Emergency medicine journal : EMJ
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The aim of this study was to investigate the factors associated with prehospital delays in patients with acute ischaemic stroke who are indicated to receive thrombolysis if arriving within 2 h. ⋯ Early symptom recognition and arrival at the hospital are important in acute stroke. Further effort to improve these parameters should be made in terms of public health.
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To evaluate the efficacy of the UK swine flu algorithm as a screening tool in unwell children, and to compare the management advice given with the National Institute for Health and Clinical Excellence (NICE) feverish illness guideline advice. ⋯ The swine flu algorithm is of little use in differentiating unwell children, and advice given does not correlate well with that of the NICE guidance. There is a significant risk of harm with false-positive diagnoses and potential delays in appropriate treatment. The authors were unable to obtain the data and rationale behind the algorithm, and believe that this should be published. Face-to-face consultations may be the only way to ensure patient safety.
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Clinical experience with hydroxocobalamin in acute cyanide poisoning via ingestion remains limited. This case concerns a 35-year-old mentally ill woman who consumed more than 20 apricot kernels. Published literature suggests each kernel would have contained cyanide concentrations ranging from 0.122 to 4.09 mg/g (average 2.92 mg/g). ⋯ Hydroxocobalamin was then administered. After 24 h, she was completely asymptomatic with normalised blood pressure and other haemodynamic parameters. This case reinforces the safety and effectiveness of hydroxocobalamin in acute cyanide poisoning by ingestion.