Annals of emergency medicine
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The Medical Information Center at The Hospital for Sick Children in Toronto began in March 1977 to improve triage, provide an improved poison information center, improve response to telephone callers seeking medical advice, and establish a telephone consultation service for physicians. It employs specially trained nursing staff and integrates functionally related services. To determine program effectiveness we studied the records of patients triaged, telephone calls to the poison information center, and calls for other medical information, for periods both before and after the center's opening. ⋯ The Medical Information Center telephone service ensures that more children are managed at home rather than (unnecessarily) treated in the emergency department. Most parents express satisfaction with this service. Few physicians have used the telephone consultation service.
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Lidocaine is recognized as a first line drug for ventricular arrhythmias and has recently been used in acute myocardial infarction as prophylaxis against ventricular fibrillation. A 68-year-old man was erroneously given 2 gm of lidocaine by intravenous push and sustained a cardiac arrest. He was treated supportively and had complete recovery. We discuss complications of therapeutic and excessive doses of lidocaine and outline measures for treatment of massive lidocaine overdose.