839 e-Letters

  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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,...

    Show More
  • Re: Not Cas, not A&E but Emergency Medicine
    Simon D Carley

    John Ryan raises an interesting question from an editorial point of view. Like him I suspect that I refer to my own department as an emergency department, and see myself as an emergency physician. I am a proud member of the College of Emergency Medicine and despite familial protestations refuse to watch historically named BBC dramas on principles of nomenclature.

    Hau on the other hand uses the terms terms 'A...

    Show More
  • Propofol sedation in the ED is not always "conscious"
    Jonathan R Benger


    Your recently published Best Evidence Topic (BET) report regarding the reduction of dislocated hip prosthesis outlines a comparison of general anaesthesia with “conscious sedation”.[1] However, of the four included papers one used methohexital with or without opioids to facilitate reduction, whilst another was a prospective cohort study of patients receiving intravenous morphine followed by propofol. In...

    Show More
  • Propofol is effective but not safe for relocating hip prostheses
    Dr Keith J Anderson

    We read with interest the clinically based study, on the use of propofol to sedate patients for relocation of hip prostheses in the emergency department [1]. The authors rightly point out that there are problems with the safety and efficacy of using midazolam, and conclude that the described technique is both effective and safe. In another paper by the same authors they demonstrate this technique of “sedation” has a bet...

    Show More
  • Reduced frequent attendance: could it be seasonal?
    Elizabeth D Bateman

    Dear Editor,

    I read with interest the article by Skinner, Carter and Haxton assessing whether case management of frequent attenders to an urban emergency department reduces frequency of subsequent attendances.1 The case for multidisciplinary management of frequent attenders is well-made and the reported practice of case review and implementation of care plans highly commendable.

    However, a possible c...

    Show More
  • Original Authors' Response to Dr. Ford’s e-Letter
    Deirdre Anglin

    Dear Editor,

    We appreciate Dr. Ford’s letter in response to our article entitled “Excessive Use of Force by Police: A Survey of Academic Emergency Physicians.”[1] As he pointed out, almost all respondents to our randomized survey of academic emergency physicians in the US believed that excessive use of force by law enforcement does occur. This is substantiated by statistics from the US Department of Justice in...

    Show More