Emergency medicine journal : EMJ
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The diagnosis of pulmonary embolism demands flexible decision models, both for the presence of clinical confounders and for the variability of local diagnostic resources. As Bayesian networks fully meet this requirement, Bayes Pulmonary embolism Assisted Diagnosis (BayPAD), a probabilistic expert systems focused on pulmonary embolism, was developed. ⋯ BayPAD offers clinicians a flexible and accurate strategy to diagnose pulmonary embolism. Simple to use, the system performs case-based reasoning to optimise the use of resources available within a particular hospital. Bayesian networks are expected to have a prominent role in the clinical management of complex diagnostic problems in the near future.
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Multicenter Study
Bupivacaine in the emergency department is underused: scope for improved patient care.
To determine patterns of local anaesthetic use, knowledge and perceived use of local anaesthetic by emergency department doctors, and barriers to bupivacaine use. ⋯ Bupivacaine seems to be underused in some appropriate circumstances. Accordingly, there is scope for improvement in patient care through critical evaluation of local anaesthetic practice. This is particularly necessary because barriers to bupivacaine use are often non-clinical (habit, availability, familiarity) rather than clinical (toxicity, onset time).
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Low-flow priapism is a rare condition whereby there is a persistent, painful erection. The patient often presents late because of embarrassment. ⋯ A case of low-flow priapism, that demonstrated a lack of urgency and understanding is discussed. An internet-based literature search provided a treatment regimen with resolution of tumescence.
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Review Case Reports
Life-threatening episode after ingestion of toad eggs: a case report with literature review.
It is known that toad possesses several toxic substances in the skin and parotid glands. In the past, toad-venom poisoning had been reported from ingestion of toad soup, Kyushin and aphrodisiac pills, but the poisoning from toad eggs is observed for the first time. The case of a healthy female who had previously eaten toad soup twice without any discomfort is reported. She developed gastrointestinal symptoms and life-threatening cardiac rhythm after ingestion of toad eggs.
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Randomized Controlled Trial
The intubating laryngeal mask: is there a role for paramedics?
To compare the ability of UK paramedics to intubate a simulated difficult airway using a Mackintosh laryngoscope versus an intubating laryngeal mask airway (ILMA). ⋯ This study has demonstrated the ability of paramedics to use the ILMA when faced with a difficult intubation. However, further evaluation of this potential role for the ILMA is required.