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Narcotic error

Chang Liu, Yanlan Huang, Joyce C Pressley
BACKGROUND: While driving impaired is a well-recognized risk factor for motor vehicle (MV) crash, recent trends in recreational drug use and abuse may pose increased threats to occupant safety. This study examines mechanisms through which drug and/or alcohol combinations contribute to fatal MV crash. METHODS: The Fatality Analysis Reporting System (FARS) for 2008-2013 was used to examine drugs, alcohol, driver restraint use, driver violations/errors and other behaviors of drivers of passenger vehicles who were tested for both alcohol and drugs (n = 79,932)...
December 2016: Injury Epidemiology
N Krzyżaniak, I Pawłowska, B Bajorek
WHAT IS KNOWN AND OBJECTIVES: When considering acute care settings, such as the neonatal intensive care unit (NICU), the inappropriate use of medicines poses a great risk to vulnerable babies at the start of their lives. However, there is limited published literature that explores the current medication management practices in NICUs and where the main misuse issues lie. Therefore, the purpose of this review was to give an overview of medicine use in NICUs worldwide and identify therapeutic areas requiring more targeted pharmaceutical care...
August 31, 2016: Journal of Clinical Pharmacy and Therapeutics
Solmaz Marzooghi, Bryson E Finch, William A Stubblefield, Olga Dmitrenko, Sharon L Neal, Dominic M Di Toro
A phototoxic target lipid model (PTLM) is developed to predict phototoxicity of individual polycyclic aromatic hydrocarbons (PAHs) measured either as median lethal concentration (LC50) or median lethal time (LT50) for a 50% toxic response. The model is able to account for the differences in the physical/chemical properties of PAHs, test species sensitivities, and variations in light source characteristics, intensity, and length of exposure. The PTLM is based on the narcotic target lipid model (NTLM) of PAHs...
August 23, 2016: Environmental Toxicology and Chemistry
Brian C Hauck, William F Siems, Charles S Harden, Vincent M McHugh, Herbert H Hill
Ion mobility spectrometry (IMS) is used to detect chemical warfare agents, explosives, and narcotics. While IMS has a low rate of false positives, their occurrence causes the loss of time and money as the alarm is verified. Because numerous variables affect the reduced mobility (K0) of an ion, wide detection windows are required in order to ensure a low false negative response rate. Wide detection windows, however, reduce response selectivity, and interferents with similar K0 values may be mistaken for targeted compounds and trigger a false positive alarm...
July 2016: Review of Scientific Instruments
Lisette De Hoop, Karel P J Viaene, Aafke M Schipper, Mark A J Huijbregts, Frederik De Laender, A Jan Hendriks
There is a need to study the time course of toxic chemical effects on organisms, because there might be a time lag between the onset of chemical exposure and the corresponding adverse effects. For aquatic organisms, crude oil and oil constituents originating from either natural seeps or human activities, can be relevant case-studies. In the current study we tested a generic toxicokinetic model to quantify the time-varying effects of various oil constituents on the survival of aquatic organisms. The model is based on key parameters applicable to an array of species and compounds with baseline toxicity reflected by a generic, internal toxicity threshold or critical body burden (CBB)...
May 25, 2016: Environmental Toxicology and Chemistry
Andrea S Prentiss, Alice Cockerel, Eve Butler
Injectable medications have been found to be associated with a higher incidence of errors than with other medication preparations. Carpuject syringe systems have been implemented to protect patients and improve safety; however, an overall lack of knowledge of the device was discovered. The purpose of this study, using a pre/postsurvey design, was to investigate nursing knowledge of and practices with the prefilled Carpuject syringe system and narcotic dilution practices before and after multidisciplinary interventions...
October 2016: Journal of Nursing Care Quality
Xu Fang, Ling-Ling Zhu, Sheng-Dong Pan, Ping Xia, Meng Chen, Quan Zhou
Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011...
2016: Therapeutics and Clinical Risk Management
Chang Liu, Yanlan Huang, Joyce C Pressley
BACKGROUND: While driving impaired is a well-recognized risk factor for motor vehicle (MV) crash, recent trends in recreational drug use and abuse may pose increased threats to occupant safety. This study examines mechanisms through which drug and/or alcohol combinations contribute to fatal MV crash. METHODS: The Fatality Analysis Reporting System (FARS) for 2008-2013 was used to examine drugs, alcohol, driver restraint use, driver violations/errors and other behaviors of drivers of passenger vehicles who were tested for both alcohol and drugs (n = 79,932)...
2016: Injury Epidemiology
Toni M Rudisill, Motao Zhu, Marie Abate, Danielle Davidov, Vincent Delagarza, D Leann Long, Usha Sambamoorthi, J Doug Thornton
OBJECTIVE: Adults 65 years of age and older comprise the fastest growing demographic in the United States. As substance use is projected to increase in this population, there is concern that more seniors will drive under the influence of impairing drugs. The purpose of this analysis was to characterize the drug and alcohol usage among senior drivers fatally injured (FI) in traffic collisions. METHODS: Data from the Fatality Analysis Reporting System were analyzed from 2008 to 2012...
November 16, 2016: Traffic Injury Prevention
Joseph M Reardon, Katherine J Harmon, Genevieve C Schult, Catherine A Staton, Anna E Waller
BACKGROUND: Although fatal opioid poisonings tripled from 1999 to 2008, data describing nonfatal poisonings are rare. Public health authorities are in need of tools to track opioid poisonings in near real time. METHODS: We determined the utility of ICD-9-CM diagnosis codes for identifying clinically significant opioid poisonings in a state-wide emergency department (ED) surveillance system. We sampled visits from four hospitals from July 2009 to June 2012 with diagnosis codes of 965...
2016: BMC Emergency Medicine
Jessica A George, Paul S Park, Joanne Hunsberger, Joanne E Shay, Christoph U Lehmann, Elizabeth D White, Benjamin H Lee, Myron Yaster
BACKGROUND: Prescription errors are among the most common types of iatrogenic errors. Because of a previously reported 82% error rate in handwritten discharge narcotic prescriptions, we developed a computerized, web-based, controlled substance prescription writer that includes weight-based dosing logic and alerts to reduce the error rate to (virtually) zero. Over the past 7 years, >34,000 prescriptions have been created by hospital providers using this platform. We sought to determine the ongoing efficacy of the program in prescription error reduction and the patterns with which providers prescribe controlled substances for children and young adults (ages 0-21 years) at hospital discharge...
March 2016: Anesthesia and Analgesia
Qi Li, Eric S Kirkendall, Eric S Hall, Yizhao Ni, Todd Lingren, Megan Kaiser, Nataline Lingren, Haijun Zhai, Imre Solti, Kristin Melton
OBJECTIVE: To improve neonatal patient safety through automated detection of medication administration errors (MAEs) in high alert medications including narcotics, vasoactive medication, intravenous fluids, parenteral nutrition, and insulin using the electronic health record (EHR); to evaluate rates of MAEs in neonatal care; and to compare the performance of computerized algorithms to traditional incident reporting for error detection. METHODS: We developed novel computerized algorithms to identify MAEs within the EHR of all neonatal patients treated in a level four neonatal intensive care unit (NICU) in 2011 and 2012...
October 2015: Journal of Biomedical Informatics
Fabian P Steinmetz, Judith C Madden, Mark T D Cronin
A greater number of toxicity data are becoming publicly available allowing for in silico modeling. However, questions often arise as to how to incorporate data quality and how to deal with contradicting data if more than a single datum point is available for the same compound. In this study, two well-known and studied QSAR/QSPR models for skin permeability and aquatic toxicology have been investigated in the context of statistical data quality. In particular, the potential benefits of the incorporation of the statistical Confidence Scoring (CS) approach within modeling and validation...
August 24, 2015: Journal of Chemical Information and Modeling
Alfonso Reginelli, Anna Russo, Fabrizio Urraro, Duilia Maresca, Ciro Martiniello, Alfredo D'Andrea, Luca Brunese, Antonio Pinto
Body packing is the ingestion or insertion in the human body of packed illicit substances. Over the last 20 years, drug smuggling has increased global and new means of transport of narcotics have emerged. Among these, the most frequent one is the gastrointestinal tract: from mouth to anus, vagina, and ears. Cocaine is one of the most traded drugs, followed by heroin. Condoms, latex gloves, and balloons are typically used as drug packets for retention in the body. There are different radiologic modalities to detect illicit drugs in body packing: Plain radiography, computed tomography (CT), ultrasound, and magnetic resonance...
October 2015: Abdominal Imaging
Gregory C Wilson, Jeffrey M Sutton, Milton T Smith, Nathan Schmulewitz, Marzieh Salehi, Kyuran A Choe, John E Brunner, Daniel E Abbott, Jeffrey J Sussman, Syed A Ahmad
OBJECTIVES: Patients with minimal-change chronic pancreatitis (MCCP) are traditionally managed medically with poor results. This study was conducted to review outcomes following total pancreatectomy with islet cell autotransplantation (TP/IAT) as the initial surgical procedure in the treatment of MCCP. METHODS: All patients submitted to TP/IAT for MCCP were identified for inclusion in a single-centre observational study. A retrospective chart review was performed to identify pertinent preoperative, perioperative and postoperative data...
March 2015: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Kingsley R Chin, André V Coombs, Jason A Seale
STUDY DESIGN: Retrospective study. OBJECTIVE: To report surgical and patient-reported outcomes after outpatient lumbar fusions in an ambulatory setting. SUMMARY OF BACKGROUND DATA: There is growing interest in the potential benefits of outpatient spine surgery such as reduced costs, consistent operative team, and decreased postoperative complications during in-hospital recovery. However, there are limited studies on outcomes after outpatient lumbar fusions, to guide patient selection, treatment techniques and postoperative expectations...
January 1, 2015: Spine
Padma Kandadai, Venk Kandadai, Jyot Saini, Katharine O'Dell, Danielle Patterson, Michael K Flynn
INTRODUCTION: This study aimed to identify risk factors for postpartum urinary retention (PPUR) after cesarean delivery (CD). METHODS: A case-control study design was used. Cases of PPUR after CD were identified using billing codes for CD and "urinary retention" and confirmed by chart review. Matched controls were identified in a 2:1 ratio using an obstetrics database and billing data. Patient demographics, operative, and anesthetic data were collected. Fisher exact tests and Wilcoxon rank sum tests were used to determine differences in medical risk factors, postoperative analgesic use, and catheter management between cases and controls...
September 2014: Female Pelvic Medicine & Reconstructive Surgery
Sonya Stacey, Ian Coombes, Claire Wainwright, Brittany Klee, Hugh Miller, Karen Whitfield
AIM: To compare adverse medication events (AMEs) reported in children, via the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) coding with events reported via other data sources. METHOD: AME reports were retrieved using codes Y40-Y59 and X40-X44 over 6 months. Patients' charts were manually reviewed to identify events associated with error and/or harm with medicines during a hospital admission. Medication name, group, error, harm and alert documentation were recorded...
December 2014: Journal of Paediatrics and Child Health
Betsy J Lahue, Bruce Pyenson, Kosuke Iwasaki, Helen E Blumen, Susan Forray, Jeffrey M Rothschild
BACKGROUND: Harmful medication errors, or preventable adverse drug events (ADEs), are a prominent quality and cost issue in healthcare. Injectable medications are important therapeutic agents, but they are associated with a greater potential for serious harm than oral medications. The national burden of preventable ADEs associated with inpatient injectable medications and the associated medical professional liability (MPL) costs have not been previously described in the literature. OBJECTIVE: To quantify the economic burden of preventable ADEs related to inpatient injectable medications in the United States...
November 2012: American Health & Drug Benefits
Aleece Caron, Adam Perzynski, Charles Thomas, Jimmy Y Saade, Michael McFarlane, Jeffery Becker
BACKGROUND: Although interpersonal and communication skills are essential to physician practice, there is a dearth of effective tools to meaningfully teach and assess communication skills. OBJECTIVE: The purpose of our study was to create a standardized tool for evaluation of communication skills for residents across specialties. METHODS: We designed an Objective, Structured Communication Assessment of Residents (OSCAR) tool, consisting of 4 clinical stations, to assess intern communication skills with relationship development, their establishment of case goals, and their organization and time management skills...
December 2013: Journal of Graduate Medical Education
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