Journal of the Royal Army Medical Corps
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Hypertonic saline solutions have properties that may be advantageous for resuscitation. In both animal and human studies rapid improvements in cardiovascular status occur when hypertonic saline is administered to hypovolaemic subjects and the possible side effects of hypertonic solutions have not been shown to be of clinical importance. Hypertonic saline certainly has a potential role in resuscitation of hypovolaemic casulaties in the modern military setting.
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Many studies have drawn attention to deficiencies in the management of major trauma, both in the UK and elsewhere. One area that has received little attention is the documentation of such cases in the Emergency Room. When outcome may be sub-optimal, documentation assumes greater importance if advances are to be made in the organisation of trauma care. ⋯ It unifies the recording of vital signs, whilst acting as an assessment and resuscitation template. By ensuring no life-threatening illness is missed it is likely to improve patient survival. The document can act as a basis for teaching and a medico-legal record, whilst providing the necessary data for quality assurance and outcome audit.
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Case Reports
Complications of prophylactic intercostal tube drainage--including tension pneumothorax.
A case is presented of tension pneumothorax associated with intercostal tube drainage. Complications of intercostal tube drainage are reviewed.
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Plasmodium falciparum malaria poses an increasing risk to travellers to West Africa. The development of chloroquine resistant in West Africa has further compounded the risk. ⋯ These cases highlight the danger of the missed or late diagnosis; the need for chemoprophylaxis, even in emigrants; the threat posed to the international traveller by malaria; and the problem of chloroquine resistant Plasmodium falciparum (CRPF) malaria from West Africa. The position of Plasmodium falciparum malaria in West Africa is reviewed along with the problem caused by chloroquine resistance.