Emergency medicine journal : EMJ
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There is a growing interest in the interface between emergency medicine and critical care medicine. Previous articles in this journal have looked at the opportunities and advantages of training in critical care medicine for emergency medicine trainees. ⋯ This article describes a personal experience of such a job, looking at the advantages and disadvantages. Depending upon future developments in the role of emergency medicine in the UK, together with the proposed expansion in critical care medicine, such posts may become more common.
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To determine outcomes and markers of serious illness for febrile patients presenting to an adult emergency department. ⋯ Few febrile adults presenting to the emergency department suffer an adverse outcome suggesting effective risk stratification is occurring. The identification of factors associated with adverse events may further improve this process.
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Delayed herniation of the abdominal contents through a congenital diaphragmatic hernia may occur beyond the neonatal period. The case is reported of a 9 month old child presenting with acute respiratory distress secondary to tension gastrothorax. ⋯ The late presenting congenital diaphragmatic hernia poses considerable diagnostic challenges often leading to misdiagnosis and risk of thoracocentesis. The possibility of late presenting congenital diaphragmatic hernia should be considered in unusual cases of pneumothorax, especially in the absence of trauma so that unnecessary procedures like chest tube drainage can be avoided.
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Case Reports
Lignocaine toxicity; a complication of local anaesthesia administered in the community.
Local anaesthetic agents are among the most commonly used drugs in the emergency department. A case is reported of a complication arising from systemic toxicity after the injection of lignocaine (lidocaine). Emergency practitioners should maintain a high level of vigilance for the symptoms of toxicity after local anaesthetic administration. Particular care should be taken when calculating the maximum safe dose for young children.