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Biomedical subjects

D W Hodgkinson

Publications and source records attributed to D W Hodgkinson.

15 recordsLinked to original sources
PubMed2000

Hyperventilation: cause or effect?

A young person presenting with shortness of breath is common to the accident and emergency department. Usually this hyperventilation is anxiety related or a panic attack, but sometimes it can be caused by a serious underlying condition like pulmonary embolus. Acute shortness of breath in any patient should never be dismissed lightly. It is important to realise that pulmonary embolus can present without chest pain and with shortness of breath as the major symptom. Such patients can be distinguished by close attention to history and examination, risk factors for thromboembolic disease and the use of basic investigations (electrocardiogram, chest radiography and arterial blood gas analysis). A serious cause for shortness of breath must be excluded before labelling it as "hysteria" or "panic".

Acute Disease↗
PubMed2000

Chest pain in the emergency department.

The assessment of patients with chest pain is challenging for any emergency physician because of the spectrum of illness covered by this symptom. Patients may have a serious life-threatening condition or a trivial self-limiting illness. This article presents an approach to the assessment and early management of patients presenting with acute non-traumatic chest pain in the emergency department.

Acute Disease↗
PubMed1999

Cocaine induced myocardial infarction.

The case of a 29 year old man who presented with chest pains after the use of cocaine is reported. The diagnosis of myocardial infarction was made on the electrocardiogram changes and lactate dehydrogenase profile. The diagnosis may be overlooked if there is no direct questioning about the use of drugs such as cocaine. Diazepam has an important role in the management of cardiac complications after cocaine use and should be used early in management. The use of thrombolysis should be a joint decision between the emergency physician and cardiologist.

Adult↗
PubMed1995

Doctors' legal position in treating temporarily incompetent patients.

Doctors in accident and emergency departments are sometimes presented with patients with potentially life threatening conditions who refuse to consent to treatment. The doctors then face a dilemma: to withhold necessary treatment or to act against a patient's express wishes. Two such cases are presented, and we asked a lawyer, two medical ethicists, a psychiatrist, and an accident and emergency physician to comment on the implications.

Adult↗
PubMed1994

Mild head injury--a positive approach to management.

It is estimated that 1.4 million patients each year attend Accident and Emergency (A&E) departments in the UK with a head injury. The vast majority are, in retrospect, diagnosed as a 'mild' injury. There is evidence to suggest that many develop short term morbidity and some long term problems. The incidence is unknown. Early recognition and treatment many hasten recovery. A national postal survey of A&E departments revealed a general unawareness for this morbidity. Written advice given to patients on discharge from the departments was exclusively concerned with the symptoms expected if serious complications developed. A description of the common symptoms of fatigue, poor memory and concentration were not given to the patients in a written format. Arrangements for follow up are, in the majority of hospitals, unstructured. We recommend a positive approach to the management and follow up of mild head injury. This should recognize the common problems experienced by these patients and cater for their needs. More interest and research is required into this aspect of head injury.

Craniocerebral Trauma↗
PubMed1993

Scaphoid fracture: a new method of assessment.

The value of colour flow Doppler ultrasound scanning in patients with suspected acute carpal scaphoid fracture has been examined. A prospective study of 78 patients with signs and symptoms of carpal scaphoid injury was undertaken over a period of 6 months. Both wrists of all patients were scanned within 12-72 h of injury. The radial artery and carpal scaphoid bone contours are visible using this type of imaging technique. The distance between the medial wall of the radial artery and the outer cortex of the scaphoid waist was measured. The scaphoid index is described and was calculated from this measurement. Patients were managed without knowledge of the ultrasound imaging result, using plain radiographs and clinical examination as the standard for determining the presence of a scaphoid fracture. All patients were followed to the resolution of symptoms. All 12 patients who were subsequently considered to have scaphoid fractures were identified using this imaging technique within 12-72 h after injury. We conclude that this imaging may be useful in the assessment of patients with carpal scaphoid fracture. It can be used early, as a supplementary investigation, in patients with suspected carpal scaphoid fracture in whom the initial plain radiographs are normal.

Adolescent↗
PubMed1993

An important complication of upper cervical spine fracture: a case report.

A case report is presented of a patient who sustained a high cervical spine fracture, the possible mechanisms of injury and details of the fracture are discussed. The patient developed bilateral vagal nerve palsies 48 h after the accident. This complication was only recognized after dysphagia and an aspiration pneumonia developed. The complication of aspiration pneumonia was preventable. Meticulous and repeated examination of the cranial nerve function in this type of injury is recommended. Normal feeding should commence only when the cranial nerve function has been shown to be normal after repeated examination.

Cervical Vertebrae↗
PubMed1991

A review of the management of oral drug overdose in the Accident and Emergency Department of the Royal Brisbane Hospital.

Two-hundred and eighty-nine patients who made a total of 323 presentations to the Royal Brisbane Hospital Accident and Emergency Department with a known or suspected oral drug overdose were reviewed. The majority of patients (76%) could be managed in a 24 h Accident and Emergency observation unit. Activated charcoal given orally or via a nasogastric tube was the recommended method of preventing further absorption of an ingested drug. The use of syrup of ipecac was not encouraged and orogastric lavage was used in only specific situations. The morbidity and mortality of these patients when compared with other studies, was not adversely affected by this protocol which dramatically reduced the indications for the use of orogastric lavage and syrup of ipecac.

Administration, Oral↗