Emergency medicine journal : EMJ
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A short-cut review was carried out to establish whether doctors know how to use autoinjectors (for anaphylaxis). Three hundred and twenty-four papers were found of which five presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are shown in table 3. The clinical bottom line is that the majority of doctors studied are unable to use autoinjectors correctly and may therefore be unable to teach patients or parents effectively.
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Therapeutic hypothermia has become the standard treatment for unconscious patients in cardiac arrest. Although various body parts, including the oesophagus, rectum, bladder and tympanum, can be used for measurement of the core temperature, the oesophageal temperature is preferred because of its accuracy and stability. We first investigated the success rate and procedure time of oesophageal temperature probe (ETP) insertion according to the insertion method. ⋯ The new ETP insertion method had a better first attempt success rate than the conventional method and the alternative method.
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Failure to identify eye injuries associated with facial fractures can lead to life-altering morbidity. Oral and maxillofacial surgery teams receiving referrals of patients with these injuries have a vital role in ensuring that visual acuity (VA) is recorded at the time of presentation. We present a clinical audit of documentation of VA in 126 patients who sustained orbital floor and zygoma fractures. ⋯ VA was appropriately documented in 16.5% before the session and 57.1% afterwards. This study shows that education of junior trainees gives rise to an increase in the proportion of patients where VA is properly documented. We suggest this teaching should occur routinely at junior doctor departmental inductions.
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The increasing Indo-Pacific migration has affected the biodiversity of the Mediterranean Sea, and the prevalence of the puffer fish (Lagocephalus sceleratus), a well-known poisonous migrant, is increasing. The fish, which contains tetrodotoxin, is lethally poisonous when consumed. As its population increases it becomes more available in the markets of southern Turkey, but local people seem to be unaware of the danger. Probably because of the depressed stocks of the surrounding waters and demand on affordable seafood, local anglers are catching the fish. The situation constitutes an alert for the local emergency medicine organisation and is a public health issue. ⋯ General health organisations are unprepared for the serious health hazards caused by this fish, including fatalities. Health workers should have sufficient knowledge regarding the clinical manifestations, complications and management of puffer fish poisoning. Official authorities should make the public aware of the potential risk of consuming puffer fish.
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This study aimed to determine the factors associated with successful endotracheal intubation (ETI) on the first-attempt in an emergency department. ⋯ The predicted airway difficulty was the major factor associated with FAS in emergency department ETI on adults regardless of intubator's specialty. Especially in EM physician group, level of training and using of RSI also affecting on first-attempt success. The overall ETI success rate on first attempt was 80.1%, but EM physicians had success rate of 87.3%. Systematic technical and non-technical airway skill training focused on RSI and continuous quality control and ETI recording could help non-EM physicians increase their FAS rate.