11 th November 2015
ECG: normal sinus rhythm Raised Neutrophils (11.9 x 10 9 cells/ml) CK = 409 IU/l Normal U&Es Normal LFTs Normal Troponin I
Justice Keith, R v. Michael Brown [2013] EWCA Crim. 1726
Emerg Med J. 2014; 31: Reproduced with thanks from TICTAC, St Georges’ Hospital, London. Ketamine
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N Engl J Med. 2005;352(11):
Hyperpyrexia Kills!
+/- GI Obstruction
Urgent Surgical Removal if toxic or obstructed Body packers & body stuffers: Management
Incomplete combustion of hydrocarbons Sources Vehicle emissions Cigarette smoke Gas heaters, fires, boilers Solid fuel heaters Coal fires ConcentrationSource 0.1ppmNatural atmosphere 0.5-5ppmAverage home level 5-15ppmNear gas stoves in homes ppmExhaust fumes, Mexico City 5000 ppmExhaust home wood fire 7000ppmUndiluted car exhaust, no catalytic convertor
1921, Dr William Wilmer, American Journal Ophthalmology Couple c/o headache and fatigue, heard bells and footsteps, saw mysterious figures... Severely damaged furnace 2005, 23 year old saw “ghost in shower”... New gas water heater, improperly installed American Journal Emergency Medicine 2005; 23:
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