Early management of suspected bacterial meningitis and meningococcal septicaemia in adults.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
I O'Sullivan
Publications and source records attributed to I O'Sullivan.
Nitrous oxide in emergency medicine.
Safe and predictable analgesia is required for the potentially painful or uncomfortable procedures often undertaken in an emergency department. The characteristics of an ideal analgesic agent are safety, predictability, non-invasive delivery, freedom from side effects, simplicity of use, and a rapid onset and offset. Newer approaches have threatened the widespread use of nitrous oxide, but despite its long history this simple gas still has much to offer. "I am sure the air in heaven must be this wonder-working gas of delight". Robert Southey, Poet (1774 to 1843)
Analgesics, Non-Narcotic↗
How to get on a SpR rotation in emergency medicine (and make the most of it).
Emergency medicine is now proving a popular specialty in the United Kingdom. A recent report ranks emergency medicine second in specialties attracting the most applications for specialist registrar (SpR) interview. Numbered posts are becoming increasingly competitive as a result. This paper offers advice to aspiring emergency department SpRs. It identifies areas in which a curriculum vitae may be improved. It should also enable emergency department trainees to set objectives for their early SpR years.
Biomedical Research↗
Myocardial contusion: emergency investigation and diagnosis.
Cardiac contusion is an infrequent but occasionally serious complication of deceleration injury. According to ATLS teaching, the true diagnosis of contusion can only be established by direct inspection of the myocardium. The clinically important sequelae of myocardial contusion are hypotension and arrhythmia. Despite recent advances in investigative techniques, myocardial trauma remains an important diagnostic and management challenge. This paper presents an evidence-based review of the topic.
Contusions↗
Metal fume fever: a case report and review of the literature.
Metal fume fever is an acutely noxious inhalation syndrome secondary to metal oxide fumes. Despite preventative strategies sporadic cases are likely to continue to present to emergency departments.
Adolescent↗
The role of magnesium in the emergency department.
Magnesium has been advocated for the treatment of a variety of conditions seen in emergency medicine. The authors present a systematic review and advice on appropriate indications for its use. Evidence supports its use in severe asthma, eclampsia, and torsade de pointes. There is insufficient evidence to justify its routine use in other emergencies.
Arrhythmias, Cardiac↗
Dissection or embolism.
Cardiac myxomas have a wide range of clinical presentations. The patient in this case presented with chest and back pain gradually radiating to her legs. ECG demonstrated an acute myocardial infarct. In cases of apparent aortic dissection, other disgnoses such as myxoma embolisation should be considered.
Aortic Dissection↗
False positive results do not have a negative effect on reattendance for subsequent breast screening.
OBJECTIVES: To find out whether a false positive breast screening result has a negative effect on subsequent screening attendance. Also considered was the proportion of women who had ever failed to reattend for screening, having previously attended routinely. DESIGN: The study was a retrospective cohort design. SETTING: Data from the call and recall records of the Central and East London Breast Screening Service (CELBSS) were used. PARTICIPANTS: Women who had been invited to attend for breast screening by the CELBSS during 1997. MAIN OUTCOME MEASURES: Subsequent attendance or non-attendance for the next routine breast screen, after a false positive screening result. RESULTS: A substantial number of women failed to reattend for a breast screen during their screening history, having attended for their previous routine breast screen. No differences in the rates of reattendance were found between those who had previously received a false positive result and those who had not. CONCLUSION: From the results obtained in the present study it would seem that the experience of a false positive breast screen does not deter women from reattending in the future. However, many women living in inner city areas who attend for an initial breast screen are failing to attend for subsequent routine mammograms. This may have a deleterious effect for these women in terms of the benefits of attendance for regular screening.
Breast Neoplasms↗
Is fasting necessary before prilocaine Bier's block?
OBJECTIVE: To determine whether fasting is necessary before intravenous regional anaesthesia (Bier's block). METHODS: A questionnaire study was carried out to assess accident and emergency (A&E) departments' policies and opinions in relation to Bier's block anaesthesia. Questionnaires were sent to 282 A&E consultants, of whom 216 replied (77% response rate). RESULTS: About 5000 Bier's block procedures are carried out each year in the United Kingdom. Intravenous regional anaesthesia appears safe. Over one third of units did not fast their patients. The complication rate was similar in fasted and unfasted groups. CONCLUSIONS: Starvation of the patient before intravenous regional anaesthesia is not necessary and should be abandoned.
Anesthesia, Conduction↗