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https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#1
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29132953/emergency-department-visits-involving-opioid-overdoses-u-s-2010-2014
#2
Gery P Guy, Emilia Pasalic, Kun Zhang
No abstract text is available yet for this article.
November 10, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29129552/clinical-characteristics-of-suicidal-behavior-in-an-intensive-care-unit-at-a-university-hospital-in-japan-a-7-year-observational-study
#3
Takashi Takeuchi, Yasuyuki Okumura, Akihito Uezato, Toru Nishikawa
BACKGROUND: Suicidal behavior accounts for at least 40,000 admissions per year to emergency departments in Japan; however, little is known about emergency admissions owing to suicidal behavior in metropolitan areas. Therefore, we examined the clinical characteristics of suicidal behavior using psychosocial assessments performed by experienced psychiatrists in an intensive care unit. METHODS: Participants were 971 patients admitted to a university hospital's intensive care unit for suicidal behavior between July 2006 and June 2013...
November 7, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29128677/macroeconomic-conditions-and-opioid-abuse
#4
Alex Hollingsworth, Christopher J Ruhm, Kosali Simon
We examine how deaths and emergency department (ED) visits related to use of opioid analgesics (opioids) and other drugs vary with macroeconomic conditions. As the county unemployment rate increases by one percentage point, the opioid death rate per 100,000 rises by 0.19 (3.6%) and the opioid overdose ED visit rate per 100,000 increases by 0.95 (7.0%). Macroeconomic shocks also increase the overall drug death rate, but this increase is driven by rising opioid deaths. Our findings hold when performing a state-level analysis, rather than county-level; are primarily driven by adverse events among whites; and are stable across time periods...
August 23, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/29127600/a-review-of-current-and-emerging-approaches-to-pain-management-in-the-emergency-department
#5
REVIEW
Knox H Todd
INTRODUCTION: Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29123931/rapid-ascending-sensorimotor-paralysis-hearing-loss-and-fatal-arrhythmia-in-a-multimorbid-patient-due-to-an-accidental-overdose-of-fluoxetine
#6
Matthew Herrmann, Prissilla Xu, Antonio Liu
Background: Common side effects of selective serotonin reuptake inhibitors (SSRIs) include tachycardia, drowsiness, tremor, nausea, and vomiting. Although SSRIs have less toxic side effects compared to more traditional antidepressants, serious and life threatening cases of SSRI overdose have been reported. We describe a 24-year-old multimorbid female who presented to the emergency department with rapid onset ascending sensorimotor paralysis, complicated by respiratory and cardiac arrest, found to have fatal levels of fluoxetine by toxicological analysis, not taken in a suicidal act...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29121560/evaluation-of-attempted-older-adults-suicides-admitted-to-a-university-hospital-emergency-department-izmir-study
#7
Duygu Keskin Gokcelli, Pınar Tosun Tasar, Nur Ozge Akcam, Sevnaz Sahin, Funda Karbek Akarca, Ekin Ozgur Aktas, Soner Duman, Fehmi Akcicek, Aysin Noyan
INTRODUCTION: Advanced age is one of the risk factors for attempting suicide. Suicide attempts are one of the reasons for elderly patients to admit emergency services. The aim of this study was to investigate the relationship between suicidal behavior and sociodemographic factors and concurrent somatic diseases. METHODS: The medical records of patients aged 60 years and over who presented to the emergency department of our university hospital for attempted suicide between the dates of January 1, 2007 and December 31, 2015 were screened retrospectively...
October 16, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29118840/too-many-pills-to-swallow-a-case-of-a-mixed-overdose
#8
Louise Emily Hopkins, Jonathan Sunkersing, Andrew Jacques
Propranolol is a highly lipid-soluble beta-receptor antagonist. We describe a case of mixed overdose, including propranolol, amlodipine and olanzapine, resulting in severe resistant hypotension which was successfully treated. A 21-year-old student ingested 6.4 g of propranolol, 280 mg of amlodipine and 560 mg of olanzapine. The patient was brought to the emergency department and exhibited signs of severe systemic toxicity - profound hypotension and circulatory collapse, respiratory depression and coma...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29113574/a-novel-sexual-health-referral-pathway-for-patients-presenting-to-the-emergency-department-with-gamma-hydroxybutyrate-or-gamma-butyrolactone-overdose
#9
A Hegazi, S Morton, M Pakianathan, C Cosgrove, R Aroney, E Dore, M Hempling
No abstract text is available yet for this article.
December 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/29107318/a-quality-improvement-project-to-improve-education-provided-by-nurses-to-ed-patients-prescribed-opioid-analgesics-at-discharge
#10
Daria L Waszak, Ann M Mitchell, Dianxu Ren, Laura A Fennimore
BACKGROUND: The opioid crisis continues to take an unprecedented number of lives and is the top cause of injury death in the United States. The emergency department is a setting where patients with pain seek care and may be prescribed an opioid, yet many patients do not receive evidence-based education about taking their opioid safely. Like many communities across the country, Allegheny County, Pennsylvania, has experienced an increased rate of opioid overdoses; from 2015-2016, the number of opioid-related overdose deaths in the county increased by 44%...
October 26, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29103410/acupuncture-s-role-in-solving-the-opioid-epidemic-evidence-cost-effectiveness-and-care-availability-for-acupuncture-as-a-primary-non-pharmacologic-method-for-pain-relief-and-management-white-paper-2017
#11
Arthur Yin Fan, David W Miller, Bonnie Bolash, Matthew Bauer, John McDonald, Sarah Faggert, Hongjian He, Yong Ming Li, Amy Matecki, Lindy Camardella, Mel Hopper Koppelman, Jennifer A M Stone, Lindsay Meade, John Pang
The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives...
November 2017: Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29084121/promoting-health-department-opioid-prescribing-guidelines-for-new-york-city-emergency-departments-a-qualitative-evaluation
#12
Frederick W Nagel, Jessica A Kattan, Shivani Mantha, Lewis S Nelson, Hillary V Kunins, Denise Paone
To address the epidemic of opioid misuse and overdose, the New York City Department of Health and Mental Hygiene partnered with an expert panel of emergency medicine physicians to develop voluntary guidelines for judicious prescribing of opioids upon discharge from an emergency department. A qualitative evaluation of the guidelines was conducted using semistructured interviews with emergency department directors and providers. The guidelines were widely supported by respondents and cited as helpful in easing difficult negotiations with patients requesting opioids...
October 27, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/29055963/a-fatal-case-of-acute-bentazone-overdose-despite-cricothyroidotomy-during-cardiopulmonary-resuscitation
#13
Kyungwon Lee
Bentazone is classified as a moderately hazardous (class II) herbicide by the World Health Organization. A 53-year-old Korean woman was transferred to the emergency department after a suicide attempt using approximately 500 mL of bentazone one hour prior to admission. Upon admission, she was alert and tachycardia of 125/min was observed. She was treated with gastric lavage and activated charcoal, during which she experienced diarrhea. Two hours after bentazone ingestion, cardiac arrest and muscle rigidity throughout the body occurred...
October 20, 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29046744/clinical-and-epidemiological-characteristics-of-patients-with-acute-drug-intoxication-admitted-to-icu
#14
Jose Orsini, Nanda Din, Ershad Elahi, Anthony Gomez, Salil Rajayer, Ryan Malik, Elie Jean
Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). Methods: A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March)...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29021114/a-police-led-addiction-treatment-referral-program-in-gloucester-ma-implementation-and-participants-experiences
#15
Davida M Schiff, Mari-Lynn Drainoni, Zoe M Weinstein, Lisa Chan, Megan Bair-Merritt, David Rosenbloom
BACKGROUND: The increasing rates of opioid use disorder and resulting overdose deaths are a public health emergency, yet only a fraction of individuals in need receive treatment. OBJECTIVE: To describe the implementation of and participants' experiences with a novel police-led addiction treatment referral program. METHODS: Follow-up telephone calls to participants in the Gloucester Police Department's Angel Program from June 2015-May 2016...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29016517/pediatric-poisonings-in-a-rural-ugandan-emergency-department
#16
Katherine L Boyle, Usha Periyanayagam, Kavita M Babu, Brian T Rice, Mark Bisanzo
OBJECTIVE: This study aims to describe pediatric poisonings presenting to a rural Ugandan emergency department (ED), identifying demographic factors and causative agents. METHODS: This retrospective study was conducted in the ED of a rural hospital in the Rukungiri District of Uganda. A prospectively collected quality assurance database of ED visits was queried for poisonings in patients under the age of 5 who were admitted to the hospital. Cases were included if the chief complaint or final diagnosis included anything referable to poisoning, ingestion, or intoxication, or if a toxicologic antidote was administered...
October 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28987311/advances-in-diabetes-pharmacotherapy-an-update-for-the-emergency-provider
#17
Maryann Mazer-Amirshahi, Ali Pourmand
BACKGROUND: Diabetes mellitus is a disease that affects millions of Americans, and its prevalence is only anticipated to increase in coming years. It is estimated that diabetes-related visits account for 1% of all emergency department (ED) encounters. In recent years, there have been several new categories of medications approved for the treatment of diabetes, including new insulins, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, an amylin analogue, and sodium-glucose cotransporter-2 inhibitors...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28982383/unexpected-hypotension-in-catecholamine-reversal-a-case-report
#18
Yohei Okada, Wataru Ishi, Hiromichi Narumiya, Ryoji Liduka
BACKGROUND: Catecholamine agents are commonly used to support circulation; however, they may cause unexpected hypotension in a special situation. Here we describe the first unexpected case of hypotension in response to catecholamine agents. CASE PRESENTATION: A 29-year-old Japanese man with schizophrenia was transferred to our emergency department. He was in shock and in coma. After fluid resuscitation, we induced catecholamine agents; however, his blood pressure decreased to 59/40 mmHg in response to catecholamine infusion...
October 6, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28977468/opioid-crisis-at-the-jersey-shore-special-report
#19
Larissa S Dudley, Dorothy Konomos, Vince Robbins, Linda Qiu, Robert Bauter, Mark A Merlin
The USA is experiencing an epidemic of drug overdoses and deaths with a 200% increase in overdose deaths involving opioids including heroin. Legislation since 2013 has created paths to reduce opioid overdose deaths and since, basic life support (BLS) and police agencies have been administering naloxone to patients with suspected opioid overdoses as part of standard treatment protocols. Charts were reviewed from 1 January 2016 to 15 April 2016 on the de-identified electronic medical records of patients in a two-county system comprising the 'Jersey Shore' who received naloxone to determine the number of naloxone administrations and heroin overdoses...
August 31, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28971325/a-novel-oral-fluid-assay-lc-qtof-ms-for-the-detection-of-fentanyl-and-clandestine-opioids-in-oral-fluid-after-reported-heroin-overdose
#20
Matthew K Griswold, Peter R Chai, Alex J Krotulski, Melissa Friscia, Brittany P Chapman, Neha Varma, Edward W Boyer, Barry K Logan, Kavita M Babu
INTRODUCTION: The adulteration of heroin with non-pharmaceutical fentanyl and other high-potency opioids is one of the factors contributing to striking increases in overdose deaths. To fully understand the magnitude of this problem, accurate detection methods for fentanyl and other novel opioid adulterant exposures are urgently required. The objective of this work was to compare the detection of fentanyl in oral fluid and urine specimens using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) in a population of heroin users presenting to the Emergency Department after overdose...
October 2, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
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