Emergency medicine journal : EMJ
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A young man presented to the emergency department with ventricular tachyarrhythmia later attributed to varicella zoster myocarditis. Myocarditis has an unpredictable clinical sequelae, making it a difficult condition to diagnose and manage in the emergency setting. The inconsistent clinical presentations, risks and management are demonstrated through a review of the literature.
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Case Reports
An unusual presentation of congenital central hypoventilation syndrome (Ondine's Curse).
Congenital central hypoventilation syndrome is a rare illness, which classically presents in the neonatal period; newborns present with shallow breathing and cyanosis, without a physiological rise in breathing rate. Incidence has been estimated from 1 in 10,000 to 1 in 200,000 live births. This case report describes the case of a young man who was asymptomatic until his presentation in acute respiratory failure at the age of 36 years. This case is reported to highlight the importance of considering this treatable illness as a potential cause of collapse and respiratory failure in adults presenting to emergency departments.
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Falls down stairs are a common presentation to the paediatric emergency department. The pattern of injury associated with this mechanism of injury has not been described for the UK population. A retrospective analysis of attendances to the Emergency Department of Sheffield Children's Hospital was carried out. ⋯ Infants who fall down stairs with their carer or are dropped while being carried down stairs require an especially close evaluation.
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Paramedic tracheal intubation has been practised in the UK for more than 20 years and is currently a core skill for paramedics. Growing evidence suggests that tracheal intubation is not the optimal method of airway management by paramedics and may be detrimental to patient outcomes. There is also evidence that the current initial training of 25 intubations performed in-hospital is inadequate, and that the lack of ongoing intubation practice may compound this further. Supraglottic airway devices (eg, laryngeal mask airway), which were not available when extended training and paramedic intubation was first introduced, are now in use in many ambulance services and are a suitable alternative prehospital airway device for paramedics.