eLetters

831 e-Letters

  • The Spaso technique: is it an improvement ?
    Kelvin D Wright

    Dear Editor,

    I read with interest the article by Yuen et al[1]. Anterior shoulder dislocation accounts for a significant proportion of joint injury in emergency medicine and any technique that improves our care for these patients is to be welcomed. The authors state that the technique is easily learned by senior house officers and this certainly is important. Often the patient is seen by a junior doctor when se...

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  • John Ryan

    Dear Editor

    It seems that the authors of this paper were surprised to find such an elevated phenytoin level. A few questions sprung to mind:

    1) Did they repeat the level ?
    2) Are they sure this level was before the phosphenytoin was commenced?
    3) Was the patient symptomatic of phenytoin toxicity prior to being found seizing? One would have suspected ataxia and nystagmus e...

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  • Re: Analgesic drugs are common intoxicating agents
    GREINGOR JL

    Dear Editor

    We thank Dr Kennedy for highlightning an unfortunate omission in our review and we agree with his comments that carbon monoxide intoxications are the most fatal reported poisoning in Western develloped countries. Analgesics, which include acetaminophen, aspirin, and other nonsteroidal antiinflammatory drugs are probably the leading cause of poisoning in several countries. Paracetamol poisoning is very c...

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  • HIV prophylaxis after assault
    S G Ralph

    Dear Editor

    The effects of sexual assault can be devastating; we commend Fong for raising the profile of this topic within Accident and Emergency Medicine.[1] There are, however, a number of areas where we feel the guidance in that paper could be improved. The data about HIV prevalence and risk groups were out of date. We cite more recent data and guidance that may alter readers' approach to this situation.

    ...

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  • Names for 'A & E'
    Richard Hardern

    Dear Editor

    There has been considerable discussion recently about the best name for the specialty currently called Accident and Emergency Medicine. Could I suggest the specialty be renamed "Emergency and Trauma Care"? If this name were adopted, both the name and the abbreviation would reflect the nature of work undertaken by the specialty.

    Richard Hardern

  • Analgesic drugs are common intoxicating agents
    Julian Kennedy
    Dear Editor

    In the article by Greingor et al on carbon monoxide poisoning in pregnancy, one word is notably absent from the Discussion. I quote, with the word inserted,'CO intoxication is the most frequently reported (FATAL) poisoning in Western developed countries'. Most of us are aware that analgesic drugs are still the commonest intoxicating agent - are we not?

    Julian Kennedy

  • Emergency Medicine:a name change is one issue-acceptance is another
    Alan O'Connor
    Dear Editor

    While I agree that the specialty in the UK should move to using the title "Emergency Medicine" I would council that it may be difficult to gain acceptance of the name amongst the wider community - both medical and non- medical.

    Here in Australia, the specialty has been officially named "Emergency Medicine" since the Australasian College for Emergency Medicine was incorporated in 1984. However, this mes...

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  • Re: The diagnosis of tuberculosis is difficult to verify
    MC Yuen
    Dear Editor,

    We thank Dr. T. Ho for his comment on our article reporting a young patient with tuberculous osteomyelitis [1]. We wrote the article from the perspective of emergency medicine. Although polymerase chain reaction (PCR) is a good adjunct to microbiological culture for diagnosing mycobacterium tuberculosis, it is not available to the majority of emergency physicians in Hong Kong. Nonetheless, we should discuss it b...

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  • The diagnosis of tuberculosis is difficult to verify
    T Ho
    Dear Editor,

    Yuen and Tung describe a case of tuberculous osteomyelitis of the foot [1] and the potential difficulties in making the diagnosis. The authors were fortunate enough to have typical histological biopsy findings which subsequently cultured Mycobacterium tuberculosis (TB), providing diagnostic confirmation and estimations of sensitivities. However, in many instances, the diagnosis of tuberculosis is difficult to ve...

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  • Re: What should be clearcut has somehow been usurped
    C Reid
    Dear Editor

    We are delighted that our paper [1] has stimulated a response from overseas colleagues, who have shared with us some Australasian opinions.

    Whilst we agree that adopting the term 'emergency medicine' would bring us into line with international standard terminology, the fact remains that 'accident and emergency' appeals to many, and debate will continue as long as practice between and within United Kingdom...

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