Use of a screwdriver in the emergency department

Abstract

concluded cyclizine may be useful if avoidance or prompt reversal of the hypotensive effect of opiate is required. 3 It is also relevant to observe that no data were given for simultaneous administration of cyclizine with opiate, because cyclizine is usually administered simultaneously with opiate, considerable caution is required if the conclusions of this study are to be translated into advice about clinical care. The clinical bottom line begs the question ''if not cyclizine, what should I use?'' We repeated their search strategy but replaced the ''cyclizine'' with ''metoclopramide'' or ''stemetil/prochlorperazine'', revealing no studies of the effects of these two commonly used drugs. A Cochrane study is being undertaken to review other anti-emetics, 4 we suggest that a more appropriate conclusion would be ''There is the possibility of adverse haemodynamic effects of cyclizine in patients with heart failure, and of beneficial effects in patients with opiate induced hypotension; the effects of other known anti-emetics are unknown.''

Management of unusual case of self-inflicted penetrating craniocerebral injury by a nail

“…We are reporting such a case due to its rarity in clinical practice. Till now, only few cases of penetrating brain injury (PBI) by screwdriver have been described,[ 6 – 8 ] in which four cases were homicidal and in two cases accidental. In these six patients, only one patient who got accidental injury survived.…”