Hong Kong Journal of Emergency Medicine

To identify the roles of follow-up clinic (FUC) of emergency departments (ED), which is unique of the western medicine of Hong Kong, a study was conducted between 1998 to 1999 to collect data on the case-mix of the FUC patients, their satisfaction with the services, the waiting period of the specialist out-patient department (SOPD) and the functions of the FUC as viewed by the Emergency Physicians in the ED of Tuen Mun Hospital. One hundred and fifty-eight patients were surveyed. The majority was of musculoskeletal trauma. Most were satisfied with the services. The waiting period of the SOPD was in terms of month. The respondent doctors considered the functions of the FUC were to fill in the gaps bridging the specialist and primary health care as well as to provide training for the physicians for medium-term after-care.

This is a survey on the knowledge and beliefs of 100 parents or guardians of asthmatic children presenting to the emergency department with an asthmatic attack and staying in the observation ward for treatment. The parents were asked to fill in a questionnaire on their knowledge and beliefs about asthma. Demographic data and data related to routine asthma care were also collected. The mean age of the children was 6.2± 3.2. The mean duration of asthma was 3.4 year (±2.6). In the preceding 6 months the mean attendance frequency at our accident and Energency department was 1.5±1.4. The majority of respondent (79%) agreed that asthma is caused by bronchoconstriction but only 42% understood that mucosal oedema is involved during an acute attack. Many people (82%) believed that asthma is just sensitive bronchus. Less than half (40%) believes asthma is a hereditary disease. It was a common belief that asthmatic attack can be precipitated by a change of weather (89%) and cold food/drink (77%). Over 75% agreed that carpet in the house is undesirable for an asthmatic child. The majority of parents (69%) disagreed that an asthmatic child should avoid physical exercise and only 13 would not allow the child to attend physical exercise class. Over half (54%) of the respondents believed that asthma could be cured. Only a minority (17%) believed that antibiotics are useful in shortening the attack. Thirty (30%) respondents also used alternative means of therapy for example crocodile meat. Parents' knowledge of preventive medication was inadequate. Understanding common beliefs among parents is beneficial in patient and parental education.

Dologesic is a commonly prescribed analgesic in accident and emergency department. Yet report of overdose with this drug is not common. We report a case in which the patient developed cardiac arrest within an hour of ingestion. Dextropropoxyphene, a component of the drug Dologesic, used to be a common cause of fatalities after drug overdose in the seventies. It is highly toxic in overdose and therefore caution should be exercised when prescribing this drug.

Head and neck injuries are very common in Hong Kong, especially resulting from assaulted or traffic accidents. Delayed manifestation of post-traumatic carotid thrombo-embolism and aneurismal formation are known pitfalls that emergency physicians and neurosurgeons may encounter. We present a patient with blunt neck injury with the complication of traumatic dissection of the extracranial internal carotid artery.

Difficult airway is a challenging emergency problem for emergency physicians. We reported a patient with partial upper airway obstruction managed by percutaneous transtracheal jet ventilation (PTJV) before definite airway was secured. The development, the set up, the advantages, and the precautions of using PTJV are briefly described.

Recent international situation has brought our attention back to the imminent threat of biological weapon. Contrary to other weapons of mass destruction, biological warfare is relatively silent and invisible. This review will examine the history and characteristic of biological warfare. Several biological agents like Anthrax, Plaque, Smallpox, Tularemia and Viral Haemorrhagic Fever will be discussed in details.

The attendance of Accident & Emergency (A&E) departments in Hong Kong increased from 1.1 million in 1990 to 2.3 million in 2000. The statistics of Hospital Authority showed that about 75% of the attendance belonged to the semi-urgent or non-urgent cases. It is expected that the A&E attendance will drop after implementation of A&E charges. A cross-sectional study was done using the database of a typical medium size A&E department in Hong Kong to analyse this impact. The result of statistical analysis showed that there would be about 30% drop in A&E attendance. Other factors, however could affect the results and these were discussed. After adjustment, it was concluded that there would be about 20% drop in attendance after the implementation of A&E charges.