European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Case Reports
First case report of recreational use of 2,5-dimethoxy-4-chloroamphetamine confirmed by toxicological screening.
Routine toxicological screening is generally not undertaken in patients with recreational drug toxicity. We report here the benefits of toxicological screening in confirming drugs that have been ingested and potentially detecting drugs that have not previously been reported in the medical literature. ⋯ As 2,5-dimethoxy-4-chloroamphetamine is a substituted amphetamine, it is covered under the generic Misuse of Drugs act (1971) in the UK; although in the majority of the EU it remains uncontrolled, as there is no similar generic drug legislation. We believe that discrepancies in the legal status of recreational drugs in the EU limit the effectiveness of drug enforcement policies and that EU drug legislation should be harmonized to ensure consistency.
-
The objective of this study is to report a case of ischemic subglottic damage after a short-time intubation with a large, overinflated endotracheal tube cuff in a child. The study uses individual case report. ⋯ The child presented postextubation stridor with subglottic edema. Inappropriate handling of tracheal intubation without accurate measurement of endotracheal tube size and intracuff pressures of endotracheal tubes, can cause airway trauma and place patients at risk.
-
The UK paediatric early warning score (PEWS) was developed for inpatients, looking at admission to the HDU and PICU and trying to produce a system which would recognize those children at risk of admission. Since the introduction of the '4-h wait', accident and emergency (A&E) departments have been under increasing strain to assess, treat and admit patients (if required) as quickly as possible. We designed this study with the view of identifying if the PEWS score could be used as a triage tool, to detect those patients who will need admission and therefore speed up the process of admitting children to the ward. ⋯ A PEWS score of >or=2 had a sensitivity of 37% and a specificity of 88%. PEWS is of limited value in predicting admission (in a triage setting) in a population of undifferentiated disease. However, a low PEWS score has a high specificity, that is, a patient scoring <2 is unlikely to need admission.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Oral, axillary, and tympanic temperature measurements in older and younger adults with or without fever.
The purpose of this study was to compare the results of body temperature obtained by a nurse with standard mercury thermometers from axillary and oral regions with the results of infrared tympanic thermometer in febrile and afebrile patients/in older and younger adults with or without fever, and to determine whether tympanic measures are suitable for use in the elderly population. ⋯ Tympanic thermometers seem to be optimal for use with the elderly population. Owing to the ease of application, safety, and tolerability in the elderly; their use in routine practice seems to be advantageous. Higher reading of tympanic measurements may lead to a suspicion of infection, especially in the elderly, which may be helpful in clinical treatment in this age group.
-
Case Reports
Management of acute gastrothorax with respiratory distress: insertion of nasogastric tube as a life saving procedure.
An 86-year-old patient was transferred to our institution with acute respiratory distress. A tension pneumothorax was suspected, but needle decompression was unsuccessful. Instead of the suspected pneumothorax, the chest radiograph revealed a large 'tension gastrothorax'. ⋯ Nasograstric tube insertion is a life saving procedure to be undertaken without delay. However, tension gastrothorax is a rare entity. Therefore, if tension pneumothorax is suspected, needle decompression should not be delayed.