eLetters

107 e-Letters

published between 2013 and 2016

  • Re: Clinical navigation for beginners: the clinical utility and safety of the Paramedic Pathfinder
    James Goulding
    We applaud Newton et al[1] in their efforts developing the Paramedic Pathfinder tools. We feel that supporting paramedics in decision making regarding non-conveyance and use of alternative referral pathways is vital in meeting the challenges facing modern pre-hospital care, and appreciate their efforts in empowering pre-hospital staff to safely make decisions regarding such patients. However we remained unconvinced that protocolis...
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  • Access to a helipad and the impact to the hospital
    Samira S Fatehi

    We read with interest the article written by Freshwater et. al. (1) 'Extending access to specialist services: the impact of an onsite helipad and analysis of the first 100 flights' and were very impressed with the findings and at the outset we would like to congratulate the authors on this innovative analysis. This paper demonstrates the great impact retrievals and transfers can have on the referred hospital, however we...

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  • Don't ignore the ASA grade.
    Gavin Lloyd

    We welcome our Edinburgh colleagues' further contribution1 to the emergency medicine literature regarding procedural sedation for relocating hip prostheses. Their work raises a number of points worthy of debate.

    The number of patients in their study is unlikely to accurately determine a relationship between ASA grade and complication rates. This is particularly so for (meaningful) sentinel adverse events and outc...

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  • Re:AP pelvis and frog lateral for a limping child
    Jawad Sultan

    Many thanks for your letter. With the benefit of hindsight, the radiographs do show signs suggestive of SUFE. However, the original radiographs were reviewed by a senior A&E doctor in a peripheral hospital, and reported by a consultant radiologist as possible Perthes. This was also the working diagnosis of a consultant paediatric orthopaedic surgeon who reviewed the chid in clinic. SUFE was not suspected possibly beca...

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  • Mobile apps - are we culturally out of signal?
    Nicholas E Boxall

    As an avid user of mobile apps currently working in Emergency Medicine, I enjoyed reading this article (and have since downloaded a couple of apps!). I have found mobile apps are a useful adjunct to my work in the Emergency Department, most commonly for checking drug doses using the British National Formulary app or using a Snellen Chart app in a departmental bay.

    I do think, however, if mobile apps are to be in...

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  • Is videolaryngoscope superior to direct laryngoscopes for tracheal intubation during chest compressions?
    Fu Shan Xue

    In a manikin study simulating cardiopulmonary resuscitation, Tandon et al.1 showed that intubation time was shorter for GlideScope?? videolaryngoscope than direct laryngoscope. This result agrees with the findings of Shin et al2 and Xanthos et al3 in manikin studies simulating cardiopulmonary resuscitation. However, in other similar manikin studies, GlideScope?? videolaryngoscope was not superior to direct laryngoscope with r...

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  • AP pelvis and frog lateral for a limping child
    Thomas F Beattie

    We read the article "AP pelvis and frog lateral for a limping child"(1) with some concern for radiation safety. The AP pelvis radiograph at presentation does not show merely slight irregularity of the articular surface as stated in the article, but a reduction of height of 50% of the left femoral capital epiphysis, increased density projected across the growth plate, loss of clarity and contour of the growth plate and la...

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  • COMMENTS ON: "BET 3: Evaluation of intra-aortic balloon support in cardiogenic shock"
    Quintilio Caretta

    COMMENTS ON: "BET 3: Evaluation of intra-aortic balloon support in cardiogenic shock"

    Maria Cristina Acconcia(a), MD, Flavia Chiarotti(b), DStat, Francesco Romeo(c), MD, Quintilio Caretta(d*), MD.

    (a)Department of Cardiovascular Disease, University of Rome - La Sapienza, Rome, Italy (b)Department of Cell Biology and Neuroscience, Italian National Institute of Health, Rome, Italy (c)Department of Cardio...

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  • A lesson in PR
    NICHOLAS A MOORE

    I thoroughly enjoyed reading this honest perspective from an experienced colleague. Like most junior doctors, my career to this point has been littered with examples of unpleasant exchanges. As unpleasant as they are, at my level being put in ones place seems to have some value. As an example I remember when the on call general surgical registrar informed me that she was "not the only one in the hospital with effing finger...

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  • Reliability and validity of a new French- language triage algorithm: the ELISA scale. Methodological error
    Siamak Sabour

    I was interested to read the papers by Jobe J and colleagues published in Feb 2014 issue of Emerg Med J.1 The authors aimed to investigate the validity and efficiency of a specific French-language triage system named Echelle Liegeoise d'Index de Severite a l'Admission (ELISA). 1 As the authors pointed out validity was estimated by studying the correlations between the triage ranking assigned by the nurse and actual reso...

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