European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The objective of this study was to assess, by questionnaire survey, national practice in respect of radiological assessment of the cervical spine in the conscious adult patient with suspected neck injury. The physicians in charge of accident and emergency departments with more than 25000 new patients per year were sent a questionnaire. One hundred and ninety-one replies were received from 243 physicians (79%). ⋯ It is concluded that the majority of departments use three standard views in the first instance. Swimmer's views are the most common additional X-rays taken if the C7-T1 junction is not visualized, even though supine oblique views give better information about spinal alignment. Imaging of the cervical spine following trauma is difficult and guidelines should be drawn up to address these problems.
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Septic complications arising from drug misuse are well documented. It is likely that most complications occur as a result of attempted intravenous (i.v.) injection. We report four cases of soft tissue infections where the patients were unable to obtain i.v. access and gave injections of drugs using a technique known as 'popping'. 'Popping' is the deliberate injection of drugs subcutaneously or intramuscularly when i.v. access is not possible. This practice is further discussed and the literature associated with soft tissue infections from drug misuse is reviewed.
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Prehospital on-scene time (OST) has only been recorded sporadically and has not been related to different types of therapy. In order to create a reference standard for a European emergency medical system involving field stabilization (FS) by physicians, a retrospective analysis was performed of 639 consecutive missions over 81 months in relation to the extent of therapy evaluated by the Emergency Therapy Index (ETI). ⋯ A variety of prehospital therapy is demonstrated. The study supports the view that only exceptional conditions can justify an OST exceeding 20 minutes in ETI-3-4, 24 minutes in ETI-5-6 and 33 minutes in ETI-7.