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To the editor:
In the September FP Report, the article "Common Office Emergencies May Demand Creativity" shows an ammonia inhalant ("smelling salts") being used as a treatment for fainting. Patients who feel faint are almost always having a vasovagal reaction, with cerebral hypoperfusion caused by vagal-mediated bradycardia and hypotension. The proper treatment is to lay the patient down or place them in Trendelenburg position, possibly administering atropine in severe cases.
Wafting a poisonous gas under a fainting patient's nose does nothing to reverse the underlying pathophysiology and is dangerous. If the patient has asthma, severe bronchospasm may result, worsening the situation. Ammonia in the eye can cause severe corneal injury. On the skin, ammonia can cause an alkali burn.
Canadian health authorities have stopped the sale of ammonia inhalants, and I urge all family physicians to rid their offices of these inhalants. The ampules and pads should be removed from first-aid kits and should not be used by paramedics or hospital personnel. I further urge the FDA to follow Canada's lead and stop the sale of these inhalants in the United States.
Ronald Reynolds, M.D.
New Richmond, Ohio
To the editor:
I thoroughly enjoyed reading your article in the August issue of FP Report about Dr. (Susan) Andrews' paperless office ("EHR Improves Work Flow, Patient Care"). I would go one step further and invite you to visit my office in Pennington Gap, Va. Like Dr. Andrews, I utilize an electronic medical records system; however, my setup differs somewhat from hers. I use a tablet PC for my interactions with my patients. Our patients love the system and the care they get.
I am hoping through this article, and hopefully others to come, that my physician colleagues will see the true benefits of utilizing an EMR for their practices. I suppose I am selfish in asking for that, but it sure would be nice to receive old records from another physician in a "legible" or typewritten format.
My hat is off to the AAFP for promoting something that President Bush is trying to put into action.
Scott Litton Jr., M.D.
Pennington Gap, Va.
FP Report is
published by the AAFP News Department.
Copyright © 2004 by American Academy of Family Physicians.