A case is reported of pneumoperitoneum after prolonged ventilation of a smoke inhalation victim at the scene by a fireman using intermittent positive pressure ventilation. The clinical presentation, treatment and aetiology, when associated with cardiopulmonary resuscitation, are discussed. The need for adequate training in the use of resuscitation equipment is emphasized, especially for non-med...

Two-hundred and eleven Irish GPs responded to a questionnaire survey of their experience and management of acute myocardial infarction (MI) and their attitudes to the use of thrombolytic therapy Three-quarters of the respondents felt they dealt with three or more MIs per year; most felt that the majority of MIs were initially seen by a GP. Diagnosis is based on clinical findings; only 11% routi...

Pre-hospital emergency anaesthesia with oral tracheal intubation is the technique of choice for trauma patients who cannot maintain their airway or achieve adequate ventilation. It should be carried out as soon as safely possible, and performed to the same standards as in-hospital emergency anaesthesia. It should only be conducted within organisations with comprehensive clinical governance arra...

BACKGROUND Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better. CASE PRESENTATION The Norwegian Acute Stroke Pre-hospital Project (...

Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides greater blood flow and oxygen delivery during cardiac arrest than closed chest compressions. Hospital-based ECPR is currently offered to selected OHCA patients...

BACKGROUND Various studies have shown that stroke morbidity and mortality could be decreased if patients receive early diagnosis and treatment. Iranian Pre-hospital Stroke Scale (IPSS) is designed based on other prehospital stroke scales available across the world as well as experiences of emergency medicine specialists and pre-hospital emergency technicians to improve the diagnostic accuracy o...

Noting that a variety of pre-hospital interventions can now be applied to treat traumatic injury, David J Lockey calls for research to determine which of these actually improve survival and reduce morbidity.

Sir, Recommendations for the treatment of gastroenteritis in children have stressed the importance of oral rehydration solutions and withdrawal of milk feeds for 24 hours in bottle fed infants.' The use of antibiotics should be limited to specific indications such as giardiasis or shigellosis, and antidiarrhoeal agents should be avoided as they are ineffective and may be harmful.2 In view of th...

Introduction Rescue of the injured has always been an inherent feature of peacetime and operational medical support (1). Despite this, doctrine and skills training in technical rescue and extrication has not been formally developed for Army Medical Services (AMS) personnel (2). This is in stark contrast to the civilian emergency services who have the capability of delivering a wide range of res...