eLetters

839 e-Letters

  • We'd still prefer to pull.
    Stewart C Teece

    Dear Editor

    Having already recieved correspondence via the BestBETs website regarding various writer's preferred method of tick removal it would seem that applying an evidence base to the subject was not as laughable as our work colleagues first thought.

    With reference to the De Boer paper,[1] although the authors felt that rotation was justified by their results, these figures can equally be applied to...

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  • Freezing ticks
    Kevin Maguire

    Dear Editor

    We read with interest your article on tick removal and agree with Mr McGlone in his assessment of the evidence as presented and feel that rotation is indeed the best method for tick removal. We also feel that a useful practical point to raise is that the use of Ethyl Chloride to freeze the body of the tick and crystallise its stomach contents will reduce the risk of regurgitation during removal.

    ...
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  • JRCALC Regocgnition of Adult Death Task Force
    Andrew K Marsden

    Dear Editor

    The paper by Lockey on 'Recognition of death and termination of cardiac resuscitation attempts by UK ambulance personnel' [1] demonstrates inconsistencies across UK ambulance services in following previously published recommendations for the recognition of adult death by ambulance crews. His findings are timely given our recent remit from the Joint Royal Colleges Ambulance Liaison Committee to review the...

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  • What’s in a name? Casualty to Emergency Medicine
    Niall O' Connor

    Dear Editor

    The Specialty of Emergency Medicine has evolved over the last 25 years. During this time it has had to work hard to establish its credentials as being integral to the provision of emergency services. In tandem with this, the name of the discipline has changed from Casualty to Accident and Emergency Medicine to Emergency Medicine. This has also been reflected in the name of the specialty journal.

    ...
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  • Re: Cardioversion by venepuncture in sustained stable supraventricular tachycardia
    Ian K Dukes

    Dear Editor

    I very much enjoyed reading Dr Carroll's two papers in this month's EMJ; however I was disappointed to see the reference to "casualty department" which should be strongly discouraged. My colleagues at Stoke have used the term "emergency department" for many years. I was glad to see the correct terminology used in Dr Carroll's second paper.

  • Rotate don't pull
    Ray McGlone

    Dear Editor

    Living in a tick endemic area I have already researched this topic, so I was surprised on reading the "clinical bottom line".

    De Boer [1] and his co-authors state, "When the tick is removed by pulling without rotation, large portions of tick tissue (possibly containing pathogens) often are left behind in the skin. Pulling also applies more pressure on the tick. We therefore recommend rotation ra...

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  • Thoughts on tick removal
    Andrew M King

    Dear Editor

    I have some experience in the removal of ticks. Not on humans but on dogs, during the spring in particular almost weekly.

    I use a couple of drops of 'Frontline' (a household flee spray) to kill the tick, and then remove it with a small curved hook device with a 'V' shaped notch (available at vets). I have 100 % success in removing ticks with their mouth parts intact with this method.

    Th...

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  • Re: transthoracic echocardiography
    Paul Knowles

    Dear Editor

    I read with interest the case report by MacCarthy et al.[1] describing the use of transthoracic echocardiography during cardiac arrest due to massive pulmonary embolism (PE). Such cases raise the question of whether thrombolysis could be used routinely during all non-traumatic cardiac arrests, not just those known to be caused by PE. Up to 70 % of cardiac arrests have thrombosis (PE or myocardial inf...

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  • Re: Caution: printing error and reply to previous eLetters
    Andrew B Rowlands

    Dear Editors,

    I wonder if we may make further comment in light of the reply of Jones et al. to our initial concerns over perceived weaknesses of their flowchart on the management of paracetamol poisoning.

    Our ongoing major concern is that, in their reply, Jones et al. appear to be holding to the position that INR is the best prognostic indicator in paracetamol poisoning. Studying the r...

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  • Why have anaesthetic machines in A&E at all
    Joerg Kuehne

    Dear Editor

    I read the position statement about anaesthetic machines in the accident and emergency resuscitation room by M J Clancy [1] with some disappointment. A perfect opportunity for the FAEM and BAEM to dispose of many ancient and probably only a few newer Anaesthetic Machines has been missed.

    This position statement does not contain anything that should not be done anyway. All modern Anaesthe...

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