Pericarditis is an inflammation of the two layers of pericardium, the thin, sac-like membrane that surrounds the heart. Its causes are thought to be viral, fungal or bacterial. Pericarditis may also present as a result of a myocardial infarction. Its signs and symptoms include chest pain, which may radiate to the arm and jaw and pericardial friction rub (a scratching or creaking sound produced by the layers of the pericardium rubbing over each other) on auscultation of heart sounds. The diagnosis of straightforward pericarditis may be within the scope of practice of the emergency care practitioner. It should be possible for an emergency care practitioner to reach a working diagnosis and to initiate a treatment regimen, which would predominantly consist of providing analgesia to make the patient more comfortable.
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About Journal of Paramedic Practice
Journal of Paramedic Practice (JPP) is the only monthly peer-reviewed journal dedicated to the clinical and professional needs of paramedics. It is a vital resource for helping paramedics enhance their professional knowledge and stay ahead of all their continuing professional development (CPD) requirements.
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2,4-Dinitrophenol (DNP) is an industrial chemical. It is illegal to sell it for human consumption in countries including the UK and the US. However, as DNP is available illegally online, accidental or deliberate DNP poisoning may be seen in people using it for weight loss or bodybuilding. Aggressive, multidisciplinary medical management is required to manage the ensuing hyperthermia, respiratory failure, cardiovascular collapse and multi-organ failure; there is a high risk of cardiac arrest. Emergency services should be vigilant in both initiating prompt treatment and alerting the receiving emergency department as well as taking precautions to minimise their own exposure. This case report concerns a deliberate, fatal DNP poisoning and considers DNP's history, resurgence and toxicity management.
Acute cough is one of the most common illnesses in the UK, with an estimated 48 million cases per annum. The majority of these presentations are thought to be of viral aetiology and self-limiting in nature, yet some studies report antibiotic prescription rates of approximately 65% in the UK. Clincians' decision-making process can be influenced by both patient expectations and difficulty in differentiating between viral and bacterial aetiologies by clinical examination alone. This article will consider the feasibility, efficacy, benefits and limitations of using point-of-care testing of C-reactive protein within primary care in the United Kingdom to help inform management of acute cough.
The provision of multimodal analgesia is a core concept in the management of acute and chronic pain. In the prehospital setting, non-steroidal anti-inflammatory drugs (NSAIDs) can be used alongside paracetamol and opioids to provide such analgesia. Ketorolac is an NSAID which can be administered by injection and is used internationally in civilian and military prehospital care. This CPD article discusses Ketorolac as an analgesic option for paramedics.
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