Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jul 2005
Letter[The level of first aid and basic life support for the next generation of physicians].
According to Dutch medical-education guidelines junior doctors are expected to be able to carry out first aid and basic life support. We determined the level of first aid and basic life support of junior doctors at the Radboud University Nijmegen Medical Centre, The Netherlands. Of the 300 junior doctors 54 (18%) were submitted to a theoretical test, consisting of 52 multiple-choice questions on first aid and basic life support. ⋯ The first-aid scenario was performed correctly in 11% of the cases. According to the examiners the CPR situation was performed correctly by 30% of the junior doctors but when assessed by Berden's international criteria only 6% of the junior doctors had performed CPR correctly. The level of first aid and basic life support amongst junior doctors was low and so the majority of them did not meet the required level as stated in the guidelines for practice of medical education in The Netherlands on this subject.
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Ned Tijdschr Geneeskd · Jul 2005
Case Reports[Physostigmine for the immediate treatment of a patient with the central anticholinergic syndrome induced by cocaine cut with atropine].
A 34-year-old man was admitted in a coma after a nightlong abuse of cocaine and alcohol, whereupon he fell and convulsed at home. There was a fracture of the nose, hyperpyrexia, tachycardia and hypertension. Dry mouth and mydriasis were suggestive of anticholinergic poisoning. ⋯ Cocaine and atropine were found in the patient's urine. Several users of cocaine in various European countries have recently developed a central anticholinergic syndrome due to adulteration of cocaine with atropine. In the presence of indications for such an intoxication, physostigmine is the antidote of first choice.
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Ned Tijdschr Geneeskd · Jul 2005
Comment[The threatening influenza pandemic: a national store of oseltamivir is necessary].
The Netherlands are insufficiently prepared for an influenza pandemic. In the early phase, adequate measures will probably depend entirely on the use of oseltamivir, apart from epidemiologic efforts. The advice of the Dutch Health Council to establish a large store of oseltamivir therefore deserves strong support.
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Ned Tijdschr Geneeskd · Jun 2005
Case Reports[Active management of children after ingestion of a button battery].
Four children, three girls in the age range up to 14 months and a boy aged 10 years, were admitted because of button battery ingestion. In two patients, the course was uncomplicated, with spontaneous passage of the batteries. Two other patients, a girl aged 11 months and a girl aged 6 weeks, developed severe complications: stenosis of the oesophagus in one patient and a dramatic clinical course with a tracheo-oesophageal fistula and oesophageal damage in the other. ⋯ Electrochemical tissue damage and impaction may lead to serious complications within hours. If the battery is located in the oesophagus, endoscopic removal should be attempted as soon as possible. A conservative approach can be followed when the battery is located in the stomach or beyond, and complaints are absent.