Emergency medicine journal : EMJ
-
Diabetic muscle infarction (DMI) is a rare complication of longstanding, poorly controlled diabetes. Only a few cases have been reported in the literature. The case of a 34-year-old man with a 7-year history of type 2 diabetes mellitus, with sudden onset of left thigh pain, is described here. ⋯ Short-term prognosis is very good; however, the recurrence rate is high. Long-term prognosis is poor, with most patients dying from cardiovascular complications of diabetes within 5 years of diagnosis. This case supports the need for a high index of suspicion, when a poorly controlled patient with diabetes presents with non-traumatic limb pain.
-
A short cut review was carried out to establish whether routine chest x rays are required following bronchoscopy guided percutaneous dilational tracheostomy (PDT). A total of 393 citations were reviewed of which six answered the three part question. The clinical bottom line is that at present there is no clinical evidence to support routine postprocedure chest x ray following bronchoscopy guided percutaneous dilatianal tracheostomy.
-
To examine whether current validation methods of emergency department triage scales actually assess the instrument's validity. ⋯ Numerous limitations are embedded in the process of validating triage scales. Methods of triage scale validation in developed countries may not be appropriate and repeatable in developing countries. Even in developed countries there are problems in conceptualising validation methods. A new consensus building validation approach has been constructed and recommended for a developing country setting. The Delphi method, a consensual validation process, is advanced as a more appropriate alternative for validating triage scales in developing countries.
-
The case of a 17-year-old girl brought into the emergency department (ED) having been found in a field semi-clad and overtly hypothermic is reported. A weak carotid pulse, agonal breathing and fixed dilated pupils were noted. ⋯ After 4 h of closed cardiopulmonary resuscitation and rewarming using a haemofiltration circuit, she made a full recovery with no adverse neurological sequelae. In this case report, the importance of prolonged resuscitation in cardiopulmonary arrest secondary to acute severe environmental hypothermia and the successful use of a haemofiltration circuit to deliver active core rewarming are highlighted.