Table Of Content

VOLUME 16 * CONTENTS No 1 JANUARY 1999 Reviews Stroke—a medical emergency C Lott, H ¥ Hennes, W Dick b~oI Recent advances in the acute management of ischaemic stroke M Roberts, G Hughes Original articles 13 Analysis of intensive care populations to select possible candidates for high dependency care ¥ V Pappachan, B W Millar, D F Barrett, G B Smith yiss ic n Searching for the evidence in pre-hospital care: a review of randomised controlled trials H Brazier, A W Murphy, C Lynch, G Bury, on behalf of the Ambulance Response Time Sub-Group of the National Ambulance Advisory Committee Commentary—S Wilson Prospective single blinded randomised controlled trial of two orally administered activated charcoal preparations R Boyd, #H anson The PEP transducer: a new way of measuring respiratory rate in the non-intubated patient D Dodds, ¥ Purdy, C Moulton Excessive morphine requirements after pre-hospital nalbuphine analgesia K°P G Houlihan, RG Mitchell, A D Flapan, D $ Steedman Microbiological evaluation of infected wounds of the extremities in 214 adults L Holzapfel, T Facquet-Francillon, ¥ Rahman, P Achard, E Marcellin, TF offre, P Y Lallement, A Bousquet, Negaeee re en Sabine Devaux, A Coupry UK accident and emergency departments and emergency contraception: what do they think and do? BA Gbolade, M Elstein, D Yates 39 Attitudes towards general practice and primary care: a survey of senior house officers in accident and emergency 7 Dale, S Williams Report 43 Criminal injury compensation: from B to A P Burdert-Smith Personal view Accident and emergency medicine—the next 25 years 7 Binchy Clinical management Vi Wn Investigation and management of patients with pleuritic chest pain presenting to the accident and emergency department K Jones, A Raghuram Best evidence topic reports 60 Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary Edited by K Mackway-Fones 60 Pelvic radiography in severe blunt trauma T Gilpin, K Mackway-Jones 61 The management of anterior epistaxis K Mackway-fones, R Morton 62 Topical analgesia in corneal abrasions S Carley, B Martin 63 Wound cleaning methods S Thompson, F Lecky Journal scan Journal scan Edited by ¥ Wardrope, this scan coordinated by M Potts Management issues Organising training for undergraduates and SHOs 7 N Rawlinson Emergency casebooks ~l bo Mitral regurgitation presenting as localised right middle lobe pulmonary oedema F-C Chen, M F Bullard, W-F7 Cherng, C-M Lee, TF Chiu, S-¥ Liaw ~I Qo Traumatic pseudoaneurysm of the superficial temporal artery W R Cross, H Nishikawa Letters to the editor Accident and emergency medicine or emergency medicine? L G Rocke Planning cannot rely on emergencies arriving by ambulance M W Cooke, S Finks Inappropriate ambulance usage is a retrospective diagnosis S Wilson, S Edwards, M W Cooke ssa>ws ni n On site computed tomography in the district general hospital for severe head injury N E Scholes “Empirical” thrombolysis in catastrophic pulmonary embolism T Kehoe, D DaCruz OO Spontaneous carotid artery dissection P Gupta, S Moalypour Minor injuries units AdM Leaman Risk of fire outweighed by need for oxygen and defibrillation G R McAnulty, H Robertshaw ~“]I ni Child Protection Register—time for change M F Nicol, A Harris <+~«~~=)J)}]) (o.2) Relatives in the resuscitation room R Boyd VOLUME 16 * CONTENTS No 1 JANUARY 1999 Reviews Stroke—a medical emergency C Lott, H ¥ Hennes, W Dick b~oI Recent advances in the acute management of ischaemic stroke M Roberts, G Hughes Original articles 13 Analysis of intensive care populations to select possible candidates for high dependency care ¥ V Pappachan, B W Millar, D F Barrett, G B Smith yiss ic n Searching for the evidence in pre-hospital care: a review of randomised controlled trials H Brazier, A W Murphy, C Lynch, G Bury, on behalf of the Ambulance Response Time Sub-Group of the National Ambulance Advisory Committee Commentary—S Wilson Prospective single blinded randomised controlled trial of two orally administered activated charcoal preparations R Boyd, #H anson The PEP transducer: a new way of measuring respiratory rate in the non-intubated patient D Dodds, ¥ Purdy, C Moulton Excessive morphine requirements after pre-hospital nalbuphine analgesia K°P G Houlihan, RG Mitchell, A D Flapan, D $ Steedman Microbiological evaluation of infected wounds of the extremities in 214 adults L Holzapfel, T Facquet-Francillon, ¥ Rahman, P Achard, E Marcellin, TF offre, P Y Lallement, A Bousquet, Negaeee re en Sabine Devaux, A Coupry UK accident and emergency departments and emergency contraception: what do they think and do? BA Gbolade, M Elstein, D Yates 39 Attitudes towards general practice and primary care: a survey of senior house officers in accident and emergency 7 Dale, S Williams Report 43 Criminal injury compensation: from B to A P Burdert-Smith Personal view Accident and emergency medicine—the next 25 years 7 Binchy Clinical management Vi Wn Investigation and management of patients with pleuritic chest pain presenting to the accident and emergency department K Jones, A Raghuram Best evidence topic reports 60 Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary Edited by K Mackway-Fones 60 Pelvic radiography in severe blunt trauma T Gilpin, K Mackway-Jones 61 The management of anterior epistaxis K Mackway-fones, R Morton 62 Topical analgesia in corneal abrasions S Carley, B Martin 63 Wound cleaning methods S Thompson, F Lecky Journal scan Journal scan Edited by ¥ Wardrope, this scan coordinated by M Potts Management issues Organising training for undergraduates and SHOs 7 N Rawlinson Emergency casebooks ~l bo Mitral regurgitation presenting as localised right middle lobe pulmonary oedema F-C Chen, M F Bullard, W-F7 Cherng, C-M Lee, TF Chiu, S-¥ Liaw ~I Qo Traumatic pseudoaneurysm of the superficial temporal artery W R Cross, H Nishikawa Letters to the editor Accident and emergency medicine or emergency medicine? L G Rocke Planning cannot rely on emergencies arriving by ambulance M W Cooke, S Finks Inappropriate ambulance usage is a retrospective diagnosis S Wilson, S Edwards, M W Cooke ssa>ws ni n On site computed tomography in the district general hospital for severe head injury N E Scholes “Empirical” thrombolysis in catastrophic pulmonary embolism T Kehoe, D DaCruz OO Spontaneous carotid artery dissection P Gupta, S Moalypour Minor injuries units AdM Leaman Risk of fire outweighed by need for oxygen and defibrillation G R McAnulty, H Robertshaw ~“]I ni Child Protection Register—time for change M F Nicol, A Harris <+~«~~=)J)}]) (o.2) Relatives in the resuscitation room R Boyd No 2 MARCH 1999 Editorial State of the journal 7 Heyworth Reviews 83 Corticosteroids in head injury—the CRASH trial D Yates, B Farrell, G Teasdale, P Sandercock, I Roberts 84 Gastric decontamination—a view for the millennium D N Bateman 87 Injury control strategies: extending the quality and quantity of data relating to road traffic accidents in children R Henson, } M Hadfield, S Cooper Special report 91 Carbon monoxide: not gone, not to be forgotten # A Henry 92 Carbon monoxide poisoning: an update M Turner, M R Hamilton-Farrell, R $ Clark 96 Carbon monoxide poisoning treated with hyperbaric oxygen: metabolic acidosis as a predictor of treatment requirements M Turner, M Esaw, R } Clark British Hyperbaric Association carbon monoxide database, 1993-96 M R Hamilton-Farrell Original articles 104 Systemic hormonal, electrolyte, and substrate changes after non-thermal limb injury in children T H Rainer, T Beattie, P Crofton, K Sedowofia, R Stephen, C Barclay, N McIntosh 108 Older people’s use of ambulance services: a population based analysis M # Clark, G FitzGerald 112 Provision of telephone advice from accident and emergency departments: a national survey R Crouch, ¥D ale, B Visavadia, C Higton 114 Doctor’s assistants—do we need them? H Law, F Sloan LL? Tissue donation after death in the accident and emergency department: an opportunity Saee eee wasted? H P Magrath, L # Boulstridge 120 A risk management audit: are we complying with the national guidelines for sedation by non-anaesthetists? M F Nicol Metal detector and swallowed metal foreign bodies in children N V Doraiswamy, H Baig, L Hallam Education 126 Teaching and learning evidence based medicine skills in accident and emergency medicine R D Hardern Clinical management 130 Management of vaginal bleeding presenting to the accident and emergency department K Buckingham, A Fawdry, D Fothergill Best evidence topic reports 136 Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary Edited by K Mackway-fones 136 Eye patches and corneal abrasion K Mackway-Jones, S Carley 137 Paracetamol or ibuprofen in febrile children S Carley, M Thomas 139 Alkalinisation in the management of tricyclic antidepressant overdose K Mackway-fones, M Thomas 140 Collar and cuff or sling after fracture of the clavicle S Carley, K Mackway-fones 140 Curettage or silver nitrate for pyogenic granulomas on the hand W Dollery, V Choudrey 141 Support for uncomplicated shaft of humerus fractures K Herren, S Carley Journal scan 142 Journal scan Edited by ¥ Wardrope; this scan coordinated by G Quin Management issues Managing a bed crisis N Egan Case reports Chickenpox pneumonia: case report and literature review P A Nee, P ¥ Edrich Management of laryngeal foreign bodies in children H S Sharma, S Sharma An acutely painful elbow as a first presentation of von Willebrand’s disease H D M Poncia, F Ryan Emergency casebooks Glioblastoma presenting as carbon monoxide poisoning M Turner, R ¥ Clark Covert tamponade M G Jenkins, D Cochrane h— ntaNV iu Ou w Acute airway obstruction—an unusual cause D Williamson, T Llewellyn Letters to the editor Non-invasive cardiac output assessment in children C Childs, P Dark Safe use of thrombolysis in acute myocardial infarction 7 Edhouse Capnography and “major” accident and emergency departments in East Anglia R Florance, R Griffiths, A Cope Violence in the accident and emergency department: liaison with the police 7 Bache, D Chambers, P Guildford 159 Book reviews 160 Correction No 3 MAY 1999 Reviews 163 Multiple organ failure. How valid is the “two hit” model? R Saadia, M Schein Commentary—B Foéx 168 CS exposure—clinical effects and management E Worthington, P A Nee Original articles AKA unknown male Foxtrot 23/4: alias assignment for unidentified emergency room patients A ¥ Brooks, C Macnab, K Boffard Who calls 999 and why? A survey of the emergency workload of the London Ambulance Service C R Victor, ¥ L Peacock, C Chazot, S Walsh, D Holmes Does the Manchester triage system detect the critically ill? 4/1 W Cooke, S Finks Outcome after severe head injury treated by an integrated trauma system T ¥ Coats, C F C Kirk, M Dawson Early prediction of neurological outcome after falls in children: metabolic and clinical markers G Paret, R Tirosh, D Lotan, M Stein, R Ben-Abraham, A Vardi, R Harel, Z Barzilay 189 Injury surveillance in a children’s hospital—overcoming obstacles to data collection N V Doraiswamy 194 Analysis of illicit ecstasy tablets: implications for clinical management in the accident and emergency department K Sherlock, K Wolff, A W M Hay, M Conner 198 Open water scuba diving accidents at Leicester: five years’ experience A ¥ Hart, S A White, P F Conboy, G Bodiwala, D Quinton ECG interpretation for the emergency department 201 Clinical ECG interpretation—an introduction 7 Wardrope 202 The additional lead electrocardiogram in acute myocardial infarction W ¥ Brady, F Morris Clinical management 208 Clearing the cervical spine of adult victims of trauma M F Clancy Best evidence topic reports Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary Edited by K Mackway-Fones Treatment of ruptured Achilles tendon T Gilpin, S Southworth Treating avulsion fractures of the base of the fifth metatarsal B Martin, K Mackway-Jones Magnetic resonance imaging in acute knee haemarthrosis A Mukerjee, K Mackway-Fones Mobilisation of lateral ligament ankle sprains G Higgins, B Martin Journal scan ~bNHNN~oYDwD) — _ ‘ nonO Journal scan Edited by ¥ Wardrope; this scan coordinated by K Lendrum Management issues bdob do eo Organising a medical conference ¥ Wyatt Case reports Abdominal pain as an atypical presentation of meningococcaemia A P Winrow dbdN a~o)I Hyponatraemic convulsion secondary to desmopressin treatment for primary enuresis D C Apakama, A Bleetman Hyperkalaemic paralysis—a bizarre presentation of renal failure G L A Cumberbatch, T ¥ Hampton bo An unusual case of urinary retention due to imperforate hymen D 7 Hail Axillary vein thrombosis mimicking muscular strain 7 Louis bbblKd OLWDe UOie Boerhaave’s syndrome presenting as tension pneumothorax W O C Onyeka, S F Booth Emergency Medicine i) OQ~ Emergency Medicine contents page Letters to the editor 238 Accident and emergency medicine or emergency medicine? C Reid, B Watts, ¥N icholas, S Slack, K Hartington, M Howell, A Okwonko, N Robinson, G L A Cumberbatch, H Simpson, A Stearman, E Ivory, D Wakely, H Vecht, S Brady 238 Accident and emergency medicine or emergency medicine? A Jones 238 Use of the Cochrane Library by emergency physicians G L A Cumberbatch, M # Clancy 238 Journal clubs G K Lloyd; Reply S D Carley 239 Securing intercostal drains A Boyle 239 Ingested coins K D Wright, D F Potts Book reviews 240 Anaesthesia and Analgesia in Emergency Medicine 240 The High Altitude Medicine Handbook 240 Books received 240 Notices 240 Correction No 4 JULY 1999 Consensus guidelines 243 Emergency medical treatment of anaphylactic reactions Project Team of the Resuscitation Council (UK) For debate Should UK emergency physicians undertake diagnostic ultrasound examinations? NA S Robinson, M F Clancy Current and future role of ultrasound in the emergency department H C Burnett, DA Nicholson Original articles Effect of closed circuit television on urban violence V Sivarajasingam, ¥P Shepherd Prospective survey to verify the Ottawa ankle rules S Perry, N Raby, P T Grant Who gives pain relief to children? R L Spedding, D Harley, F }D unn, L A McKinney dbdbNdSd Dvi OVU—aICW w Oral contraceptives and oral antibiotics: interactions and advice in an accident and emergency setting M H Mullan, A R Harris (e) Antibiotics, the pill, and pregnancy M Mastrantonio, H Minhas, A Gammon bddN 15 Questionnaire survey of interpreter use in accident and emergency departments in the UK P Leman, D # Williams ECG interpretation for the emergency department Electrocardiographic diagnosis of acute myocardial infarction in the presence of left bundle branch block W ¥ Brady, F Morris Best evidence topic reports ‘Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary Edited by K Mackway-Fones Needle aspiration or chest drain for spontaneous pneumothorax A Mukerjee, K Mackway-fones Oral or intravenous steroids in acute severe asthma M Smith, T Gilpin The role of therapeutic needle aspiration in radial head fractures S Carley, R Birkenshaw The role of diagnostic needle aspiration in olecranon bursitis V Choudhery, K Herren Journal scan Journal scan Edited by ¥ Wardrope; this scan coordinated by P Baylis Management issues Dealing with the police PA W Howarth Case reports Massive pulmonary embolus in a 14 year old boy S D Crane, D W Beverley, M 7 Williams 291 Right heart thrombus: the importance of early intervention H Cosgrove, P Hyland-McGuire Serotonin syndrome caused by overdose with paroxetine and moclobemide C R FitzSimmons, S Metha 296 A case of acute renal failure and compartment syndrome after an alcoholic binge N Sofat, S Bell, }T urner, A N Warrens D2 ERE Aortic rupture as a result of low velocity crush C Reid, S A Livesey, C V Egleston Emergency casebooks 301 An unusual case of patella dislocation S Awan, A Parfitt, P Selvuakumar, P Reid SLEEVE. 301 Massive hiatal hernia A Villa, G Ceriani, M Negrini, D Ubezio TS 302 Retroperitoneal abscess presenting with a buttock swelling and anaemia R L Spedding, IK Walsh 303 Persistent “haematoma” M Clancy, M Sampson, S Lambert Trauma care 304 Trauma care—a vision for the future J Greaves Abstracts 304 2nd Trauma Care Conference: Improving Trauma Care, Bournemouth, 7—9 June 1999 Letters to the editor 313 Identity crisis A Duby, D Sage 313 Accident and emergency medicine—the next 25 years 7B enger 315 The PEP transducer A Breakell, C Townsend-Rose 313 Protocols for deep vein thrombosis G Lloyd; Reply M Thomas 314 Empirical thrombolysis in catastrophic pulmonary embolism # Kelly 314 Activated charcoal preparations P Leman; Reply R Boyd, } Hanson Book reviews 314 Paediatric Toxicology. Handbook of Poisoning in Children 315 Clinical and Resuscitative Data. A Compendium of Acute Medical Data 315 Books received 315 Notices No 5 SEPTEMBER 1999 Original articles Using clinical indicators in emergency medicine: documenting performance improvements to justify increased resource allocation J R Rogers, L Evans, G A felinek, I facobs, C Inkpen, D Mountain Consistency of retrospective triage decisions as a standardised instrument for audit S W Goodacre, M Gillett, R D Harris, K P G Houlihan Thrombolysis in acute myocardial infarction: the safety and efficiency of treatment in the accident and emergency departmen7t A Edhouse, M Sakr, ¥ Wardrope, F P Morris Suspected myocardial infarction and left bundle branch block: electrocardiographic indicators of acute ischaemia 7 A Edhouse, M Sak¥r An,gus , F P Morris Major incidents: training for on site medical personnel C A Graham, S T Hearns Study of early warning of accident and emergency departments by ambulance services 3 F Harrison, M W Cooke Validation of the Ottawa ankle rules in children C Libetta, D Burke, P Brennan, 7 Yassa Seven year follow up of children presenting to the accident and emergency department with irritable hip A Mattick, A Turner, ¥ Ferguson, T Beattie, }S harp Rollerblading and skateboarding injuries in children in northeast England J Hassan, B F Dorani ECG interpretation for the emergency department The acute myocardial infarction patient with an initially non-diagnosti¢ electrocardiogram W ¥ Brady, F Morris Clinical management Assessment, investigation, and management of acute monoarthritis S H Till, M L Snaith Best evidence topic reports 362 Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary Edited by K Mackway-Jones 362 Radiography for fish bones in the throat L Bethune, R Williams 363 Mobilisation of neck spains K Richell-Herren, R Morton 364 Oral or topical antibiotics for impetigo 7M cVicar, V Choudhery 365 Conservative or surgical management for first patellar dislocation M Thomas, P Wallman 366 Splint or plaster cylinder for first patellar dislocation M Thomas, P Wallman Journal scan Journal scan Edited by ¥ Wardrope; this scan coordinated by G L A Cumberbatch Personal view People should die at home C Reid Management issues How to conduct an appraisal of a senior house officer M # Clancy Case reports Cocaine induced myocardial infarction V A Inyang, A ¥ Cooper, D W Hodgkinson Transient quadriparesis after electric shock A Kumar, S A Sadiq Acute compartment syndrome after muscle rupture in a non-athlete A S Thennavan, L Funk, A P Volans Atraumatic bilateral Achilles tendon rupture: an association of systemic steroid treatment RA Kotnis, ¥ C Halstead, P ¥ Hormbrey Emergency casebooks 380 Diagnosis of femoral shaft fracture in pregnancy by ultrasound N A Watson, G M Ferrier 381 Plain abdominal radiography in the diagnosis of the “body packer” A Krishnan, R Brown 382 Spontaneous pneumomediastinum and ecstasy abuse G I Quin, G M McCarthy, D K Harries 382 Severe mediastinal haemorrhage after a rugby tackle C S Carr, P P Tekkis, # C Roxburgh 383 Splenic herniation causing massive haemothorax after blunt trauma 7 7 De Waele, F E G Vermassen 384 Basal skull fracture with intracranial air R S Moore 385 Posterior dislocation of sternoclavicular joint in a child S R Abdulla, S G Gandham Abstracts 386 British Association for Accident and Emergency Medicine Conference, Belfast, 13-15 April 1999 Letters to the editor 389 Best evidence topic reports: fracture of the clavicle P # Riou Best evidence topic reports: fracture of the clavicle R A Cocks 389 Best evidence topics reports: shaft of humerus fractures K S Murali; Reply K Mackway-fones 390 Management of minor head injuries by non-specialists H Pau, N Buxton 390 Visual assessment of blood loss by accident and emergency staff 7H arrison, M W Cooke 390 Transtracheal jet ventilation and the completely obstructed airway: incorporating an active expiratory phase G Kessell Treatment of scalp wounds in head injured patients requiring transfer to a neurosurgical tS unit M O Fitzpatrick, K Goyal 391 UK accident and emergency departments and emergency contraception R McGlone; Reply B A Gbolade, M Elstein, D Yates 391 Importance of histology P Gaffney, S Walsh 391 Overdose on the internet H Poncia, 7R yan 392 Excessive morphine requirements after pre-hospital nalbuphine analgesia N Robinson, N: Burrows 392 Notice 392 Correction No 6 NOVEMBER 1999 Review 395 Use of human patient simulation to teach emergency medicine trainees advanced airway skills C Ellis, G Hughes TOXBASE 399 TOXBASE on the internet A M Good, D N Bateman Original articles n 400 Markers for domestic violence in women R L Spedding, M McWilliams, B P McNicholl, C H Dearden 403 Emergency cranial computed tomography in the management of acute febrile encephalopathy in children S Nadel, R FJoarder, M Gibson, # Stevens, ¥ Britto, P Habibi, C Owens 407 Thrombolysis in acute myocardial infarction: analysis of studies comparing accelerated t-PA and streptokinase B ¥ Smith Candidates for thrombolytic treatment in acute ischaemic stroke—where are our patients | in Hong Kong? YC A Siu, TW Wong ,C C Lau Body piercing in the accident and emergency department Rakesh Khanna, S Sathish Kumar, B Srinivasa Raju, A V Kumar tN Cervicocerebral artery dissections H A Ahmad, R P Gerraty, SM Davis, P A Cameron resbb dd WI Characteristics of attenders and their attendances at an urban accident and emergency department over a one year period A W Murphy, C Leonard, P K Plunkett, H Brazier, R Conroy, F Lynam, G Bury 428 Epidemiological and clinical differences of snake bites among children and adults in south western Saudi Arabia N Al Harbi Short report 431 Palmar dislocation of the proximal interphalangeal joint—an injury not to be missed P P Tekkis, N Kessarits, M Enchill-Yawson, G V Mani, M Gavalas ECG interpretation for the emergency department 433 Electrocardiographic ST segment elevation in adults with chest pain W ¥ Brady, F Morris Clinical management it 440 Suspected deep vein thrombosis: a management algorithm for the accident and emergency department S Nawaz, P Chan, S Ireland Best evidence topic reports 443 Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary Edited by K Mackway-Jones les 443 Nebulised ipratropium bromide and bronchiolitis M Smith, M Al Zarad 444 Gag reflex and intubation K Mackway-Jones, C Moulton 445 Bell’s palsy and prednisolone 7 Desmond, P Wallman 446 Glue or sutures for facial lacerations in children S Carley, M Al Zarad Journal scan Journal scan Edited by ¥#W ardrope; this scan coordinated by L Walker Case reports 451 Use of autologous transfusion in the management of acute traumatic haemothorax in the accident and emergency department A McGhee, S Swinton, M Watt 453 Phytophotodermatitis associated with parsnip picking L Lutchman, V Inyang, D Hodgkinson Emergency casebooks 454 Shock and ipsilateral pulmonary oedema after tube thoracostomy for spontaneous pneumothorax A V Desai, P R Phipps, D ¥ Barnes 455 Trauma to a horseshoe kidney A Daudia, T B Hassan, D Ramsay 456 Intra-orbital foreign body: an unusual route of entry S B Thakore, U Guly ‘ive Just a pulled hamstring? A P Mattick, T F Beattie, M F Macnicol 458 Eye muscle paralysis after Vipera aspis envenomation G Re, G Trisolino, F Miglio Rupture of tibialis anterior associated with a closed midshaft tibial fracture R Din, L Therkilsden Bilateral atraumatic dislocation of the shoulder R Mihai, ¥H Dixon Letters to the editor General Medical Council registration M F facobs, P M Reid, P D Kelly Carbon monoxide poisoning and hyperbaric oxygen R Thomas; Reply M Turner et al Pre-hospital nalbuphine analgesia A G Jones; Reply K P Houlthan et al Securing intercostal drains 7 7M Black Ectopic pregnancy S S Ahmad, K Chumbley, D Hulbert Foreign body in the throat H # B Gonsalves Is this a record? Six years in “Paris” M R Martin, P Hardwick, A Killick Book reviews The Midnight Meal and Other Essays About Doctors, Patients, and Medicine Oxford Handbook of Accident & Emergency Medicine Minor Injuries Unit Handbook Life in the Balance: Emergency Medicine and the Quest to Reverse Sudden Death Management of Acute and Chronic Pain Cardiac Emergencies: A Pocket Guide Emergency Medicine: The Core Curriculum Emergency Medicine contents pages Index Contents