eLetters

844 e-Letters

  • How will your Junior Doctors react?
    Joseph M Hobson

    Four years on from 7/7 I believe the issue of major incident awareness has still not been properly addressed. Wong in 2006 highlighted the inadequacy of Registrar awareness with their major incident contingency plan and their role. This year I set out to establish Junior Doctor’s (FY1 + FY2) awareness at Wrexham Maelor Hospital using a similar questionnaire.

    Greater than 90% of Junior Doctors did not know wh...

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  • It’s good, but is it utilitarian? A response to Body and Foëx
    Kirsty Challen

    Body and Foëx are to be congratulated on their thoughtful analysis of the philosophy of diagnosis in emergency medicine(1). They raise some issues which would bear further examination.

    The philosophy of truth

    As Body and Foëx point out, our continued use of “gnosis” in diagnosis implies an ongoing assumption of an inherent knowledge and a positivist paradigm briefly expressed as “reality exists”. Thei...

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  • Saving the AAAs- a Battle that can be won
    Muhammad U Shehzad

    I fully endorse this notion and conclusion by the authors that we need to suspect and diagnose this pathology very early "when the patient is stable”, since diagnosing a ruptured AAA in an unstable patient usually, means that we have lost the battle already. Suspecting and diagnosing early and "then rushing for theaters" is the only way forward for saving all these lives and I strongly feel that we will save many lives. Those...

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  • POCKET ASPRIN
    NAJMUL H MOOSVI

    With reference to your article I want your comments on the following idea - Keeping in mind that time is muscle, recommendations to have chewable asprin in Pocket's of people with IHD at all times (who have no contraindications to asprin) - Pharmaceutical companies to design a pack with two tablets resistant to weather conditions and easy to keep in pocket - may be giving the name "pocket asprin" people might understand the e...

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  • aggregated versus raw Hes data
    robin beaumont

    I was delighted to read the Hughes article, and while I agree that the published aggregated data is of little overall interest I would like to highlight the fact that clinicians can obtain the raw local data, which although it can be a tortuous complex procedure, can be of great use.

    I managed over ten years ago to work with the HES team to develop a large A&E anonymised raw Hes dataset which I have used, and...

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  • Unexplored issues relating to body stuffers
    yew meng aw-yong

    Dr Meng Aw-Yong 468 Fulham Palace Road London SW6 6Hy 11th May 2009

    Letter in response to Booker RJ, Smith JE Rodger M. Packers, pushers and stuffers- managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review. EMJ Vol 26 No 5 May 2009. Pages 316-320

    Dear Sirs,

    The article in EMJ May 2009 on packers, pushers and stuffers by Booker et al is an invaluab...

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  • Is the surgeon be consealed with the dianogsis?
    Yui-Hui Lu

    Dear authors:

    I am impressed with your article, because in our country, the major part of surgeons still believe analgesics would mask the physical findings and delay the time of accurate diagnosis.

    In your article, I have a question that patients were examined by surgeons not involved in their care while they were waiting for operation. I wondered if the surgeons had already known the diagnosis of patients or...

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  • Rapid Ultrasound for Shock/Hypotension (RUSH)
    Scott D Weingart

    We greatly enjoyed reading the ACES ultrasound protocol by Atkinson et al. to evaluate patients with hypotension of unknown etiology.[1] We have been using a similar protocol for a few years with the addition of pneumothorax windows to examine for spontaneous or iatrogenic pneumothorax as the cause for shock.[2]

    We call our protocol the RUSH exam, an acronym for Rapid Ultrasound for Shock/Hypotension. We find th...

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  • Flawed Study
    Jerry R Staton

    The Supreme Court stated in Graham v. Conner "The test of reasonableness under the 4th Amendment is not capable of precise definition or mechanical application." That means it is very difficult to judge a use of force (a better term being response to resistance) without knowing all the information known to the officer at the time the force was used. While your study may indicate a number of injuries resulting from contac...

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  • Good Work: Take the Next Step
    Richard Paz

    Thank you for your effort. The most important revelation is that there are no requirements to report obvious abuse, and there is no data collected. Most claims of abuse by police are not objectively investigated by the police themselves, few ever reach a criminal prosecution, and the only realistic "investigation" and prosecution of excessive force and gratitutious violence is by private lawyers in civil cases. This,...

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