Emergency medicine (Fremantle, W.A.)
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Emerg Med (Fremantle) · Jun 2002
Case ReportsLong distance road transport of a patient with Wegener's Granulomatosis and respiratory failure using extracorporeal membrane oxygenation.
Wegener's Granulomatosis is a necrotizing vasculitis that in its most severe form can cause respiratory failure, renal failure and subglottic stenosis requiring surgical airway access. We describe the use of portable extracorporeal membrane oxygenation and the long distance road transport of a patient with Wegener's Granulomatosis who developed respiratory failure that was refractory to conventional mechanical ventilation. We have demonstrated the effective use of portable extracorporeal membrane oxygenation for stabilization and safe acute interhospital transfer over a long distance by road ambulance to a tertiary centre for further management.
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Emerg Med (Fremantle) · Jun 2002
A review of the accuracy of references in the journal Emergency Medicine.
To assess the accuracy of references in articles published in Emergency Medicine, and to categorize these errors. ⋯ Poor reference accuracy is a common problem in medical literature, and Emergency Medicine is not immune to these failings. Authors need to take more care to ensure that the accuracy of citations improves.
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Emerg Med (Fremantle) · Jun 2002
Case ReportsAcute methyl salicylate toxicity complicating herbal skin treatment for psoriasis.
We present an interesting case of salicylism arising from the use of methyl salicylate as part of a herbal skin cream for the treatment of psoriasis. A 40-year-old man became quite suddenly and acutely unwell after receiving treatment from an unregistered naturopath. ⋯ The presence of tinnitus, vomiting, tachypnoea and typical acid/base disturbance allowed a diagnosis of salicylate toxicity to be made. Our patient had decontaminated his skin prior to presentation, limiting the extent of toxicity and was successfully treated with rehydration and establishment of good urine flow.
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Emerg Med (Fremantle) · Jun 2002
Determining the most effective level of TRISS-derived probability of survival for use as an audit filter.
To determine the most effective cut-off of TRISS-derived probability of survival (TRISS-PS) for the selection of trauma deaths for audit, using a large sample of trauma deaths from the United Kingdom (UK). ⋯ The previously accepted audit filter of TRISS-PS of greater than 0.5 fails to identify a significant proportion of avoidable deaths. This study suggests that the most effective level of audit filter cut-off of TRISS-PS for the trauma system studied is 0.33. This level would identify 90% of avoidable deaths with 80% specificity. Similar ROC curve analysis could be used to determine appropriate TRISS-PS cut-offs for institutions or other trauma systems.
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Emerg Med (Fremantle) · Jun 2002
Case ReportsA sting from an unknown jellyfish species associated with persistent symptoms and raised troponin I levels.
We describe a patient stung by an unknown jellyfish species offshore in Far North Queensland. The sting caused immediate and severe pain, multiple whip-like skin lesions and constitutional symptoms. ⋯ The patients symptoms largely resolved over seven months and were associated with elevated cardiac troponin levels, in the absence of other evidence of cardiac disease. This case highlights the envenomation risks associated with marine recreation, and the need for critical evaluation of cardiac troponin assays and for further research in marine toxicology.