European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Orbital cellulitis in children may result in severe visual morbidity and even mortality if not managed appropriately. The definitive management of orbital cellulitis is in the realms of the otolaryngologist, as the underlying pathology is associated with sinus disease in more than 90% of cases. Our observations suggest that there is a tendency for patients with suspected orbital cellulitis not to be referred promptly for otolaryngological opinion and management, which may result in adverse outcomes. The aim of this study was to determine the initial management by establishing general practitioners' attitudes to the referral and management of suspected orbital cellulitis. ⋯ Better education for primary care physicians is needed regarding the initial management and referral of paediatric patients with suspected orbital cellulitis. They should be referred promptly for hospital admission. A good multidisciplinary approach with quick involvement of the three specialities (ear, nose and throat, ophthalmology and paediatrics) would avoid delays in the definitive management and ensure optimal outcomes.
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Radial head fractures are a common orthopaedic injury presenting to Emergency Departments. Most are diagnosed radiographically, either with a visible fracture or by the presence of abnormal fat pads. We present two cases of delayed radiological diagnosis of radial head fractures despite a high index of clinical suspicion of a fracture at initial consultation.