)Archives of\tJ Emergency Medicine

EDITORA. D. Redmond

ASSISTANT EDITORM. Prescott

EDITORIAL ASSISTANTR. L. Gibb

EDITORIAL A. D. Redmond, North Staffordshire Trauma Centre, Princes Road,BOARD Hartshill, Stoke-on-Trent ST4 7GJ, U.K.

V. Dallos, Whipps Cross Hospital, Whipps Cross Road, Leytenstone,London Eli, U.K.K. Little, The Royal Infirmary, Lauriston Place, Edinburgh EH3 9YW,U.K.M. A. Mason, Medway Hospital, Windmill Road, Gillingham, Kent ME75NY, U.K.D. J. Williams, St Thomas's Hospital, Lambeth Palace Road, London SE17EH, U.K.D. W. Yates, Hope Hospital, Eccles Old Road, Salford M6 8HD, U.K.

BAEM N. G. Kirby, President, Guy's Hospital, St Thomas Street, London SE1REPRESEN- 9RT, U.K.

TATIVES G. G. Bodiwala, Treasurer, Leicester Royal Infirmary, Infirmary Square,Leicester LE1 5WW, U.K.C. J. Cutting, Chairman, Publications Committee, Taunton and SomersetHospital, Musgrove Park Branch, Taunton, Somerset TAl 3HQ, U.K.

INTER- R. J. Goris, The Netherlands; T. Hamilton, Australia; P. Huguenard,NATIONAL France; R. N. Illingworth, U.K.; I. McA. Ledingham, U.A.E.; R. A. Little,ADVISORY U.K.; K. I. Maull, U.S.A.; C. v. d. Merwe, South Africa; C. E. Robertson,

BOARD U.K.; B. M. T. Rowat, Canada; H. B. Stoner, U.K.

Archives of Emergency Medicine provides aforum for the publication, disseminationand discussion of original clinical and scien-tific research on all aspects of the subject.Particular emphasis is placed on the acutephase of surgical, medical, paediatric, obste-tric and psychiatric emergencies, especiallyin relation to the diagnosis and managementof the acutely ill. It is intended that resuci-tatioit oe a major component of the scientificcontent. The Journal, which has been adop-ted by the British Association for Accidentand Emergency Medicine and the Emer-gency Medicine Research Society, publishesboth original papers and review articles.Case reports or preliminary communicationswill be accepted if sufficiently noteworthy orinteresting.

Subscription information. Archives ofEmergency Medicine is published quarterly(one volume per annum) and the subscrip-tion prices for 1992 are £99.00 (U.K.), £105.00(overseas except North America) and $180.00(U.S.A. and Canada), in all cases post free.

Orders for current subscriptions and backissues should be sent to Blackwell ScientificPublications Ltd. Joumal SubscriptionsDepartment, Marston Book Services, PO Box87, Oxford OX2 ODT, U.K. all other businesscorrespondence, including orders for off-prints and advertising space, should beaddressed to Blackwell Scientific Publica-tions Ltd, Osney Mead, Oxford OX2 OEL(Telephone [0865] 240201; Telex 83355 Med-bok G; Fax [0865] 721205). The Joumal isdispatched within Europe by surface mail, toother continents by various forms of airspeeded delivery: to the U.S.* by air freightfor forwarding by second-class post, to Indiaby air freight for guaranteed local delivery,and to all other countries by AcceleratedSurface Post.

*Post Master, send address changes toArchives of Emergency Medicine c/o MercuryAirfreight Intemational Ltd, 2323 EFRandolph Avenue, Avenel NJ07001 (USMailing Agent) Second Class postage paid atRahway NJ.

This joumal is printed on acid free paper.

THE ROYAL COLLEGE OF SURGEONS OF EDINBURGHFELLOWSHIP EXAMINATION IN

ACCIDENT AND EMERGENCY MEDICINE AND SURGERYA diet of the Fellowship Examination in Accident and Emergency Medicine and Surgeryorganised jointly by the Royal College of Surgeons of Edinburgh and the Royal College ofPhysicians of Edinburgh will be held on 10 May 1993.This is an additional option in the present Fellowship Examination and is designed to test allaspects of the work of an Accident and Emergency Department.Candidates must have been engaged in the study of their profession for a period of not less thanfour years and must have passed a Section A/Part I FRCSEd or recognised equivalent.

OR(i) Part I MRCP (UK) or recognised equivalent:

OR(ii) Primary FFA RCSEng or recognised equivalent (prior to 1985):

OR(iii) Part II FFA RCSEng or recognised equivalent (with effect from 1985);

The application forn, examinations calendar and Regulations are available on request from theExaminations Secretary, The Royal College of Surgeons of Edinburgh, Nicolson Street,Edinburgh EH8 9DW.Applications for entry must be received by 26 March 1993.Fee: £325.00

Emergency ISecond Edition hI

This second editicthe emergency deinformation requiritwo volume set istext leads you in athreatening disordadministrative concommon emergenWhen you need aconsuitation or anreview, Emergencanswers.1992 2200pagestwo volumes 031

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For those concerned with emergency medicine......some outstanding titles from Churchill LivingstoneWedicine Infectious Diseasefarold L May in Emergency Medicine

Judith C Briliman IRonald W QuenzerAn extremely practical aid in the treatment of patientswith proven or suspected infectious diseases in theemergency setting. Written by emergency medicineand infectious disease specialists, the book alsoincludes material on precautions for emergencyphysicians and patients. It is divided into the blowingsections: 1) General principles 2) Clinical syndromesand differenlial diagnoses and 3) Infectious diseasesby organ system. This book addresses the challengeof dealing comprehensively with infectious disease inthe emergency department.1992 hardback 580 pages 80 illustrations0316 108383 £1 O.00 *

Essentials of Immediate Medical CareWl _ C John Eaton

This is an extremely practical, comprehensive andauthoritative guide to the immediate management oftrauma and medical emergencies. The book is basedon materia oginally prepared by the author for theBritish Association of Immediate Care (BASICS) and

in covers the conditions you treat in reflects up-to-date, safe and effective managementpartment every day. All the vital practice in this vital area.9d is found quickly and easily. This 1992 spiral bound 584 pages 180 illustrationsdivided up into five parts and the 0 44304575 5 £19.50ilogica progression from life- Intensive Care Medicineers of the vital organ system, to J M Rippe, R S Irwin, J SAlpert, M P Finkcerns. The final part ilustrates One of the most comprehensive books on intensiveicy procedures in an atlas format. care medicine. Coverage is extended to provide theready reference for on-the-spot most up-to-date authoritative guidance on bothauthoritative text for comprehensive medica and surgica aspects of patient care.y Medicine will provide the 1991 hardback 2100 pages 525 illustrations

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Resuscitation Training Office Post

The British Heart Foundation is pleased to announce its decisionto offer pump-priming funds to enable the creation of a

Resuscitation Training Officer post. Awards are for up to£25,000 over a 2 year period and are towards the salary of thepostholder. As the post must be full-time, the balance of the costshould be met by the responsible Health Authority/NHS Trust.The closing date for applications is Friday 12 February 1993.Up to ten awards will be granted to commence from April 1993.

For further information and an application form, please contact

Sam Harrison,Cardiac Care Department,

British Heart Foundation on 071-935 0185.

To advertise in this journal

TelephoneMaura 0'Dohertyon 0865 240201

Blackwell Scientific Publications Ltd.,Osney Mead, Oxford, OX2 OEL.

Telex 83355 Medbok G, Fax (0865) 200918

Archives of Emergency Medicine, 1992, 9, 379-386

JOURNAL SCAN 21

Acta Psychiatrica Scandinavica

Ojehagen A. et al. Deliberate self-poisoning: treatment follow-up of repeaters and nonrepeaters1992: 85, 370-375

American Journal of Surgery

Treatment of compound fractures 1991: 161, 693-701

Fabian T. C. et al.

Annals of Surgery

Factors affecting morbidity following hepatic trauma. A prospective analysis of482 injuries 1991: 213, 540-547

Australian and New Zealand Journal of Psychiatry

Graham C. &Burvill P. W.

A study of coroner's records of suicide in young people, 1986-88 in WesternAustralian 1992: 26, 30-39

BASICS

Robertson B.

Matthews

Fisher J.

Major incident management. The implications of HC (90) 25 1991: 14, 3

Survival prospects for out of hospital, non-traumatic cardiac arrest victims inthe coming decade 1991: 14'Administrative and therapeutic options to improve out of hospital resuscitation'

The Asmund Laerdal Lecture. The origin and development of the UK Resus-citation Council 1992: 15, 1

Brain Injury

Recurrent traumatic injury injury

British Journal of Hospital Medicine

Linker N. J.

Holmberg S. R. M.

Touquet R. &Fothergill J.

Adenosine: a must for every casualty department

Thrombolysis in acute myocardial infarction

Putting A&E consultants in their place: Letter

1992: 47, 565-567

1992: 47, 572-580

1992: 47, 625

379

Seligson D. &Henry S. L.

Salcido R. &Costich J. F.

1992: 6, 293

380 Journal Scan 21

Samuels M. &Southall D. F.

Hamilton-FarrellM. R.

Shneerson J.

Ross Russell R. I.

Koes et al.

Redmond A. D.

Nolan J. P. et al.

Parke T. R. J.

RCR W. P.

Cooper C. &

Melton L. J.

George S. et al.

Richmond P. W.

et al.

Hawton K.

Kemp A. &

Sibert J. R.

Cooke M. W. et al.

McGribben L. et al.

Shah P. et al.

Pell A. C. H. et al.

Munchausen syndrome by proxy

Applications of hyperbaric oxygen

Transtracheal oxygen catheters

British Journal of Intensive Care

Drowning and near-drowning in children

1992: 47, 759-762

1992: 47, 803-804

1992: 48, 24-26

1992: 2, 135-140

British Medical Journal

Randomised clinical trial of manipulative therapy and physiotherapy forpersistent back and neck complaints: results of one year's follow-up

1992: 304, 601-605'It works'

Medical response to disasters overseas (Ed) 1992: 304, 653'? Brain drain'

Advanced trauma life support courses 1992: 304, 654

Response to the Kurdish refugee crises by the Edinburgh MEDIC 1 team1992: 304, 695-697

Influence of the Royal College of Radiologists' Guidelines on hospital practice:a multicentre study 1992: 304, 740-743'Useful'

Vertebral fractures (Ed) 1992: 304, 793-794

Evaluation of nurse triage in a British accident and emergency department1992: 304, 876-878

'Is this your experience?'

Perforation of gloves in an accident and emergency department1992: 304, 879-880

By their own young hand (Ed) 1992: 304, 1000'Increasing suicide in young men'

Drowning and near-drowning in children in the UK: Lessons for prevention'Keep children and water apart'

Management of sudden bereavement in the accident and emergency department1992: 304, 1207-1209

School attendance as a factor in deliberate self poisoning by 12-15 year oldadolescents 1992: 304, 16-19'Children are happier in the holidays'

Acute angle glaucoma associated with nebulised ipratropium bromide andsalbutamol 1992: 304, 40-41'Co-administration may provoke glaucoma in the susceptible'

Effect of 'fast track' admission for acute myocardial infarction on delay inthrombolysis 1992: 304, 83-87'An effective way to significantly reduce delays'

Journal Scan 21 381

McPherson G. A. D.& Wolfe J. H. N.

McLeod D.

Barton N. J. et al.

Lowry S.

Armstrong A. M. &Molyneux E.

Teanby D.

Mansfield A. 0. &Wolfe J. H. N.

Balarajan R. et al.

Pearce M.

Godlee F.

ABC of Vascular Diseases: Acute ischaemia of the leg

Ocular injuries from boxing: What about prophylacticboxers' retinas?'What about banning the sport?'

Occupational causes of disorders in the upper limb

Injuries from domestic glazing (Ed)

Glass injuries to children'Children are softer than glass'

Under-reporting of pedestrian road accidents

ABC of Vascular Disease: Trauma

Deprivation and general practitioner workload"Deprivation index' -What about an A&E study?'

Seat belts in pregnancy (Ed)'Above and below bump please'

On your bikes (Ed)'Set an example'

1992: 304, 169-172

laser coagulation of1992: 304, 197

1992: 304, 309-311

1992: 304, 332

1992: 304, 360

1992: 304, 422

1992: 304, 439-442

1992: 304, 529-534

1992: 304, 586-587

1992: 304, 588

Chest

Bradley & Gore

Varriale et al.

ST segment depression in right-sided ECG leads in patients with acutemyocardial infarction 1992: 101, 416-419'Said to be a reciprocal expression of ST elevation in the lateral leads'

Bradyarrhythmias incident to thrombolysis for acute inferior wall infarction1992: 101, 732-735

'High incidence of slow rhythms in this situation, which respond to Atropine'

Current Opinion in Psychiatry

Suicide and suicidal bevaviour

Post-traumatic strss disorder

1992: 5, 201-206

1992: 5, 245-248

Dwyer T. &Ponsunby A.-L.

Cleghom D. B. et al.

Ferguson J. A. et al.

Epidemiology and Conintunity Health

Sudden Infant Death Syndrome 1992: 46, 98-102

Fracture rates calculated from fracture histories in normal post-menopausalwomen 1992: 46, 133-135

Some epidemiological observations on medicinal and non-medicinal poisoningin preschool children 1992: 46, 207-210

Geriatric Medicine

Vecchio P. &Hazleman B. L.

Shoulder problems: some practical solutions: Part 1 1992: 22, 42-47

Black D. W.

Loughrey G.

382 Journal Scan 21

Kenny R. A.

Kemohan S. M.et al.

Smith H. et al.

Gillett G. R.

Carty H.

Gillett G. R.

Wilson R. &

Moorehead R.

Lewis J. & Myers R.

Coupland R. &Pesonen P.

Ryan M. &Henderson J.

Edwards D. et al.

Thomas H. et al.

Tiel-van Buul M.et al.

Bredahl C. et al.

Watson J. &Hollingdale J.

Driscoll P. &Vincent C.

Driscoll P. &Vincent C.

Isbister E. &Roberts J.

Pattimore D. et al.

Morrison W.

Kirgala V. et al.

Ricketts D. et al.

Some new perspectives on falls. Part 2: orthostatic hypotension 1992: 22, 49-58

Health Bulletin

Telephone calls to a Paediatric Accident and Emergency Department1992: 50, 233-236

The ergonomic analysis of a trauma resuscitation room 1992: 50, 252-258

Hospiniedica

Medical malpractice: no-fault compensation

Non-accidental injury

Do-not-resuscitate orders

1992: X, 20-22

1992: X, 45-49

1992: X, 22-23

Injury

Management of splenic trauma 1992: 23, 5'Also covers incidence, mechanism, classification'

Non-obstructive colonic dilatation in the trauma patient; an analysis of sixpatients 1992: 23, 10

Craniocerebral war wounds: non specialist management 1992: 23, 21

The epidemiology of fractures and fracture-dislocations of the cervical spine1992: 23, 38

Fractures of the distal clavicle 1992: 23, 44

Value of rediograph audit in our accident service department 1992: 23, 47

Diagnosing scaphoid fractures: radiographs cannot be used as a gold standard1992: 23, 77

Mortality after hip fracture: results of operation within 12 hours of admission1992: 23, 83

Early management of displaced ankle fractures 1992: 23, 87

Organizing an efficient trauma team 1992: 23, 107

Variation in trauma resuscitation and its effect on patient outcome 1992: 23, 111

Autokabalesis: a study of intentional vertical deceleration 1992: 23, 119

Torso injury patterns and mechanisms of car crashes: an additional diagnostictool 1992: 23, 123

Pseudoaneurysm and penetrating trauma 1992: 23, 127

ABO blood groups and musculoskeletal injuries 1992: 23, 131

Streptococcal gangrene presenting as hip pain: two case reports and review ofliterature 1992: 23, 134

Journal Scan 21 383

Williams P. et al.

Driscoll P.

Simpson A. &Mineiro J.

Casserly H. &Thomas P.

Hadfield J. et al.

Hadfield J. &Little R.

Parkingson R. &Paton R.

Bannister G. et al.

Stephenson G. &Gibson R.

Lowry M. &Meiler P.

Dalton M. et al.

Roux A. et al.

Cornes P.

Ritchie A.

Driscoll P. et al.

Packer G. et al.

Gibbons C. &Giddins G.

Osman A. &Govender S.

Pitfalls in diagnosis of femoral neck fracture

Trauma: today's problems, tomorrow's answers'62 references'

Prevention of bicycle accidents

1992: 23, 140

1992: 23, 151

1992: 23, 171

Updating the accident and emergency record 1992: 23, 174

Measures energy expenditure and plasma substrate and hormonal changesfollowing severe head injury 1992: 23, 177

Substrate oxidation and contribution of protein oxidation to energy expenditureafter severe head injury 1992: 23, 183

Carpometacarpal dislocation: an aid to diagnosis 1992: 23, 187

A classification of acute radiological and anatomical study

Fatal penetrating head injury during a game of soccer

Low voltage electrothermal neck injury

1992: 23, 194

1992: 23, 197

1992: 23, 205

Proceedings of the British Trauma Society 1992: 23, 209

Helicopter doctors? 1992: 23, 249

The Johannesburg Hospital mobile anaesthetic service 1992: 23, 251

Return to work of accident victims claiming compensation for personal injury1992: 23, 256

Plastic bullets: significant risk of serious injury above the diaphragm1992: 23, 265

Diagnostic peritoneal lavage: It's red, but is it positive? 1992: 23, 267

Effect of algorithm on the treatment of knee injuries 1992: 23, 270

Stage diving injuries 1992: 23, 273

Traumatic dislocation of the lumbar spine at two levels 1992: 23, 277

Journal of Bone and Joint Surgery

Lyons & Tomlinson

Hardcastle et al.

Clinical diagnosis of tears of the rotator cuff 1992: 74B, 414-415'High accuracy obtainable by careful examination without fancy investigationY

Spinal abnormalities in young fast bowlers 1992: 74B, 421-425'High risk of spondylolysis and disc problems'

Journal of Emergency Medicine

Bertolin

Schmidt &Markovchick

Hydrofluoric acid, a review of toxicity

Non-traumatic spinal cord compression

1992: 10, 163-169

1992: 10, 189-201

384 Journal Scan 21

Prince M. &Worth C.

Cornes P. &Aitken R. C. B.

Journal of Public Health Medicine

A study of 'inappropriate' attendances to a Paediatric Accident and EmergencyDepartment 1992: 14, 177-182

Journal of the Royal College of Physicians

Medical reports on persons claiming compensation for personal injury1992: 85, 329-333

Journal of the Royal College of Surgeons of Edinburgh

Tolley N. S. &Brookes G. B.

Adejuyigbe 0. et al.

Wyatt J. P. et al.

Lavelle-Jones M.et al.

Rowley D. I.

Burdett-Smith P.

Malki A. A. et al.

Surgical management of cerebrospinal fluid rhinorrhoea 1992: 37, 12-15

Abdominal injuries in Nigerian children 1992: 37, 29-33

Variation among trainee surgeons in interpreting diagnostic peritoneal lavagefluid - blunt abdominal trauma 1992: 37, 104-106

Disc battery ingestion: a review and management plan 1992: 37, 120-122

Trauma care in the UK the debate must continue

Estimating trauma centre workload

New techniques for assessing muscle damage after trauma

1992: 37, 127

1992: 37, 127-130

1992: 37, 131-133

Journal of the Medical Defence Society

Dealing with an emergency

Resuscitation - some medico-legal problems

Journal of the Royal Society of Medicine

Fairhurst R.J.

Siddiqui M. N. et al.

Letters

Letters

Karay-Jones et al.

Santavirta et al.

Thompson et al.

Use of the emergency ambulance service 1992: 85, 306

Spontaneous rectus sheath haematoma: a rare cause of abdominal pain1992: 85, 420-421

Helicopters 1992: 85, 431

Compensation for injury - re-appraisal 1992: 85, 432

Journal of Traunia

Results of a multi-institutional outcome assessment:results of a structuredpeer review of TRISS-designated unexpected outcomes 1992: 32: 196-203'Only 16.1% of unexpected deaths as judges by TRISS were considered correct'

Ruptures of the heart in seat-belt wearers 1992: 32, 275-279'Reports a high incidence of heart rupture in seat-belt wearers who die in trafficaccidents'

Community Hospital Level II Trauma Centre Outcome 1992: 32, 336-343'Non resident trauma surgeons do not significantly worsen outcome'

Husson R.

Dando P.

1992: 8, 32-34

1992: 8, 42-43

Journal Scan 21 385

Lancet

Berden H. J. J. M.et al.

Read S. J. et al.

de Silva H. J. et al.

Merson S. et at.

Letters

Woods K. L. et al.

Letters

Editorial

Gore S. M. et al.

Sataline L.

Redfern L. et al.

Renvoize E. et al.

A GP

Variation in the quality of cardiopulmonary resuscitation 1992: 339, 1019-1020

Acute transverse myelitis after tetanua toxoid vaccination 1992: 339, 1111-1112

Does pralidoxime affect outcome of management in acute organophosphoruspoisoning? 1992: 339, 1136-1138

Early intervention in psychiatric emergencies: a controlled clinical trial1992: 339, 1311-1314

Quality of CPR 1992: 339, 1542-1543

Intravenous magnesium sulphate in suspected acute myocardial infarction:results of the second Leicester Intravenous Magnesium Intervention Trial(LIMIT-2) 1992: 339, 1553-1558

Desferrioxamine in acute iron poisoning 1992: 339, 1601-1602

Diagnosing recurrent suffocation of children 1992: 340, 87-88

The Lancet's statistical review process: areas for improvement by authors1992: 340, 100-102

Chest pain and the oesophagus 1992: 340, 119

Medical Audit News

Self-poisoning: need for biochemical monitoring 1992: 2, 55

Attempted suicide: the importance of accident and emergency data1992: 2, 55-56

Sins of omission in an A&E department 1992: 2, 93

Medicine, Science and the Law

Cembrowicz S. P. &Shepherd J. P.

Strom C.

Chao T. C. et al.

Violence in the accident and emergency department

Injuries due to violent crimes

Common poisons in Singapore

1992: 32, 118-122

1992: 32, 123-132

1992: 32, 139-147

New England Journal of Medicine

Madsen J. R. &Rosenberg A. E.

Larsen G. L.

A 27-year-old woman with pain in the neck and shoulder

Asthma in children. Review article

1992: 326, 1070-1076

1992: 326, 1540-1545

Nturse Education Today

Dealing with verbal abuse: evaluation of the efficacy of a workshop for studentnurses 1992: 12, 108-115

Wondrak R. &Dolan B.

386 Journal Scan 21

Postgraduate Medical Journal

Odeh M. et at.

Norton KRW

Kheterpol S. et al.

Armstrong A. M. &Robson W. J.

Morphine and severe lip dryness 1992: 68, 303

'The Health of the Nation': the impact of personality disorder on 'key areas'1992: 68, 350-344

A case of polycythaemia presenting with intramuscular chest wall haematoma1992: 68, 381-382

Public Health

Deaths from injury and poisoning of children in Liverpoorl: a ten-year survey1978-1987 1992: 106, 225-230

Quality Health Care

Bedford H. E. et al. Use of an east end children's accident and emergency department for infants:a failure of primary health care 1992: 1, 29-33

Radiology Now

Brindle M. J. A beginner's guide to the use of the X-ray department - one man's view1988: 5, 19-20

Surgery

Acute pancreatitis

Spinal cord compression

Early management of burns

1992: 10, 49-53

1992: 10, 64-71

1992: 10, 109-117

Surgical Nurse

Respiratory observations'No mention of its importance in trauma scoring'

1992: 5, 22-25

Update (Hospital)

Hackney R.

Thomson N. C.

de Lacey G.

Jacyna M. R.

Sports medicine: time for recognition 1992: 18, 335-336

Management of asthma in adults: Part 2 1992: 18, 365-376

1. What is audit? Why should we be doing it? 1992: 18, 458-466

2. Pros and cons of medical audit a conversation with a sceptic1992: 18, 512-520

Enmergency Medicine

Medline updates, 17 June 1992Available from the British Library, Boston Spa

Larvin M.

Johnston R.

Frame & Kelly

Torrance C. &Hale N.

Archives of Emergency Medicine, 1992, 9, 387-391

Author Index

ABU-SALEH R., see CHRISTENSON J. T.AHEE P., see LUKE L. C.AHNEFELD F.W., see Rossi P.AL SARRAF A., see CHRISTENSON J. T.ALLEN H.: Case Report. Carbon monoxide poisoning in a diver, 65ASHBY R. H., see BROWN A. F. T.AUNG T. S., see WARD A. B.AUSTWICK D. H., see HAY S. M.

BANERJEE A.: Thrombolytic therapy in A & E departments in the U.K., 249BANNON M. J., CARTER Y. H. & MASON K. T.: Causes of fatal childhood

accidents in North Staffordshire, 1980-1989, 357BARRETT K., see WARD A. B.BEATnIE T. F., see RODGER A.

see also DEEHAN D. J.BECKETT M. W., see WILKINS P. S.BLACK N., see MCKEE M.BLANCHARD J., see PHIPPS A. R.BOOTH A. J., HARRISON C. J., GARDNER C. J. & GRAY A. J.: Waiting times and patient satisfaction in the

accident and emergency department, 162BOUGHEY A. M., see WARD A. B.BRADLEY M., KADZOMBE E., SIMMS P. & EYES B.: Percutaneous ultrasound-guided extraction of non-palpable

foreign bodies, 181BROWN A. F. T., MYERS C., DUNJEY S. & ASHBY R. H.: Teaching trauma management, 334

see also SOMERS S. S.BRYCE G. & FAKHER A. N.: Public awareness of home accident risks: some implications for health promotion,

225

CARTER Y. H., see BANNON M. J.CARTLIDGE D., see GRAY A. J.CHRISTENSON J. T., AL SARRAF A. & ABU-SALEH R.: The effect of low molecular weight dextran on

haemodynamics and respiratory function during endotoxin-induced shock, ICOALS J., see KADZOMBE A.COOKE M. W.: Paramedic care, 252COPE A. R., see JEYARAJAN R.CRAWFORD R. see MOULTON C.CURRY C.: Accident - an anachronism, 331CUSACK S., STEEDMAN D. J., ROBERTSON C. E. & LITTLE K.: Flying squad response to out-of-hospital cardiac

arrest: a decade of experience, 203

DE DOMBAL F. T.: Computers, diagnosis and patients with acute abdominal pain, 267DEEHAN D. J., BEATTIE T. F., KNIGHT D. & JONGSCHAAP H.: Avulsion fracture of the straight and reflected

heads of rectus femoris, 311DORANI B., see MAITRA A. K.DOYLE M. & TAYLOR R. J.: Prevalence of human immunodeficiency virus risk factors in patients attending an

accident and emergency department, 196DRISCOLL P., see GULY U.DUNJEY S., see BROWN A. F. T.

EBBS S. R., FOTHERGILL N. J. & HASHEMI K.: The Purley train crash: procedural difficulties, 130see also FOTHERGILL N. J.

387

388 Author Index

EVANS R. J., CUSACK S. & PARKE T.: Exposure of the hands to ionizing radiation in the resuscitation room ofan accident and emergency department, 220

EYES B., see BRADLEY M.

FAKHER N., see BRYCE G.FERGUSON J., see RODGER A.FLOWERS M., see TAIWO B.FODDEN D. I.: A study of wrist injuries in children: the incidence of various injuries and of premature closure of

the distal radial growth plate, 9FOTHERGILL N. J., EBBS S. R., REESE A., PARTRIDGE R. J., MOWBRAY M., SOUTHCOTTR. D. G. & HASHEMI

K.: The Purley train crash: mechanism, injuries and prevention, 125see also EBBS S. R.

FREELAND P., see MACLEOD A. J.see STONEBRIDGE P. A.

GALASKO C. S. B., see GAVALAS M.GARDENER G. J., see BOOTH A. J.GAVALAS M., POTTS H. & GALASKO C. S. B.: Case Report: Bone infection and the limping child in the accident

and emergency department: a diagnosis to be considered, 323see GRAY A. J.

GIBSON M. & ZOLTIE N.: Radiography for back pain presenting to accident and emergency departments, 28GINZLER M., see MCKEE M.GRAY A. J., CARTLIDGE D. & GAVALAS M. C.: Can ambulance personnel intubate?, 347

see also BOOTH A. J.GREENE M. K. & RODEN R. K.: Trauma courses for senior house officers, 258GULY U. & DRISCOLL P.: Case Report: The management of quinine-induced blindness, 317

HABASHI S., see MARTIN-HIRSCH D. P.HARBORNE D. J.: Measuring respiratory rate, 377HARBORNE D. J., see KENDALL I. G.HARKER C., MATHESON A. B., Ross J. A. S. & SEATON A.: Occupational accidents presenting to the accident

and emergency department, 185HARRISON C. J., see BOOTH A. J.HASHEMI K., see EBBS S. R.

see also FOTHERGILL N. J.HAY F. A., see HAY S. M.HAY S. M., HAY F. A. & AUSTWICK D. H.: Bee sting brachial block, 369HERDMAN R. C. D., SAEED S. R. & HINTON E. A.: The lateral soft tissue neck X-ray in accident and emergency

medicine, 149HEYWORTH J.: Conjunctival oxygen monitoring in the initial assessment of trauma, 274HEYWORTH J. R. C., see MORRISON W. G.HINTON A. H., see MARTIN-HIRSCH D. P.HINTON E. A., see HERDMAN R. C. D.HOGG F., see PENNYCOOK A. G.HOLDRIGHT D., see JAHANGIRI M.HULSE W., see JOHNSON G.

INGLIS M. D., see MCLEOD G. A.

JACK A., see THOMSON L. F.JAGER G., see Rossl P.JAHANGIRI M. & HOLDRIGHT D.: Myocardial infarction secondary to dipyridamole overdose, 62JAMES A. S. & STEVENSON J.: Cutaneous myiasis due to tumbu fly, 58JEYARAJAN R. & COPE A. R.: Anaesthesia for reduction of anterior dislocations of the shoulder, 71JOHNSON C. & WILLIAMS M.: Delays to thrombolytic treatment following acute myocardial infarction, 70

Author Index 389

JOHNSON G., HULSE W. & MACGOWAN A.: The Milch technique for reduction of anterior dislocations in anaccident and emergency department, 40

JONGSCHAAP H., see DEEHAN D. J.

KADZOMBE A. & COALS J.: Complaints against doctors in an accident and emergency department: a 10-yearanalysis, 134see also BRADLEY M.

KENDALL I. G.: Seat-belt injury, 253Stick in stoic, 256

KENDALL I. G., HARBORNE D. J. & PREMSWARUP I.: Beware spontaneous bilateral pneumothorax, 51KLEIN J., see SOMERS S. S.KNIGHT D., see DEEHAN D. J.KOTECHA B., see MARTIN-HIRSCH D. P.

LEVINE A. J. & WILLIAMS D. J.: Rare diseases do occur: an acute presentation of Huntington's Chorea, 255LITTLE K., see CUSACK S.LITTLE R. A., see PARKE T. R. J.LUKE L. C. & AHEE P.: Spontaneous pneumomediastinum 250LYONS C., see SOMERS S. S.

MCBRIEN M. E., POLLOCK A. J. & STEEDMAN D. J.: Advanced airway control in trauma resuscitation, 177MACGOWAN A., see JOHNSON G.MCKEE M., PRIEST P., GINZLER M. & BLACK N.: Can out-of-hours operating in gynaecology be reduced, 290MACLEOD A. J. & FREELAND P.: Should nurses be allowed to request X-rays in an accident and emergency

department?, 19MACLEOD D. A. D. see STONEBRIDGE P. A.MCLEOD G. A. & INGLIS M. D.: Equipment Review. The Mini Cap III Co2 Detector: assessment of a device to

distinguish oesophageal from tracheal intubation, 373MCNAUGHTON G., see PENNYCOOK A. G.MCNICHOLL B. P.: Toxicity awareness and unintended suicide in drug overdoses, 214MAITRA A. K. & DORANi B.: Role of zinc in post-injury wound healing, 122MAKOWER R. M., PENNYCOOK A. G. & MOULTON C.: Intravenous drug abusers attending an inner city

accident and emergency department, 32MARDEL S. N., see THOMSON L. F.MARREN-BELL U., see SCHNEIDEN V.MARTIN-HIRSCH D. P., HABASHI S., HINTON A. H. & KOTECHA B.: Orbital cellulitis, 143MASON K. T., see BANNON M. J.MATHESON A. B., see HARKER C.MAYCOCK P. F., see PARKE T. R. J.MOORE R. S. & ROBSON W. J.: Cases of assault attending a children's accident and emergency department: an

epidemiological study, 239MORRISON W. G. & HEYWORTH J. R. C.: Needle injury to the heart, 54MOULTON C., PENNYCOOK A. & CRAWFORD R.: Intracardiac therapy following emergency thoracotomy in the

accident and emergency department: an experimental model, 190see also MAKOWER R. M.

MOWBRAY M., see FOTHERGILL N. J.MURPHY N. M. & OLNEY D. B.: Applied hand anatomy: its importance in accident and emergency medicine,

14MYERS C., see BROWN A. F. T.

NAYEEN N. & STANSFIELD D.: Management of corneal foreign bodies in A & E departments, 257

OLNEY D. B., see MURPHY N. M.O'SULLIVAN G.: Pharyngeal perforation: an unusual complication of fish bone impaction, 71OWEN R. J., see PACKER G. J.

390 Author Index

PACKER G. J. & OWEN R. J.: Case Report: Intra-articular dislocation of the patella, 244PARKE T., see EVANS R. J.PARKE T. R. J., STEEDMAN D. J., ROBERTSON C. E., LITTLE R. A. & MAYCOCK P. F.: Plasma catecholamine

responses in acute severe asthma, 157PARKER M. J.: Missed hip fracture, 23PARTRIDGE R. J., see FOTHERGILL N. J.PEARSON T.: Self-induced grand mal epilepsy, 367PENNYCOOK A. G., MCNAUGHTON G. & HOGG F.: Irregular discharge against medical advice from the accident

and emergency department - a cause for concern, 230see also MOULTON C.see also MAKOWER R. M.

PFENNINGER E., see Rossi P.PiipPS A. R. & BLANCHARD J.: A review of in-patient hand infection, 299POLLOCK A. J., see MCBRIEN M. E.PoTTs H., see GAVALAS M.PREMSWARUP I., see KENDALL I. G.PRIEST P., see MCKEE M.PUTTERMAN C.: Massive haemothorax from central venous catheterization: a note of caution, 335

RAINEY J. B. see STONEBRIDGE P. A.REDMOND A. D.: ATLS and beyond 103REESE A., see FOTHERGILL N. J.ROBERTSON C. E., see CUSACK S.

see also PARKE T. R. J.see also STEEDMAN D. J.

ROBINSON S. M. & TACHAKRA S. S.: Case Report: Skin ulceration due to cement, 326ROBSON W. J., see MOORE R. S.RODEN R. K., see GREENE M. K.RODGER A., FERGUSON J. & BEATTIE T. F.: Teaching basic life support, 338ROSS J. A. S., see HARKER C.ROSSI P., JAGER G., AHNEFELD F. W. & PFENNINGER E.: Efficiency of suction pumps for the emergency

medicine setting, 44ROUSE A.: The effect of the Cornwall and Isles of Scilly helicopter ambulance unit on the ambulance services'

ability to deliver acutely traumatized patients to hospital, 113

SAEED S. R., see HERDMAN R. C. D.SANDERSON S. A.: Medical statements 107SCHNEIDEN V. & MARREN-BELL U.: Violence in the accident and emergency department, 330SEATON A., see HARKER C.SELLWOOD N.: An ambulance helicopter for emergency calls, 280SHERRIFF H. M., see SOMERS S. S.SHIELDS T. G., see THOMSON L. F.SOMERS S. S., LYONS C., BROWN A. F. T., KLEIN J. & SHERRIFF H. M.: The Flexipore 6000 membrane as awound dressing for use in the accident and emergency department, 246

SOUTHCOTT R. D. G., see FOTHERGILL N. J.STANSFIELD D., see NAYEEN N.STEEDMAN D. J. & ROBERTSON C. E.: Acid base changes in arterial and central venous blood during

cardiopulmonary resuscitation, 169see also CUSACK S.see also MCBRIEN M. E.see also PARK T. R. J.

STEVENSON J., see JAMES A. S.STONEBRIDGE P. A., FREELAND P., RAINEY J. B. & MACLEOD D. A. D.: Audit of computer-aided diagnosis of

abdominal pain in accident and emergency departments, 271

Author Index 391

TACHAKRA S. S., see ROBINSON S. M.TAiwo B., FLOWERS M. & ZOLTIE N.: Reducing children's fear when undergoing painful procedures, 306TAIWO B. & WILLIAMS C. J.: An octopus in my stomach: atypical depression presenting as hypochondriasis, 69

see also ZOLTIE N.TAYLOR R. J., see DOYLE M.THOMSON L. F., MARDEL S. N., JACK A. & SHIELDS T. G.: Management of the moribund carbon monoxide

victim, 208

WARD A. B., BOUGHEY A. M., AUNG T. S. & BARRETT K.: Use of head injury instruction cards in accidentcentres, 314

WILKINS P. S. & BECKETT M. W.: Audit of unexpected return visits to an accident and emergency department,352

WILLIAMS C. J., see TAIWO B.WILLIAMS D. J. see LEVINE A. J.WILLIAMS M., see JOHNSON C.

ZOLTIE N. & TAIWO B.: Effects of the Gulf War on accident and emergency attendance, 332see also GIBSON M.

Archives of Emergency Medicine, 1992, 9, 392-394

Subject Index

Abdominal, pain, computer diagnosis, 267, 271Abuse, intravenous, drug, 32Accident, an anachronism, 331Acid, base, changes, blood, CPR, 169Airway, control, trauma resuscitation, 177Ambulance:

helicopter, for A & E, 280personnel, intubation, 347

Anachronism, accident, 331Anaesthesia, reduction of anterior dislocations,

shoulder, 71Analysis, complaints against doctors, 10-years,

134Anatomy, hand, applied, 14Assault, children's A & E, 239Assessment:

device to detect oesophageal from trachealintubation, 373

trauma, conjunctival oxygen monitoring, 274Asthma, plasma catecholamine responses, 157ATLS, and beyond, 103Audit:computer-aided diagnoses, abdominal pain,

271unexpected return visits to A & E, 356

Avulsion, fracture, rectus femoris, 311

Back, pain, radiography, 28Base, acid changes, blood, CPR, 169Bee, sting, brachial block, 369Blindness, quinine-induced, management, 317Blood, acid base changes, CPR, 169Bone:

fish, oesophagus, 256infection, limping child, diagnosis to be con-

sidered, 323Brachial block, bee sting, 369

Carbon monoxide, management of moribundvictim, 208

Carbon monoxide poisoning, diver, 65Cardiac:

arrest, flying squad response, 203intra, therapy after thoracotomy, 190

Care, paramedic, 252Catecholamine, plasma, response, asthma, 157Catheterization, central venous, massive haemo-

thorax, 335Cellulitis, orbital, 143Cement, skin ulceration, 326

392

Childhood, fatal accidents, causes, NorthStaffordshire, 352

Children, fear reduction when undergoing pain-ful procedures, 306

Closure, premature, distal radial growth plate, 9Complaints, against doctors, 134Computer, diagnoses, acute abdominal pain,

267, 271Conjunctival, oxygen monitoring, trauma ass-

essment, 274Control, airway, trauma resuscitation, 177Cornea, foreign bodies, management, 257Courses, trauma, 258CPR, acid base changes in blood, 169Crash, train, Purley, 125, 130Cutaneous myiasis, tumbu fly, 58

Delays, thrombolytic treatment, myocardialinfarction, 70

Depression, presenting as hypochondriasis, 69Dextran, low MW, endotoxin-induced shock, 1Diagnoses, computer, abdominal pain, 267, 271Dipyridamole, overdose, myocardial infarction,

62Discharge, irregular, from A & E, 230Dislocation:

intra-articular, patella, 244Milch technique, 40shoulder, anaesthesia, 71

Diver, carbon monoxide poisoning, 65Dressing, wound, Flexipore 6000, 246Drug:

abusers, intravenous, 32overdose, toxicity awareness, 214

Electromagnetic, pulsed energy, pre-tibiallacerations, 335

Endotoxin-induced, shock, low MW dextran, 1Epidemiological, study, assault at children'sA & E, 239

Epilepsy, self-induced grand mal, 367Extraction, non-palpable foreign bodies, 181

Fatal, childhood accidents, North Staffordshire,352

Fear, children's, reduction, 306Flexipore 6000, membrane, wound dressing, 246Flying squad, response to cardiac arrest, 203Fracture:

avulsion, rectus femoris, 311hip, missed, 23

Grand mal epilepsy, self-induced, 367Growth plate, premature closure, 9Gulf War, effects on A & E, 332Gynaecology, reducing out-of-hours operating,

290

Haemodynamics, low MW dextran, endotoxin-induced shock, 1

Haemothorax, central venous catheterization,335

Hand:applied anatomy, 14exposure to ionizing radiation in resuscitation

room, 220infection, in-patient, 299

Head injury, instruction cards, 314Healing, post-injury, role of zinc, 122Health promotion, home accident risks, 225Heart, needle injury, 54Helicopter, ambulance:emergency calls, 280trauma patients, 113

Hip, fracture, missed, 23Home, accident risks, health promotion, 225Human immunodeficiency virus, risk factors in

patients, 196Huntingdon's Chorea, 255Hypochondriasis, 69

Impaction, fish bone, pharyngeal perforation, 71Incidence, wrist injuries, children, 9Infarction, myocardial:dipyridamole overdose, 62thrombolytic treatment delays, 70

Infection:bone, limping child, diagnosis to be con-

sidered, 323hand, in-patient, 299

Injury, prevention, Purley train crash, 125Instruction, cards, head injury, 314Intra-articular dislocation, patella, 244Intracardiac therapy, after thoracotomy, 190Intravenous drug abusers, 32Intubation:ambulance personnel, 347device to distinguish oesophageal from

tracheal, 373Ionizing radiation, exposure to hands in resusci-

tation room, 220

Journal Scan 18, 73;19, 25920, 33921, 379

Subject Index 393

Lacerations, pre-tibial, pulsed electromagneticenergy, 335

Life support, teaching, 338Limping, child, bone infection, diagnosis to be

considered, 323Management of:

corneal foreign bodies, 257moribund carbon monoxide victim, 208quinine-induced blindness, 317teaching trauma, 334

Measurement, respiratory rate, 377Membrane, Flexipore 6000, wound dressing, 246Milch technique, dislocations, 40Mini Cap III CO2 detector, 373Missed, hip fracture, 23Model, intracardiac therapy after thoracotomy,

190Monitoring, conjunctival oxygen, trauma assess-

ment, 274Moribund, carbon monoxide victim, manage-ment of 208

Myiasis, cutaneous, tumbu fly, 58Myocardial infarction:

dipyridamole overdose, 62thrombolytic treatment delays, 70

Neck, soft tissue, X-ray, 149Needle, injury to heart, 54Nurses, requesting X-rays, 19

Occupational accidents, presenting to A & E, 185Operating, out-of-hours, gynaecology, 290Orbital, cellulitis, 143Overdose:

dipyridamole, myocardial infarction, 62toxicity awareness, 214

Oxygen, conjunctival monitoring, assessment oftrauma, 274

Painabdominal, computer aided diagnoses, 267,

271back, radiography, 28

Paramedic care, 252Patella, intra-articular dislocation, 244Patient, satisfaction, waiting times, 162Percutaneous, ultrasound-guided extraction,

non-palpable, foreign bodies, 181Perforation, pharyngeal, fish bone impaction, 71Personnel, ambulance, can they intubate?, 347Pharyngeal perforation, fish bone impaction, 71Plasma, catecholamine, responses, asthma, 157Pneumodediastinum, spontaneous, 250Pneumothorax, spontaneous bilateral, 51Poisoning, carbon dioxide, diver, 65

394 Subject Index

Post-injury, would healing, role of zinc, 122Prevention, injuries, Purley train crash, 125Procedure, difficulties, Purley train crash, 130Pumps, suction, 44

Quinine-induced blindness, management, 317

Radiation, ionizing, exposure of hands, resusci-tation room, 220

Radiography, back pain, 28Rectus femoris, avulsion fracture, 311Respiratory:

function, endotoxin induced shock, 1rate, measurement, 377

Resuscitation:cardiopulmonary, acid base changes in blood,

169ionizing radiation, exposure of hands, 220trauma, advanced airway control, 177

Risk:factors, in patients, human immunodeficiency

virus, 203home accidents, health promotion, 225

Satisfaction, patient, waiting times, 162Seat-belt, injury, 253Self-induced, grand mal epilepsy, 367Shoulder, dislocations, anaesthesia, 71Shock, endotoxin-induced, low MW dextran, 1Skin:

myiasis, tumbu fly, 58ulceration, due to cement, 326

Statements, medical, 107Sting, bee, brachial block, 369Stomach, hypochondriasis, 69Suction, pumps, 44Suicide, unintentional, toxicity awareness, 214

Teaching:life support, 338trauma management, 334

Therapy:intracardiac, 190thrombolytic, 249

Thoracotomy, intracardiac therapy, 190Thrombolytic:

therapy, 249treatment delays, myocardial infarction, 70

Tibia, pre-, laceration, pulsed electromagneticenergy, 335

Toxicity, awareness, unintended drug overdoses, 214Train crash, Purley:

injury prevention, 125procedural difficulties, 130

Trauma:assessment, conjunctival oxygen monitoring,

274courses, senior house officers, 258patients, helicopter ambulance, 113resuscitation, airway control, 177

Tumbu fly, cutaneous myiasis, 58

Ulceration, skin, due to cement, 326Ultrasound, guided extraction, non-palpable-

foreign bodies, 181

Virus, human immunodeficiency, risk factors inpatients, 203

Visits, return, unexpected, to A & E, 356

Waiting, times, patient satisfaction, 162War, Gulf, effects on A & E, 332Wrist, injuries, children, 9

X-ray:neck, soft tissue, 149nurses requesting, 19

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