- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note In NY and NJ, anyone is able to walk into a retail pharmacy and obtain naloxone without a prescription, but it appears that not all retail stores stock this life-saving drug. The following paper surveyed all retain pharmacies within 10 NJ cities to assess their availability of naloxone. They then looked …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Update November 2018 The following study looks to see if targeted temperature management (therapeutic hypothermia) improved hospital survival from presumed overdose related cardiac arrest. Their secondary endpoint was neurological recovery. Although the study of 121 patients found improvement in survival, there was no statistical significant improvement in neurological recovery. This goes against the belief …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note Here is a fascinating case of a 17 year old male who intentionally ingested 800 tabs of diphenhydramine and developed cardiovascular collapse. ECMO was initiated and he ultimately survived without neurologic deficits. Also interesting is that he had a biphasic clinical course, with an initial improvement but then a critical decline. …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note Ketamine for everyone, when used with Ativan Severe alcohol withdrawal can be complex and difficult to treat, especially when the patient is resistant to BZD. The follow study looks at the use of ketamine as an adjunct to lorazepam for patients admitted to the ICU for ETOH withdrawal. As ketamine is …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note The study of toxicology includes occupational and environmental health issues. Although possibly not as relevant to emergency medicine, the health effects from microplastics are something that every physician should be aware of. This short editorial defines microplastics and their effect of our marine life, with some questions on how this could …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note This letter to the editor describes an experience with a false positive phencyclidine (PCP) screen caused by metronidazole. Although we do not have PCP screens on our UDS at SBH, it is important to recall that the UDS is a screen with many false positives and negatives. The UDS also cannot …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note See references at the end of post Hydrogen sulfide is a toxin often associated with sewers (smells like rotten eggs) and leads to death rapidly. There is concern that it could be used as a weapon, and unfortunately there is no antidote. This proof of concept study looks at the use …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note This study, performed on swine, looked on the decrease in half-life of CO with different oxygen delivery techniques. They compared non-rebreathing masks, to CPAP and two pressure support ventilation devices. They found that one pressure support device, the PSV-Leg can be more efficient than NRB in eliminating CO. Further studies will …
- Written by Ethan Abbott
SBH Department of Toxicology cases and news
Toxicology Literature of Note This Canadian study looks at 6455 treatment courses with NAC and the incidence of anaphylactoid reactions. 8.2% experienced a reaction, where 75.4% were cutaneous and treated with antihistamines. Over 50% of courses were stopped before the 21 hour completion. Although not a safety study, this paper does highlight that NAC is …