Presented by Dr WONG Kin Wa at the daily Journal Club of ICU, PYNEH, Hong Kong, on 20 May 2009.
In the article "Joseph Lester MMS, MD, Steve Christos DO, MS. Terrorism: can emergency medicine physicians identify terrorism syndromes? American Journal of Emergency Medicine (2007) 25, 1019– 1024" in 36 EM attending physicians and EM residents, which of the following is incorrect?
A. Among the 17 agents asked, less than 47% (46.8%) of the biologic agent questions were answered correctly, whereas only 32.6% of the chemical agent questions were answered correctly.
B. The highest percentages of correct answers were on anthrax and smallpox.
C. Chorine is associated with delayed onset of non-cardiogenic pulmonary edema after 6 hours, while phosgene is of immediate onset.
D. Tularemia is associated with tender cervical lymphadenopathy, bradycardia and fever.
Answer: C
The reverse is correct; chlorine is associated with immediate onset, and phosgene delayed onset (after 6 hours), noncardiogenic pulmonary edema.
Editor’s impression
This article (available from eKG, HA Intranet) contains 17 very nice scenarios with pictures and multiple choice questions.
The picture shows an anthrax eschar.