Annals of emergency medicine
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We describe seven patients presenting with combination substance abuse involving γ-Hydroxybutyric acid (GHB). ⋯ Emergency physicians should be alerted to this agent, its characteristic effects, and its potential for serious sequelae including respiratory arrest and death. [Li J, Stokes SA, Woeckener A: A tale of novel intoxication: Seven cases of γ-Hydroxybutyric acid overdose. Ann Emerg Med June 1998;31:723-728.].
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γ-Hydroxybutyric acid (GHB) is unfamiliar to many physicians in the United States but enjoys clinical use elsewhere for applications in resuscitation, anesthesia, and addiction therapy. Use within the United States is restricted to Food and Drug Administration- approved clinical trials for treatment of narcolepsy. Recently illicit use of GHB has emerged within the United States where it is distributed for purported euphoric and "fat-burning" metabolic effects. ⋯ Recommended management of acute GHB intoxication includes prevention of aspiration, use of atropine for persistent symptomatic bradycardia, consideration of neostigmine as a reversal agent, and treatment for coingested substances. Emergency physicians are urged to become familiar with GHB because of its potential for severe morbidity, as well as its potential use as a future resuscitative agent. [Li J, Stokes SA, Woeckener A: A tale of novel intoxication: A review of the effects of γ-hydroxybutyric acid with recommendations for management. Ann Emerg Med June 1998;31:729-736.].
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To describe a community's experience with the use of emergency department services by nursing home residents. ⋯ Elders living in nursing homes are frequently transferred to EDs for costly medical evaluations, and more than 40% of such visits lead to admission to the hospital.