Emergency medicine journal : EMJ
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There are consensus guidelines on the appropriate use of gut decontamination in the management of poisoned patients. This study demonstrates that few doctors have read these guidelines and that they have poor knowledge of the use of gut decontamination, which can be improved with specific clinical toxicology teaching. Future guidelines should be published in journals more widely read by those doctors treating poisoned patients.
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Bariatric surgery is a rapidly expanding surgical sub-speciality, with a large proportion of the relevant surgical procedures being performed in the private sector. Acute complications of newer surgical procedures can lead to emergency department presentation, with which the staff may be unfamiliar. A 34-year-old woman was seen in the emergency department with acute total dysphagia following laparoscopic adjustable gastric banding, which was treated successfully by a simple bedside procedure.
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Most patients with penetrating cardiac wounds die within minutes of injury from uncontrolled haemorrhage and acute cardiac dysfunction. Thus, sustaining sufficient circulation rapidly is crucial to saving lives. Emergent cardiopulmonary bypass (CPB) is a potential intervention to maintain circulation after penetrating cardiac wounds from a gunshot. ⋯ Emergent CPB in the field can maintain haemodynamic stability and supply vital organs with sufficient blood flow, but surgery following CPB is essential to rescue patients with penetrating cardiac wounds.