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https://www.readbyqxmd.com/read/28500785/don-t-label-me-a-qualitative-study-of-patients-perceptions-and-experiences-of-sedation-during-behavioral-emergency-in-the-emergency-department
#1
Celene Y L Yap, Jonathan C Knott, David C M Kong, Marie Gerdtz, Kay Stewart, David McD Taylor
OBJECTIVES: Behavioral emergencies are commonly seen in emergency departments. Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and staff. While the experience of staff caring for this population has been reported, patients' experiences with their overall management remains unknown. We aimed to describe the perceptions and experiences of patients regarding the use of sedation during acute behavioral emergencies...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28471280/bad-trip-due-to-25i-nbome-a-case-report-from-the-eu-project-spice-ii-plus
#2
Maren Hermanns-Clausen, Verena Angerer, Josephine Kithinji, Christina Grumann, Volker Auwärter
OBJECTIVE: The potent hallucinogenic drug 25I-NBOMe has recently emerged on the drug market. We present a case with analytically confirmed 25I-NBOMe intoxication from the prospective study "SPICE II Plus". CASE REPORT: Because of a severe headache a 42-year-old man took one sip of a pediatric analgesic syrup, which had been refilled with a self-made solution of 25I-NBOMe in ethanol. Thirty minutes later restlessness occurred. On arrival in the emergency department mydriasis, strong sweating, disorientation, and agitation were noticed...
May 4, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28457767/clinical-and-financial-implications-of-emergency-department-visits-for-synthetic-marijuana
#3
Eric Rowley, David Benson, Aaron Tiffee, Adam Hockensmith, Henry Zeng, Glenn N Jones, Mandi W Musso
BACKGROUND: Many users believe that synthetic cannabinoids offer a safe and legal means of getting high. However, spikes in emergency department visits have been associated with use of synthetic cannabinoids. The purpose of the current study was to document emergency department visits from three large hospitals in one metropolitan area over a two month period. METHOD: This was a retrospective chart review examining 218 patients presenting to three inner city emergency departments between March and April 2014...
April 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28421836/analytical-confirmation-of-synthetic-cannabinoids-in-a-cohort-of-179-presentations-with-acute-recreational-drug-toxicity-to-an-emergency-department-in-london-uk-in-the-first-half-of-2015
#4
Rachelle Abouchedid, Simon Hudson, Natalie Thurtle, Takahiro Yamamoto, James H Ho, George Bailey, Michelle Wood, Nele Sadones, Christophe P Stove, Alison Dines, John R H Archer, David M Wood, Paul I Dargan
CONTEXT: Synthetic cannabinoid receptor agonists are the largest group of new psychoactive substances reported in the last decade; in this study we investigated how commonly these drugs are found in patients presenting to the Emergency Department with acute recreational drug toxicity. METHODS: We conducted an observational cohort study enrolling consecutive adult patients presenting to an Emergency Department (ED) in London (UK) January-July 2015 (6 months) with acute recreational drug toxicity...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28399647/%C3%AE-blockers-cocaine-and-the-unopposed-%C3%AE-stimulation-phenomenon
#5
John R Richards, Judd E Hollander, Edward A Ramoska, Fareed N Fareed, I Charles Sand, María Manuela Izquierdo Gómez, Richard A Lange
Cocaine abuse remains a significant worldwide health problem. Patients with cardiovascular toxicity from cocaine abuse frequently present to the emergency department for treatment. These patients may be tachycardic, hypertensive, agitated, and have chest pain. Several pharmacological options exist for treatment of cocaine-induced cardiovascular toxicity. For the past 3 decades, the phenomenon of unopposed α-stimulation after β-blocker use in cocaine-positive patients has been cited as an absolute contraindication, despite limited and inconsistent clinical evidence...
May 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28397128/characteristics-and-treatment-of-patients-with-clinical-illness-due-to-synthetic-cannabinoid-inhalation-reported-by-medical-toxicologists-a-toxic-database-study
#6
Andrew A Monte, Diane P Calello, Roy R Gerona, Eike Hamad, Sharan L Campleman, Jeffery Brent, Paul Wax, Robert G Carlson
INTRODUCTION: Synthetic cannabinoid (SC) abuse has resulted in numerous outbreaks of severe clinical illness across the United States over the past decade. The primary objective of this study was to determine the clinical characteristics of patients abusing SC requiring bedside consultation by medical toxicologists. METHODS: This was a multicenter analysis from a prospectively collected cohort of patients presenting to medical care after synthetic cannabinoid exposure, utilizing the ToxIC Registry...
April 10, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28393558/supraventricular-tachycardia-and-acute-confusion-following-ingestion-of-e-cigarette-fluid-containing-ab-fubinaca-and-adb-fubinaca-a-case-report-with-quantitative-analysis-of-serum-drug-concentrations
#7
Rex Pui Kin Lam, Magdalene Huen Yin Tang, Siu Chung Leung, Yeow Kuan Chong, Matthew Sik Hon Tsui, Tony Wing Lai Mak
BACKGROUND: AB-FUBINACA and ADB-FUBINACA are structurally similar synthetic cannabinoids with potent CB1 receptor agonistic effects. Very little is known about their pharmacology and toxicology. OBJECTIVE: To report a case of supraventricular tachycardia and acute confusion after ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA, with quantitative analysis of the serum drug concentrations. CASE REPORT: A healthy 24-year-old man ingested two drops of e-cigarette fluid which were later found to contain AB-FUBINACA and ADB-FUBINACA...
April 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28357892/suspected-synthetic-cannabinomimetic-intoxication
#8
Regan A Baum, Abby Bailey, Ryan Chan, Karen Blumenschein
PURPOSE: The purpose of this work was to retrospectively review patient cases presenting to the University of Kentucky Chandler Medical Center (UKCMC) emergency department (ED) with symptoms of suspected synthetic cannabinomimetic (SC) intoxication. These drugs, currently undetected by standard urine drug screen tests, comprise a structurally diverse group of compounds designed to mimic the psychoactive effects of Δ(9)-tetrahydrocannabinol (Δ(9)-THC), the primary psychoactive cannabinoid in marijuana...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28286819/pain-management-via-ultrasound-guided-nerve-block-in-emergency-department-a-case-series-study
#9
Amir Nejati, Houman Teymourian, Leili Behrooz, Gholamreza Mohseni
INTRODUCTION: Pain is the most common complaint of patients referring to emergency department (ED). Considering the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of ultrasound-guided nerve blocks in this setting. METHODS: 46 patients who came to the ED with injured extremities were enrolled in the study and received either femoral, axillary or sciatic nerve block depending on their site of injury (1.5 mg Bupivacaine per kg of patient's weight)...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28283340/a-prospective-randomized-double-dummy-trial-comparing-intravenous-push-dose-of-low-dose-ketamine-to-short-infusion-of-low-dose-ketamine-for-treatment-of-moderate-to-severe-pain-in-the-emergency-department
#10
Sergey Motov, Mo Mai, Illya Pushkar, Antonios Likourezos, Jefferson Drapkin, Matthew Yasavolian, Jason Brady, Peter Homel, Christian Fromm
STUDY OBJECTIVE: Compare adverse effects and analgesic efficacy of low-dose ketamine for acute pain in the ED administered either by single intravenous push (IVP) or short infusion (SI). METHODS: Patients 18-65, presenting to ED with acute abdominal, flank, or musculoskeletal pain with initial pain score≥5, were randomized to ketamine 0.3mg/kg by either IVP or SI with placebo double-dummy. Adverse effects were evaluated by Side Effects Rating Scale for Dissociative Anesthetics (SERSDA) and Richmond Agitation-Sedation Scale (RASS) at 5, 15, 30, 60, 90, and 120min post-administration; analgesic efficacy was evaluated by Numerical Rating Scale (NRS)...
March 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28264690/presentations-to-an-urban-emergency-department-in-bern-switzerland-associated-with-acute-recreational-drug-toxicity
#11
Evangelia Liakoni, Sabine Müller, Adrian Stoller, Meret Ricklin, Matthias E Liechti, Aristomenis K Exadaktylos
BACKGROUND: Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. METHODS: Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#12
Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
March 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28243098/delirium-after-a-traumatic-brain-injury-predictors-and-symptom-patterns
#13
Jutaporn Maneewong, Benchalak Maneeton, Narong Maneeton, Tanat Vaniyapong, Patrinee Traisathit, Natthanidnan Sricharoen, Manit Srisurapanont
BACKGROUND: Delirium in traumatic brain injury (TBI) is common, may be predictable, and has a multifaceted symptom complex. This study aimed to examine: 1) the sum score of Glasgow Coma Scale (GCS) and if its component scores could predict delirium in TBI patients, and 2) the prominent symptoms and their courses over the first days after TBI. METHODS: TBI patients were recruited from neurosurgical ward inpatients. All participants were hospitalized within 24 hours after their TBI...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28242149/-hallucinations-etiological-analysis-of-children-admitted-to-a-pediatric-emergency-department
#14
D Vareilles, C Bréhin, C Cortey, A-L Chevrin, T Hamon, M Vignes, Y Chaix, I Claudet
Children's hallucinations pose the dual challenge of diagnosing a possible medical emergency and a possible psychiatric disorder. PURPOSE: The main objective was to analyze the causes of such hallucinations in children presenting to a pediatric emergency department. MATERIAL AND METHODS: We conducted a single-center, observational, retrospective study including all children aged less than 15 years experiencing hallucinations and admitted to our tertiary level pediatric emergency department between 1 January 2007 and 31 December 2015...
May 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28238395/profound-hypotension-and-bradycardia-in-the-setting-of-synthetic-cannabinoid-intoxication-a-case-series
#15
David O Andonian, Shauna R Seaman, Elaine B Josephson
Cannabinoids are the most commonly used illegal substances in the world [1]. Synthetic Cannabinoids (SCB) are also known as "Spice", "K2", "Spike", "herbal incense", "Cloud 9", "Mojo" and many others are becoming a large public health concern due to their increasing use, unpredictable toxicity, and abuse potential [2]. The most common reported toxicities with SCB use based on studies using Texas Poison control record are tachycardia, agitation and irritability, drowsiness, hallucinations, delusions, hypertension, nausea, confusion, dizziness, vertigo, chest pain, acute kidney injury, seizures, heart attacks and both ischemic and hemorrhagic strokes [3]...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28237385/ketamine-as-a-first-line-treatment-for-severely-agitated-emergency-department-patients
#16
Jeff Riddell, Alexander Tran, Rimon Bengiamin, Gregory W Hendey, Patil Armenian
OBJECTIVE: Emergency physicians often need to control agitated patients who present a danger to themselves and hospital personnel. Commonly used medications have limitations. Our primary objective was to compare the time to a defined reduction in agitation scores for ketamine versus benzodiazepines and haloperidol, alone or in combination. Our secondary objectives were to compare rates of medication redosing, vital sign changes, and adverse events in the different treatment groups. METHODS: We conducted a single-center, prospective, observational study examining agitation levels in acutely agitated emergency department patients between the ages of 18 and 65 who required sedation medication for acute agitation...
February 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28205446/intramuscular-ziprasidone-dosing-for-acute-agitation-in-the-pediatric-emergency-department
#17
Tammy Nguyen, Jillian Stanton, Robin Foster
BACKGROUND: Intramuscular (IM) ziprasidone is often used to manage acute agitation. Limited data exist on the pediatric dosing of ziprasidone in the emergency department (ED). OBJECTIVE: To characterize the mg/kg dosing differences between pediatric ED patients who respond to an initial dose of ziprasidone versus patients who do not. METHODS: This was a retrospective, observational study of 5- to 18-year-old patients who were treated with IM ziprasidone in the pediatric ED from 2007 to 2015...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28160494/intravenous-midazolam-droperidol-combination-droperidol-or-olanzapine-monotherapy-for-methamphetamine-related-acute-agitation-subgroup-analysis-of-a-randomized-controlled-trial
#18
Celene Y L Yap, David McD Taylor, Jonathan C Knott, Simone E Taylor, Georgina A Phillips, Jonathan Karro, Esther W Chan, David C M Kong, David J Castle
AIM: To examine the efficacy and safety of (1) midazolam-droperidol versus droperidol and (2) midazolam-droperidol versus olanzapine for methamphetamine-related acute agitation. DESIGN AND SETTING: A multi-centre, randomized, double-blind, controlled, clinical trial was conducted in two Australian emergency departments, between October 2014 and September 2015. PARTICIPANTS: Three hundred and sixty-one patients, aged 18-65 years, requiring intravenous medication sedation for acute agitation, were enrolled into this study...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28152160/new-or-worsening-symptoms-and-signs-in-community-dwelling-persons-with-dementia-incidence-and-relation-to-use-of-acute-medical-services
#19
Philip D Sloane, Christopher H Schifeling, Anna S Beeber, Kimberly T Ward, David Reed, Lisa P Gwyther, Bobbi Matchar, Sheryl Zimmerman
OBJECTIVES: To understand the range of symptoms that present to family caregivers of community-dwelling persons with Alzheimer's disease and related dementias (ADRD). DESIGN: Six-month longitudinal prospective study to identify the incidence of new or worsening symptoms and their association with acute care medical service use. SETTING: Community-based sample of volunteers from multiple states. PARTICIPANTS: A total of 136 patient-caregiver dyads with a range of dementia severity...
April 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28130544/mistaking-2c-p-for-2c-b-what-a-difference-a-letter-makes
#20
Adrian Stoller, Patrick C Dolder, Michael Bodmer, Felix Hammann, Katharina M Rentsch, Aristomenis K Exadaktylos, Matthias E Liechti, Evangelia Liakoni
2,5-Dimethoxy-4(n)-propylphenethylamine (2C-P) is a synthetic phenethylamine derivative belonging to the large family of the so-called 2C drugs. These compounds can differ significantly in receptor affinity, potency and duration of action, and an important structural difference is the ligand in the 4 position of the phenyl ring, such as propyl in 2C-P or bromine in 2,5-dimethoxy-4-bromophenethylamine (2C-B). The 2C drugs are known for their hallucinogenic properties. We present a case of a 19-year-old male admitted to the emergency department with severe hallucinations, mydriasis, tachycardia, agitation and confusion following the use of a substance sold as 2C-B...
January 2017: Journal of Analytical Toxicology
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