Emergency medicine journal : EMJ
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Case Reports
Haemothorax after pig-tail catheter removal in a patient with primary spontaneous pneumothorax.
A case of haemothorax is described which occurred after the removal of a small pig-tail chest tube (8.5 F) that was inserted in the second intercostal space in the mid-clavicular line, for primary spontaneous pneumothorax management. The patient was successfully resuscitated and 0.85 l of blood was aspirated. ⋯ Whether a pig-tail catheter in itself carries an additional risk of complications compared with other catheter types is questionable. However, this report highlights the potential danger that accompanies pig-tail drain insertion into the second intercostal space in the mid-clavicular line, and suggests that insertion in other sites is technically easy and potentially safer for pneumothorax drainage.
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This paper aims to assess whether emergency department physiotherapy practitioner's (EDPPs), emergency nurse practitioner's (ENPs) and emergency department doctors investigate, treat and refer patients with closed musculoskeletal injuries differently. ⋯ ENPs, EDPPs and doctors of all grades investigated patients with fractures and dislocations similarly and managed them following the written departmental guidelines. However, there were statistically significant differences in the way patients with closed soft tissue injuries were treated and followed-up.
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To determine whether the knowledge specified in the specialty-specific section of the College of Emergency Medicine curriculum covered the diagnoses presenting to a UK teaching hospital emergency department. ⋯ The curriculum covered all the diagnoses in this sample. Knowing the frequency of a diagnosis could be used to inform training and assessment.
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A short cut review was carried out to establish whether suturing provided any advantage over conservative management for small, uncomplicated hand wounds. Only one paper presented a trial addressing the clinical question. ⋯ The clinical bottom line is that there doesn't appear to be any great advantage to suturing. The importance of clinical evaluation, to ensure that the wound really is uncomplicated, is stressed.