Emergency medicine journal : EMJ
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In the UK, about 2% of the population attend the accident and emergency (A&E) department every year after a head injury. A majority of the patients have minor head injury and are discharged. Studies reveal that patients who reattend the A&E after a minor head injury represent a high-risk group. ⋯ A case of minor head injury as a result of head butt during a game of rugby, not associated with alteration in conscious state or focal neurological signs, and subsequent development of frontal lobe abscess a month later is reported. It is important that patients fit to be discharged at the time of consultation are discharged in the care of a responsible adult with clear head injury instruction sheets and are advised to return should their symptoms change. A high index of suspicion should be maintained and an early imaging technique, such as CT scan should be considered in patients reattending the A&E with persistent symptoms even after minor head injury.
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This case report describes the emergency use of a novel, single-use, anatomically shaped laryngoscope that has recently become commercially available in the UK (Airtraq, Prodol Meditec, Spain). It was used to successfully intubate a severely injured 41-year-old patient who had sustained traumatic asphyxia after attempting suicide by hanging. He was bleeding into his upper airway, necessitating regular suctioning. ⋯ The endotracheal tube was clearly seen to pass through the vocal cords and enter the trachea. The Airtraq required minimal manipulation to obtain a close-up, panoramic, high-grade view of the larynx. Further evaluation of this device is warranted to define its role in the emergency department and in prehospital care.
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To observe pain management practices by nurses in emergency departments (EDs) in Central Africa and to study the various factors influencing these practices. ⋯ Pain management by nurses in the ED in Central Africa is inadequate. Cultural factors greatly influence how nurses manage pain in the emergency room. Patients would benefit considerably if nurses received additional education about the diagnosis and management of acute pain in EDs in Central Africa.
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This study, conducted over two time periods, aimed to evaluate the effectiveness of the diffusion of data, implementation of correctives measures and updated protocols in reducing time to reperfusion in acute myocardial infarction (AMI) management in the out-of-hospital setting. Mean (SD) time to hospital admission and to arterial puncture improved (58 (13) vs 67 (18) min, p = 0.03; and 82 (16) vs 95 (29) min, p = 0.02). The study, performed according to quality control programme methodology, showed that the chronology of AMI management could be improved by appropriate interventions and monitoring of intervention times.
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Acute spontaneous compartment syndrome is a rare orthopaedic emergency that usually presents to general physicians as an acute medical admission. Most cases reported to date, in patients with diabetes, are in those with long-standing disease or with evidence of diabetic complications. An acute spontaneous compartment syndrome in a girl with recent diagnosis of type 1 diabetes is reported here. Awareness of the condition allows early recognition and diagnosis, thereby preventing more severe muscle necrosis and disability.