169 e-Letters

published between 2011 and 2014

  • 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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  • EEG in the ED
    Sarah J Wilson
    Dear Editor, We read with interest the article by Nitzschke et al, and congratulate them on their low rate of artefact in a pre-hospital environment. As part of a larger study into detecting deterioration in ED patients (REC number: 08/H1307/56), we attempted to record EEG on ED patients for the duration of their ED stay, to determine whether there was a correlation between EEG and GCS that could be useful for continuous monitori...
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  • Errors in the nomogram.
    Patrick Laffey

    In the top nomogram the CI curves are missed labelled, there are three of them with the value 0.1.

    In the bottom nomogram; the example line is drawn too low. It is showing the start point at 0.45 rather than the 0.55, thus it points to approximately 490 subjects instead of the 393 indicated in the example.

    Could you please correct these errors. Thank you. Patrick Laffey

    Conflict of Interest:...

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  • Pre-intervention data and paramedic intubation
    Tom Mallinson

    Thank you for this interesting study.

    I am curious whether you are able to provide comparable data from before the introduction of the Standard Operating Procedure (SOP) discussed here. Does the data gathered demonstrate an improvement in complication rates during pre-hospital anaesthesia compared with data from before the introduction of the SOP? In addition, did you analyse data regarding complications apart...

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