Emergency medicine journal : EMJ
-
This short report presents the case of a 32-year-old man with a knee injury sustained while playing football. A plain radiograph revealed a Segond fracture and a subsequent MRI confirmed a complete anterior cruciate ligament rupture. While the Segond fracture, and its associated intra-articular pathology, is well recognised among orthopaedic surgeons, it is less well recognised among staff in the emergency department. The report aims to emphasise the importance of plain radiographs in patients with a history of knee injury and to highlight that this seemingly innocuous avulsion fracture may reveal more severe underlying pathology.
-
SCUBA diving has several risks associated with it from breathing air under pressure--nitrogen narcosis, barotrauma and decompression sickness (the bends). Trimix SCUBA diving involves regulating mixtures of nitrogen, oxygen and helium in an attempt to overcome the risks of narcosis and decompression sickness during deep dives, but introduces other potential hazards such as hypoxia and oxygen toxicity convulsions. This study reports on a seizure during the ascent phase, its potential causes and management and discusses the hazards posed to the diver and his rescuer by an emergency ascent to the surface.
-
Patients' relatives have been allowed in the resuscitation room during active resuscitation in the UK since at least 1994. Several studies have indicated that relatives value the opportunity to observe the care provided, and this has been shown to help the grieving process. However, this enthusiasm has not always been shared by emergency department staff. In Trinidad and Tobago the concept of family presence in the resuscitation room is still a novel one. This study seeks to identify the attitudes of staff towards relatives in the resuscitation room in this setting. ⋯ Strong feelings against the presence of family members in the resuscitation room were expressed by physicians and nurses. Implementation of such a policy will require careful preparation and education of staff as to the benefits of this intervention.
-
A short cut review was carried out to establish whether emergency physicians (EPs) could confirm or refute the diagnosis of intussusception with the help of bedside ultrasonography. Two observational studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line was that EPs operated ultrasound was specific enough to rule in children with intussusception but its role to rule out this diagnosis needed to be further explored.