Emergency medicine journal : EMJ
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Comparative Study
Airway Scope versus Macintosh laryngoscope: a manikin study.
To compare the performance of the Airway Scope for tracheal intubation with that of the Macintosh laryngoscope for direct laryngoscopy. ⋯ The Airway Scope performed as well as and perhaps better than the Macintosh laryngoscope when used on a manikin.
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Epidural sacral nerve compression as an initial feature of leukaemia is a rare complication. The findings in a 16-year-old boy who presented to an emergency department with symptoms of faecal incontinence are reported herein. ⋯ The diagnosis of acute myeloid leukaemia was confirmed on bone marrow aspirate. The characteristics and management of extramedullary leukaemia are discussed.
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A case of death from severe paracetamol poisoning which presented early and received appropriate treatment according to evidence-based guidelines is presented here. It is very rare for patients to die from paracetamol poisoning when they receive N-acetylcysteine (NAC) within 8 h of ingestion. The patient had a marked lactic acidosis on presentation to hospital. This case demonstrates that a patient can die from paracetamol poisoning despite early and appropriate treatment, and raises the question whether lactic acidosis in a patient following paracetamol overdose should prompt the initiation of NAC treatment while awaiting paracetamol levels.
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(1) To define blood product requirements in patients with trauma whose underlying injuries are consistent with major blood loss; (2) to use these data to estimate the annual number of patients in Scotland who sustain significant trauma and require substantial blood product replacement; and (3) to place these data in the context of recent findings concerning the efficacy of recombinant factor VIIa in patients with major trauma. ⋯ In summary, this study estimates that approximately 67 patients annually in Scotland, above the age of 13 years, require blood transfusion as a direct result of significant traumatic injury. Of these 67 patients, an estimated 35 patients (28 of whom had a blunt form of trauma) require > or =8 units of RCC during the first 24 h in hospital. On the basis of the current limited trial evidence, the potential benefit in using recombinant factor VIIa in such patients, in Scotland, is small-approximately seven patients per million population aged >13 years, per year.
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To survey the information provided to head-injured patients on discharge from emergency departments (EDs) in Scotland. ⋯ Head injury discharge advice should be standardised throughout EDs, with more emphasis given to postconcussion features.