Accident and emergency in London. Good primary care reduces workload.
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Emergency Service, Hospital↗
Biomedical subjects
D J Harborne
Publications and source records attributed to D J Harborne.
Emergency treatment of adder bites: case reports and literature review.
Five cases of adder bites are presented. The clinical effects and current recommendations for the treatment of adder bites are described based on a review of previously published literature. All adder bites, or snake bites of unknown species, should be observed for a minimum of 2 h. Those with no local swelling may be allowed home with appropriate antitetanus prophylaxis. Patients with local reaction or signs of systemic envenoming should be admitted for 48 h with ECG monitoring, and antivenom obtained. Indications and precautions for administration of antivenom are reviewed. Early antivenom treatment may reduce mortality and morbidity from adder bites.
Adolescent↗
Beware spontaneous bilateral pneumothorax.
A previously healthy young man presented to A&E with severe dyspnoea. The cause of his distress was bilateral spontaneous pneumothoraces. Prompt insertion of chest drains relieved his distress. This rare clinical entity should be considered in an individual with severe respiratory distress. Diagnosis is difficult on clinical examination alone.
Adult↗
Distal tibiofibular synostosis due to direct trauma.
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Adult↗