Background: Visits to the ED for alcohol intoxication can create quite the clinical conundrum both for acute medical and traumatic reasons. Acutely intoxicated patients, just like young kids, don’t always have the ability to communicate due to sedation, agitation, or some other critical medical/traumatic process that is ongoing. This makes getting a complete history or […]
Archive for category: Toxicology
Do Patients with Opioid Dependence Benefit from Buprenorphine/Naloxone Treatment Initiation in the Emergency Department?
Background: North America’s current opioid crisis, much of it iatrogenic (2), has led to significant increases in ED visits associated with opioids (3). These patients often present after poisoning, in withdrawal, or with other health issues associated with their disease. It is well accepted that Opioid Replacement Therapy (ORT), namely, methadone and buprenorphine/naloxone, are successful harm […]
Background: Alcoholism is a chronic disease with a staggering impact on society, costing the nation approximately 100 billion dollars per year, an expenditure greater than the costs associated with all cancers and respiratory diseases combined (Whiteman 2000). Large public hospital emergency department studies have demonstrated the enormous strain of alcohol use on resources, and the disproportionate […]
Background: Salicylates are common substances that can be purchased over the counter. They are readily available, and in the setting of an overdose, can be fatal . Initially, as salicylates are metabolized, they can induce a respiratory alklalosis. This is then followed by an anion gap metabolic acidosis. Due to the metabolic derangements induced by […]
Definition: A life-threatening adverse reaction resulting from local anesthetic reaching significant systemic circulating levels. Local Anesthetic Systemic Toxicity (LAST) is rare and almost always occurs within minutes of injection of the local anesthetic. Causes: Injection of local anesthetic into the systemic circulation (either errantly as part of a regional block i.e. Bier block) Rapid absorption […]