Emergency medicine journal : EMJ
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The case history is presented of a patient who developed metformin-associated lactic acidosis. The patient made a complete recovery with supportive care. Recognition of metformin-associated lactic acidosis requires a high index of suspicion as presentation can be very subtle.
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Comparative Study
Near-patient testing of potassium levels using arterial blood gas analysers: can we trust these results?
Near-patient testing allows rapid availability of results to enable prompt decision-making. Potassium abnormalities are common in acutely ill patients and can be associated with life-threatening complications. At times there is uncertainty whether clinical decisions can be based on the potassium result obtained from arterial blood gas (ABG) analysers or if laboratory values should be awaited. ⋯ Most clinicians still await laboratory confirmation of results obtained from blood gas analysers but in this setting there is sufficient agreement between the results obtained from the authors' blood gas analyser and a laboratory analyser to enable effective clinical decisions to be made.
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Radiographs are vital diagnostic tools that complement physical examination in trauma patients. A study was undertaken to assess the performance of residents in emergency medicine in the interpretation of trauma radiographs. ⋯ Accurate interpretation of radiographs by emergency medicine residents who perform the initial radiological and therapeutic interventions on trauma patients is of vital importance. The performance of our residents was found to be satisfactory in this regard.
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To evaluate the use of intravenous ketamine for procedural sedation in adults attending the emergency department. ⋯ Ketamine is an effective agent for procedural sedation in the emergency department. There were no serious adverse events associated with its use, but there is a significant incidence of recovery agitation which may require treatment with a benzodiazepine.