Emergency medicine journal : EMJ
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Wound complications of closed sternal fracture are rare, but may have serious consequences if not effectively managed. We report a case of a patient who presented to the emergency department with a sternal abscess, osteomyelitis, and mediastinitis complicating a closed sternal fracture. It is hypothesised that in our patient bacteraemia post intravenous drug use resulted in seeding of the haematoma with Staphylococcus aureus. Early diagnosis and a multidisciplinary team effort were important in ensuring a favourable outcome.
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To identify the content of the postgraduate anatomy curriculum for trainees in emergency medicine (EM) in the UK. ⋯ Application of a national consensus methodology allows for determination of curricular content in anatomy. The principles can be applied to all aspects of training and curricular policy at national collegiate level to guide the development of robust documentation.
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Review Case Reports
Critical care in the emergency department: severe sepsis and septic shock.
Severe sepsis is a common and commonly fatal disease and is essentially an exaggerated inflammatory response. The epidemiology of severe sepsis and septic shock has been difficult to determine because of an inconsistent approach to definitions and diagnosis. ⋯ The Surviving Sepsis Campaign recommends a package of evidence based interventions known as the sepsis resuscitation bundles and the sepsis treatment bundles. The aim is to ensure that eligible patients receive all appropriate treatments in a timely fashion, utilising protocol driven prescriptions.
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End tidal carbon dioxide (ETCO2) monitoring is the non-invasive measurement of exhaled CO2. The Intensive Care Society guidelines include (ETCO2) monitoring as one of the objective standards required for monitoring patients in transport, and the American Heart Association recommends that all intubations must be confirmed by some form of ETCO2 measurement. ⋯ It is non-invasive and easy to apply to breathing circuits. The units now available are compact and rugged, with extended battery operating times, which are ideally suited for prehospital use and should be considered as an essential item for advanced airway management.