management

Rhabdomyolysis: an overview for pre-hospital clinicians

Rhabdomyolysis is a syndrome that is characterised by the destruction of striated (skeletal) muscle leading to the release of cellular contents into the circulating blood plasma (Vanholder et al,...

Single-dose activated charcoal as a pre-hospital treatment for self-poisoning

A search strategy was undertaken of medical and nursing databases including Medline, Cinahl, Embase, Psychinfo, the Cochrane database of systematic reviews, together with the British Medical Journal...

Diabetes mellitus: balancing blood glucose

Body cells need energy to function; glucose (sugar obtained from digestion and metabolism of carbohydrates) is the body's main energy source. The glucose in digested food is absorbed in the small...

Management of patients following cold water immersion

Golden and Hervey's four stage theory (Golden and Hervey, 1981) begins during immediate contact with the water. On initial immersion, an autonomic reflex is triggered involving uncontrollable...

Investigating gout: taking a new approach to an old disease

While gout is becoming an increasingly prevalent condition, it has its background many thousands of years ago. The Egyptians first identified gout in 2 640 BC, and in the fifth century, Hippocrates...

Understanding the process and treatment of meningitis and meningococcal disease

A large variety of organisms, such as meningococci, pneumococci and influenza type b, normally inhabit the naso- and oropharnyx, causing relatively no harm in a healthy individual. Predisposing...

Understanding the correct assessment and management of lightning injuries

A lightning strike injures patients in three main ways: electrical current, heat production and concussive forces (Table 2)..

How diabetes affects the body: outlining acute and chronic complications

Before 1922, and the work of Nobel Prize winning Canadian medics Dr Frederick Banting and Charles Best (still a medical student at the time), developing diabetes in childhood was akin to a death...

Sticking the knife in: Time to review management of tension pneumothorax

Tension pneumothorax is a build up of air between the lung and the pleura lining the chest wall. It occurs when a defect in the lung, chest wall or airways operates as a one-way valve, allowing air...

Ischaemic strokes and treatment with thrombolysis: The key lies with paramedics

In the case of an embolic cause, which creates an ischaemic stroke, alteplase (Actilyse® manufactured by Boehringen Ingelheim) can be used—this is a drug developed to break down clots. Although...

Pre-hospital coronary heart disease: Analysing performance indicators

Ischemic heart disease is a condition characterised by inadequate myocardial perfusion caused by reduced blood supply, increased myocardial oxygen demand, or both (Falk et al. 2011). Coronary heart...