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G Campbell-Hewson

Publications and source records attributed to G Campbell-Hewson.

7 recordsLinked to original sources

Should ultrasound guidance be used for central venous catheterisation in the emergency department?

In September 2002, the National Institute of Clinical Excellence (NICE) issued guidelines for England and Wales suggesting that ultrasound guidance should be used for all electives, and should be considered for most emergency, central venous catheterisations.1 These guidelines propose a major change of practice for most clinicians practising in UK Emergency Departments. There are also resource and training implications. In this paper we systematically review the literature to establish what evidence exists for the routine use of ultrasound guidance in the placement of central venous catheters in adult patients attending the Emergency Department, and provide an overview of the practical elements of this procedure.

Adult↗

The use of air weapons in attempted suicide.

The use of airguns in attempted suicide is uncommon. In such instances, the surface wounds caused by discharged pellets may be inconspicuous or appear deceptively trivial to the medical examiner. Airgun pellets however are easily capable of penetrating the skull or abdominal cavity when fired at the close ranges involved in suicide attempts. The destructive power of these weapons at close range should not be underestimated. We describe three cases of attempted suicide and review the other nine cases reported in the medical literature: of the 12 suicide attempts there were three fatalities. Seventeen out of a total of 19 pellets fired penetrated either the cranial or peritoneal cavity or damaged deep structures. Most of the victims were male. The majority of wounds were right sided. Four of the attempts were extremely determined, involving repeated discharge of the airgun or the use of other means to effect suicide.

Abdominal Injuries↗

Traumatic asphyxia in children.

Two cases of traumatic asphyxia in young children are reported. The first was a 2 year old child run over at low speed by the front wheels of a delivery van. He made an uncomplicated recovery. The second child was pinned to the floor by an empty chest of drawers in an unwitnessed accident. He was discovered in cardiac arrest and resuscitation was unsuccessful. The outcome following traumatic asphyxia is a product of duration of compression and the weight involved. Considerable weight can be tolerated for a short period, whereas a comparatively modest weight applied for a longer period may result in death.

Accidents, Home↗

Blood alcohol and cardiac arrest.

Patients who suffer a cardiac arrest with alcohol present in their blood may, theoretically, differ from patients who arrest in the absence of alcohol. Alcohol may induce certain lethal arrhythmias, deter strenuous resuscitation in the pre-hospital phase and influence the effectiveness of resuscitative manoeuvres. In this study, 150 patients presenting to an Accident and Emergency department with cardiac arrest were tested for the presence of alcohol in their plasma. 49 patients had detectable plasma alcohol and analysis of their pre-hospital resuscitation revealed no significant differences when compared with the 101 patients in whom no alcohol was detected. No particular arrhythmia predominated in the alcohol group, and patients who had alcohol detected in their blood were just as likely to be successfully resuscitated, in terms of both restoration of spontaneous circulation and survival to hospital discharge. The effect of significantly elevated plasma alcohol levels on cardiac arrest outcome remains unclear, however, as only 7/150 patients had plasma alcohol levels above the legal driving limit.

Adolescent↗