European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Posthypoxic myoclonus (Lance-Adams' syndrome) is a rare complication of cardiorespiratory arrest. It has a better prognosis than other movement disorders secondary to brain ischaemia. ⋯ The origin of the myoclonus was probably subcortical, and it improved with clonazepam 2 mg t.i.d. We emphasize that early diagnosis is necessary in intensive care units in order to avoid misinterpretation of this syndrome and to start appropriate treatment.
-
A small number of trauma patients with penetrating thoracic trauma will require formal pulmonary resections to repair severe injuries or control massive haemorrhage. Although previous reports on this subject have addressed the management of these injuries in battle conditions, civilian experience with this type of chest injury is limited. In a 3-year period, 259 patients underwent urgent thoracotomies for penetrating thoracic trauma. ⋯ Currently, the management of patients with devastating thoracic injuries to the thoracic cavity is divided into two stages. First, initial resuscitation with rapid surgery to control major bleeding, cardiac tamponade, tracheal disruptions and potentially lethal air embolism is indicated. Once the life-threatening conditions have been resolved, definitive surgical procedures are performed to repair injuries to any of the thoracic structures.
-
The proportion of abnormal chest radiographs in patients admitted following a femoral neck fracture was assessed. Significant abnormalities were found in 14%. In all these cases chest radiography was indicated. No abnormality was unexpected clinically.
-
In order to get an update on prehospital emergency medicine practice all over Europe we submitted questionnaires with a total of 61 questions concerning prehospital emergency medicine in Europe, to 123 European members of the World Association of Emergency and Disaster Medicine (WAEDM). Sixty (49%) questionnaires were returned. One up to seven questionnaires from 22 European countries were analysed: 37 (62%) from urban and 23 (38%) suburban or rural areas; 12 being from former Eastern European countries. ⋯ Physicians are frequently involved in prehospital emergency care in the Eastern European Countries, France, Germany, Italy, Belgium and Turkey, rarely in Switzerland, Denmark, the United Kingdom, Greece, Ireland and Finland, never in the Netherlands and Sweden. In more than 50%, a combination of national, regional and local organizations provide emergency care, which results in large differences of standards. We discovered remarkable differences which could be overcome by enhanced co-ordination and information exchange provided by the European Society for Emergency Medicine, WAEDM, the European Red Cross or the European Academy of Anaesthesiologists.