European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Various metal objects added to explosives increase and diversify the wounding from bombing; especially favoured are spherical missiles for their special injuring characteristics. Our objective was to study the medical consequences and ballistic effects on human tissue of spherical metal pellets used in terrorist bombings. ⋯ Metal pellets propelled by the explosion enhanced the secondary pattern of injury and injured even patients remote from the origin. Tissue destruction and specific organ injuries among survivors were limited. To evaluate and manage victims of terrorist bombings properly, medical teams should become familiar with these severe injuries.
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A 42-year-old man was brought into the Accident and Emergency Department with epigastric discomfort and severe bradycardia. Computerized tomography of the chest revealed spontaneous rupture of the left hemidiaphragm with herniation of small bowel loops.
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The objectives of the study were to study the pattern of needlestick injuries presenting to an inner city emergency department, and to highlight areas where greater training is required. The emergency department is involved in the management of injuries both in the hospital setting and in the community. The setting was an inner city area with a high incidence of intravenous drug abuse, HIV, hepatitis B and C. ⋯ There is a delay and lack of urgency in the presentation of needlestick injuries for assessment and treatment. Education of emergency staff, other healthcare workers and the general public is needed to reduce the needle-to-door and needle-to-PEP time for the effective management of needlestick injuries and prevention of hepatitis and HIV seroconversion.
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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.