitol, derived from fructose hydrogenation (sorbitol isomer), is a hyperosmolar diuretic agent. Clinically, mannitol can be administered through a central or peripheral venous catheter in the treatment of raised intracran...

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  • Log-rolling a blunt major trauma patient is inappropriate in the primary survey
    Caroline Leech

    The article by Gill et al1 provides further evidence that a log-roll is not useful for major trauma patients in the primary survey. Even with a GCS 15 and no influence from alcohol or opiates only 60% of patients with thoraco-lumbar fractures had tenderness on log-roll. The authors did not examine how many false negatives were found by examination or the impact of a distracting injury.

    Log-rolling a polytrauma...

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  • First aid - not just a practical skill
    Chris Jefferies

    Dear authors,

    Thank you for conducting this interesting study.

    I have been teaching first aid to the public for the last six years. My personal experience is that many members of the public are worried about becoming involved in emergency situations due to fears around litigation and "doing things wrong".

    Almost every first aid course I teach I answer questions regarding the legal situation...

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  • Emerging concept in cardiopulmonary resuscitation
    nayer jamshed

    We read the article Optimal position for external chest compression during cardiopulmonary resuscitation: an analysis based on chest CT in patients resuscitated from cardiac arrest by Kyoung Chul Cha et al with interest. This article has added a new concept in CPR. Cardiopulmonary resuscitation (CPR) is a life saving emergency procedure and it should be done as per protocol. ACC/AHA guideline2010 suggest that effective c...

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  • Re:Neat-patienting for RSV in the emergency department
    Paul Walsh

    Proposed response Dear Editor, We thank the writers for their interest in our work and for the most part agree with them. (1)(2) We fully agree that bronchiolitis is a clinical diagnosis; it is because the viral aetiology cannot be determined clinically that testing is contemplated. We also agree that specific treatment is not yet available; although RSV specific drugs are being developed and it behooves emergency depart...

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  • Neat-patienting for RSV in the emergency department
    Thomas F Beattie

    We note the paper on near-patient testing (NPT) for respiratory syncytial virus (RSV) in cases of bronchiolitis by Walsh et al (1). It is an interesting paper but we suggest it fails to acknowledge one of the main uses of this particular test methodology. The test analysed also has a poorer performance than the one we use.

    Bronchiolitis is a common respiratory disease in early childhood and infancy. The diagnos...

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  • Too big for the tape: limitations of the Broselow tape when applied to overweight and obese children
    Susan M. Abdel-Rahman

    Recently, Cattermole et al. discussed our work as well as the work of others in a paper describing the proportion of children for whom the Broselow tape (BT) is not applicable.[1] As the authors point out, studies that have examined the accuracy of the BT tend to omit from inclusion, or exclude from analysis, children whose length exceeds the bounds of the tape. While these studies in effect overestimate the utility of...

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  • Stroke: Spread the word to save lives
    Surinder K. Sharma

    The article by Mellon et al highlights one of the lesser researched areas in stroke.[1] Only 27% of the patients presenting for stroke services at a tertiary level hospital in India were aware they had a stroke.[2] Lack of awareness about stroke among general masses is often an underestimated cause of prehospital delays. Less dramatic nature of symptoms in acute ischemic stroke as compared to myocardial infarction or sta...

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  • The face arm speech test: does it encourage rapid recognition of important stroke warning symptoms?
    Nayer Jamshed

    We read with great interest the article by A. Ross Naylor et al ; the face arm speech test: does it encourage rapid recognition of important stroke warning symptoms? This study helps in generating awareness of the early stroke symptoms in the population. Similar studies were done in the past like Cincinnati prehospital stroke scale (CPSS) which had a positive predictive value between 72%-85%.1 Los Angeles Prehospital stro...

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