Emergency medicine journal : EMJ
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Prehospital anaesthesia is carried out regularly by a small number of prehospital care practitioners in the UK. Although mostly predictable, prehospital disorders can be more difficult than those in hospital, and, in addition, peer and skilled anaesthetic assistance is usually not available. Hence, patient safety should be given paramount importance, and systems need to be in place to ensure that the highest standards are achieved.
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Emergency physicians often manage wounds contaminated with glass. Even when glass is visible on x rays, removal may require real-time bedside imaging. ⋯ Novices can easily be taught to detect GFBs using fluoroscopy, with accuracy comparable to that achieved by radiologists using plain films. Further studies are needed to assess doctors' use of the technique in real patients.
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A case of a patient who presented with massive pulmonary embolism (PE) requiring thrombolysis with alteplase is reported. The subsequent presence of a patent foramen ovale and paradoxical embolism clinically demonstrated the speed of action of the recombinant tissue plasminogen activator. The advantage of this class of medication when considering the treatment options for a PE in an acute setting is highlighted.