eLetters

837 e-Letters

  • Authors reply
    F Andrew I Riordan
    Dear Editor,

    I was interested to read Dr de Andrade Nishioka’s letter. He wonders which interventions we should focus on to decrease the mortality from meningococcal disease. In a review of deaths from meningococcal disease, the most frequent and lengthy delays were parents not recognising that their child was seriously ill and doctors failing to make the diagnosis [1]. We therefore need to improve both of these. Early...

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  • Response to Brooks, Sakr, and Dugdale
    A M Leaman
    Dear Editor,

    Thank you for giving me an opportunity to respond to the correspondence concerning my article on minor injury units [1].

    Dugdale and Sakr make so many points that it is difficult to keep my response brief. However, neither of them deny my main concern which is that thousands of minor injury patients are being treated by nurses who had no nationally recognised training and who themselves decide what condi...

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  • A limited definition of a minor injury
    Alison Dugdale
    Dear Editor

    Having worked in a nurse led minor injuries unit for the last six years I would like to respond to Mr Leaman's article in the Emergency Medicine Journal supplement of January 2001. Especially as his definition of a minor injury is very limiting and bears little resemblance to the type of patients seen in our local units.

    I work in East Kent which is 600 square miles and has a population of 580 000. We ha...

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  • Seniors for minors, juniors for majors: an unbalanced and dangerous equation
    M Sakr
    Dear Editor,

    I read the article titled "The management of minor injuries- a personal view" and while I agree with the author on the title, I believe that the contents are very biased and unrealistic. Of course the author is entitled to give his views but in the era of evidence-based medicine nobody can deny the evidence and antagonise all the research results because simply he "does not like it".

    Throughout the arti...

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  • The care of minor injuries
    S C Brooks

    Dear Editor,

    I write in support of the article by Alan Leaman in the EMJ Supplement January 2001

    I agree with him completely that the care of minor injuries is one of the skills of the A&E department and one in which Consultants should and do have a considerable expertise. The focus has for a long time been on improving the care of the major injuries which present to our department. Although obvio...

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  • Indicators of mortality from meningococcal disease
    Sérgio de Andrade Nishioka

    Dear Editor,

    Dr Riordam's study on promptness of antibiotic treatment for meningococcal disease revealed that "door to needle" time to administration of appropriate antibiotic for children decreased clearly from before to after a teaching intervention was given to nurses and doctors.[1] That this decrease occurred only for the children who had typical rash on arrival is not a surprise, given that the interventi...

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  • Re: Methodological problems in the study on deprivation and attendance at an A&E department
    T F Beattie
    Dear Editor

    Dr. Leung's first comment relates to our method of calculating the proportions of child attenders in each deprivation category. The numerator we use to calculate each proportion is based on the number of first-time attenders, while the denominator represents the total population in each category. Dr. Leung argues that the proportion of children who were 'at risk' of being first attenders will be lower in the de...

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  • Earlier examples of intraosseous drug and fluid administration
    Eskil Dalenius

    Dear Editor,

    In his article, Dr Foëx sketched the history of intraosseous drug and fluid administration, citing Tocantins and co-workers as the pioneers of this technique. In all fairness, however, it should be pointed out that this method was indeed described, and used clinically, even earlier than that. In fact, one of the pioneers in this field, Henry Turkel, traces the experimental studies of the bone marrow...

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  • A valuable lesson is reiterated
    Nick W Emms
    Dear Editor,

    Further to the case report presented by Carter and Wilby (Emerg Med J 2000 17:387) where a valuable lesson is demonstrated regarding overlooking lisfranc fractures in the presence of polytrauma, we would like to add to this a patient we encountered in order to emphasize the point.

    A 27-year-old male was admitted following a road traffic accident where the patient riding a motorcycle collided with a car...

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  • Re: Use 10mg of naloxone before abandoning resuscitation of cardio-respiratory arrest caused by opia
    Alison Walker
    Dear Editor,

    While it is reasonable to use large doses of Naloxone as described in the BNF (the maximum dose recommended is 10mg), the National poisons information service recommend that dose is titrated to response. Naloxone however, has also been attributed to improving GCS in gamma-hydroxybutyrate and alcohol overdoses.

    Large doses of opiate antagonists may be used in simple opiate overdose, however it was not cle...

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