Emergency medicine journal : EMJ
-
Capnocytophaga canimorsus infection is the most severe and rapidly progressive bacterial infection transmitted by dog bite and fortunately is very rare. The authors describe a 68-year-old gentleman who presented in an acute confusional state 2 days after having been bitten on the left hand by a dog. ⋯ Our case illustrates a life-threatening presentation of infection with C canimorsus, which is known as 'the dog bite organism'. Early diagnosis and aggressive treatment is key to survival.
-
This study aimed to compare ultrasound examinations performed within a land ambulance (stationary and moving) with those completed in a simulated emergency department (ED) to determine the feasibility of undertaking ultrasound examinations within the UK prehospital care environment. The findings suggest that abdominal aortic aneurysm and extended focused assessment with sonography in trauma emergency ultrasound examinations can be performed in the stationary or moving land ambulance environment to a standard consistent with those performed in the hospital ED.
-
Allocation decisions in emergency medicine must occur when demand for emergency services exceeds supply. In many circumstances, strong clinical or cost evidence upon which to base allocation decisions is lacking. ⋯ If preference is to be incorporated into allocation decision-making, scientifically rigorous quantitative methods should be chosen for measuring preference. This article describes the theoretical background, advantages, risks and applications of discrete choice experiments for measuring patient preference in emergency medicine.
-
During a multiple casualty chemical, biological, radiological and nuclear incident it is imperative that triage is accurately undertaken to use resources effectively and give the greatest chance of survival to those who need it. This reflection explores an option to assist in this matter by proposing a colorimetric breathing detection system, while remembering that this it is untested, may be a useful aid.
-
A short cut review was carried out to establish whether prophylactic antibiotics should be given to prevent Weil's disease after a fall into standing water. 30 papers were found using the reported searches, of which 4 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that if there is immersion in an endemic area for leptospirosis, or if there is higher risk of water contamination such as standing water, known rat infestation, drainage channels then doxycycline would have to be recommended. Other scenarios are not as clear.