Journal of accident & emergency medicine
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To devise a proforma for clinical documentation of psychiatric illness in an accident and emergency (A&E) department, since A&E senior house officers (SHOs) have little psychiatric experience before starting their jobs. ⋯ A standard form for documenting psychiatric history, designed according to local needs, is useful and should be available in A&E departments.
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Case Reports
Oesophageal rupture in the course of conservative treatment of bleeding oesophageal varices.
Fatal oesophageal rupture is described as a complication of the management of bleeding oesophageal varices with repeated sclerotherapy and tamponade using the Sengstaken-Blakemore tube. The importance of chest radiographs is stressed in the early detection and prevention of malposition of the Sengstaken-Blakemore tube, as inflation of the gastric balloon in the oesophagus can result in oesophageal rupture.
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Tension pneumoperitoneum developing in a middle aged asthmatic male during resuscitation after a respiratory arrest is reported. This was associated with bilateral tension pneumothorax and caused severe respiratory embarrassment which was relieved by needle decompression, after decompression of the pneumothoraces. The chest is not the only body cavity that can contain air under tension.