European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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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.
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Comparative Study
Advanced trauma life support (ATLS) courses: should training be refocused towards rural physicians?
Recently there has been an increase in the number of courses designed to improve the theoretical knowledge and practical skills of health workers for immediate emergency management under life-threatening conditions. However, the numbers of applicants for these courses far exceed the available places. Priorities should be reviewed to solve the current shortfall. ⋯ Furthermore, the net gain was significantly higher (p < 0.05). Efforts should be made to increase the participation of paediatricians practising in rural level II trauma centres in trauma care courses. Further research should address the applicability of these results for recruiting primary care physicians to the ATLS courses.