We read with interest the review of the OPAT service in Birmingham, featured in the most recent issue of Acute Medicine.1 Could the authors confirm the percentages of patients deemed suitable for outpatient therapy with the various conditions compared to the totals presenting to their organisation?
Outpatient parenteral antibiotic therapy for cellulitis Read More
The article “The impact of education on the knowledge and documentation of Driver and Vehicle Licensing Agency (DVLA) driving restrictions by doctors”1 was interesting and I agree that doctors (especially those working in the acute / emergency setting) should have a good knowledge on when to advise a person to refrain from driving.
The clinician’s responsibility in relation to DVLA guidance Read More
We enjoyed the recent article by Heaps and Gormley.1 It highlights both the importance of electrolyte disturbance and the QT interval, in the context of acute drug overdose or substance misuse.
Hypokalaemia, Drugs and the QT interval – A Recipe for Disaster Read More
I read with interest the article “ The NICE Guideline on chest pain of recent onset: What does it mean for the Acute Physician?”.1 I struggle to recall a day’s take occurring without at least one or two patients presenting to the Acute Medical Unit (AMU) with chest pain, awaiting Troponin results. To admit the majority of these patients for prolonged observation, and ECG monitoring may waste resources, but needs to be weighed up against th risk of missing the one ‘troponin negative’ acute coronary syndrome with an atypical history.
The Changing Face of Chest Pain Read More
Dear Editor,
We read with interest the article “Aortic dissection: a review of the diagnosis and initial management” by Thompson-Moore and Papouchado1; the authors do not mention pleural effusion as a presenting x-ray feature of this condition. A case in our unit highlights the importance of considering aortic dissection for patients with unexplained haemothorax.
Dear Editor
I was disappointed to read, in the case scenario of a recent article regarding the investigation of a patient with polyarthritis 1 that a patient was not offered an HIV test despite there being clinical indication. The reason given was the absence of risk factors.
Please click link below to view the PDF. References I Sanusi. British Society of Echocardiography Adult Accreditation: An Unrealistic Expectation for Acute Physicians? Acute Medicine 2014; 13(2): 84-85 Susanna Price, Gabriele Via, Erik Sloth et al and WINFOCUSECHO-ICU Group. Echocardiography practice, Training and accreditation in the intensive care: document for the World Interactive Network Focused
Please click link below to view the PDF. References Ghosh Dastidar A, Garg P, West JN, et al. ST elevation in ECG lead aVR signals severe acute left main coronary artery disease. Acute Medicine 2013;12(4):220-223. Engelen DJ, Gorgels AP, Cheriex EC, et al. Value of the electrocardiogram in localizing the occlusion site in the left...
I read the case report of cocaine induced methemoglobinemia¹ in the recent edition of the acute medicine journal with interest.
Drug-Induced Methaemoglobinaemia Read More
We read with interest the article by Rogers et al in the recent edition of Acute Medicine, regarding the evaluation and management of adrenal failure. It was noted that the investigation and diagnosis of adrenal failure during pregnancy was not discussed; we feel this is an important omission, which was highlighted recently by a young woman who presented to our medical take, two weeks post-partum following her first pregnancy with clinical features in keeping with an Addisonian crisis.