The poisoned patient

Publication date: Available online 16 October 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Nora Gonzalez, Fin O'SullivanAbstractPoisoning is a common reason for admission to the intensive care unit. The majority of patients are due to deliberate self-harm with common poisons; however, there are occasional unusual poisons which require more detailed assessment. Patients are often obtunded or unwilling to co-operate so a knowledge of toxidromes to recognize symptoms that are related to groups of drugs that act on receptors is essential. Management of poisoned patients is generally supportive, including measures to reduce absorption and increase elimination, as well as the use of specific antidotes and techniques to remove poisons.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research

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CONCLUSION: R2PHF was safe and well-tolerated at doses ranging from 0.0625 to 0.50 mg. A single administration of 0.50 mg was determined to be the maximum tolerated dose of R2PHF. Further pharmacodynamics, safety, and efficacy testing is required to advance R2PHF to the next stage of clinical development and application.
. PMID: 31724530 [PubMed - as supplied by publisher]
Source: International Journal of Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research
Suspected seizure-survival of a lethal dose of the rodenticide alpha-chloralose. Anaesthesist. 2019 Nov 07;: Authors: Bergrath S, Castillo-Vargas JS, Koc NJ, Haake H, Graeven U Abstract A 58-year-old female was admitted due to a suspected seizure. A blue colored pharyngeal fluid was visualized during intubation, which is indicative of poisoning. Clinical research revealed an ingestion of 2.4 g of alpha-chloralose, a rodenticide with a lethal dose of 1 g. Immediate detoxification by gastroscopy, gastric lavage and hemodialysis led to full recovery. Substance detection ...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
ConclusionsAlthough anecdotal reports utilizing V-B12 for vasoplegia are available, no higher-level evidence exists. Future work is necessary to further understand the dosing, timing, adverse events, and biochemical mechanisms of V-B12 compared with other therapies such as methylene blue.
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
In conclusion, pralidoxime had a rapid onset of pressor effect. Pralidoxime administered during CPR led to significantly higher rates of ROSC and 6-hour survival by improving CPP in a pig model. PMID: 31631356 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Pharmacology and Physiology - Category: Drugs & Pharmacology Authors: Tags: Clin Exp Pharmacol Physiol Source Type: research
Publication date: Available online 15 October 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Kevin Wu, Fin O'SullivanAbstractPoisoning with chemical agents was once thought to be confined to the battlefield. However, over the past decade there has been an increase in the use of chemical weapon agents and toxic industrial chemicals as weapons of terror. As well as use during conflict, these poisons have been used in other attacks with deadly effects. These agents require particular treatments that fall out with standard medical practice to reduce harm and prevent contamination of medical treatment facilities...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
In 1819, a soon-to-be-knighted John Herschel (1792 to 1871) discovered that hyposulfite of soda could “fix” or make photographic images permanent by dissolving away unexposed and otherwise insoluble silver salts. This British genius soon coined terms for his astronomical or botanical images as “negatives” or “positives” and for the art as “photography.” Even after it was renamed sodi um thiosulfate, hyposulfite of soda retained photographers’ nickname for it: “hypo.” An antidote for cyanide poisoning, sodium thiosulfate was supplied in ampoules to physicians...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Carbon monoxide (CO) is one of the most common substances that people are poisoned by. It has no smell and is invisible to the naked eye, but can cause severe damage to tissues and lead to death. Patients who have already suffered significant lung da...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Cardiology Critical Care Emergency Medicine Public Health Source Type: blogs
This study investigated the pharmacokinetics of ropivacaine at different concentrations in elderly patients subjected to fascia iliaca compartment block. Forty patients with femoral neck fracture at American Society of Anesthesiologists (ASA) I-II status, undergoing fascia iliaca compartment block (FICB) were randomized to two groups receiving 0.7 ml/kg of solution containing 0.375% ropivacaine (group L) or 0.5% ropivacaine (group H). Samples of venous blood were obtained immediately at different time points after FICB, and the total and free plasma concentrations of ropivacaine were measured by liquid chromatography-elect...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
We present a case of a 36-year-old G0P0 with Abnormal Uterine Bleeding-Leiomyoma and resultant anemia undergoing hysteroscopic resection of a large, submucous fibroid. During surgery, the patient was found to have a critically elevated level of carboxyhemoglobin, and accompanying ECG derangements. She was managed with prolonged intubation, 100% O2, and trending of her carboxyhemoglobin levels before extubation.This demonstrates the importance of being cognizant of the potentially toxic gaseous byproducts of bipolar resection, and to include intravasation of these byproducts in one's consideration of patient safety during e...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
CONCLUSIONS: Although anecdotal reports utilizing V-B12 for vasoplegia are available, no higher-level evidence exists. Future work is necessary to further understand the dosing, timing, adverse events, and biochemical mechanisms of V-B12 compared with other therapies such as methylene blue. PMID: 31346957 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
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