Postgraduate medical journal
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In less than ideal situations wounds have to be closed without extensive cleaning using sterile adhesive strips (Steristrips). This prospective analyses the efficiency of this technique and compares it to the more conventional approach. ⋯ This technique, while contradicting the "sacred tenets" of wound closure, is a cheap, quick, and effective alternative to routine closure of traumatic wounds in a casualty department.
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Pulmonary arteriovenous malformations (PAVM) are rare pulmonary vascular anomalies. Although most patients are asymptomatic, PAVMs can cause dyspnoea from right-to-left shunt. Because of paradoxical emboli, various central nervous system complications have been described including stroke and brain abscess. ⋯ Contrast echocardiography is useful for diagnosis and monitoring after treatment. Most patients should be treated. Therapeutic options include angiographic embolisation with metal coil or balloon occlusion and surgical excision.
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To determine the normal range for carbon monoxide concentrations in the exhaled breath of subjects in the emergency department and to develop a protocol for the use of a breath analyser to detect abnormal carbon monoxide exposure. ⋯ Breath analysis was rapid and results correlated well with carbon monoxide exposure. In this population subjects with breath carbon monoxide concentrations greater than 6 ppm should be assessed for the risk of carbon monoxide poisoning. However even carbon monoxide concentrations less than 6 ppm do not exclude carbon monoxide poisoning within the last 24 hours.