eLetters

833 e-Letters

  • Critical care in the Emergency Department
    John M Butler

    Dear Editor,

    I was encouraged by reading the excellent articles by Gwinnutt [1], Nightingale [2] and Shelley [3] in the Critical Care edition of the EMJ. Emergency Departments routinely receive critically ill/injured patients, a proportion of which will ultimately require admission to an intensive care unit. Effective interfacing between A&E departments and critical care units is essential to achieve the optimal...

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  • Homelessness adds another dimension
    Pamela Logan

    Dear Editor

    I read with interest the paper on repeated use of the emergency department by some patients. Like the authors I carried out a qualitative study looking at use of the emergency department, focusing however on the use made by homeless families for minor illnesses within the UK. To explore the reasons underlying the reason to attend, I interviewed 10 families living in temporary accommodation (mainly...

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  • 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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