• Bacteraemia in the ED: Are We Meeting Targets?

      Borhan, N; Borhan, F; Ni Cheallaigh, C; Dinesh, B; O’Reilly, K; Moughty, A (Irish Medical Journal, 2018-03)
      When sepsis is identified early in the Emergency Department (ED) and its severe form is treated aggressively with the protocolised care bundle of early goal directed therapy (EGDT), improvements in mortality are significant1,2. Surviving sepsis guidelines recommend the administration of effective intravenous antimicrobials within the first hour of recognition of septic shock and severe sepsis without septic shock3. The Mater University Hospital has antimicrobial guidelines to guide empiric prescribing in adult sepsis available on the hospital intranet and on a smartphone app.
    • Multidisciplinary emergent removal of a metal penoscrotal constriction device

      Nason, GJ; Abdelsadek, AH; Foran, AT; O’Malley, KJ (Irish Medical Journal, 2017-03)
      Strangulation of the genital organs is a rare presentation to the emergency department which requires urgent intervention to avoid long term complications. Penoscrotal constriction devices are either used for autoerotic stimulus or to increase sexual performance by maintaining an erection for a longer period. We report a case of a man who presented with penile strangulation following the application of a titanium penoscrotal constriction ring during sexual intercourse seven hours previously. The Fire Brigade department attended with an electric operated angle grinder to facilitate removal of the ring as standard medical equipment (orthopaedic saws, bolt and bone cutters) were insufficient. Fully functional recovery was achieved.
    • Superior Vena Cava Obstruction (SCVO)

      Murphy, D; Murphy, D; Murray, J; Gaine, S (Irish Medical Journal (IMJ), 2014-02)
      A 68 year-old man was referred to the Emergency Department by his General Practitioner with a two week history of dyspnoea preceded by a two month history of weight loss. He also described recent onset of facial and neck swelling. He had a 40 pack-year smoking history, peripheral vascular disease and angina pectoris. Surgical history included a subtotal gastrectomy performed fifteen years previously for benign disease.