Emergency medicine clinics of North America
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Asphyxiants deprive the body of oxygen. Simple asphyxiants displace oxygen from the lungs, whereas systemic asphyxiants interfere with transport of oxygen by hemoglobin or with mitochondrial oxidative phosphorylation. ⋯ Treatment of asphyxiant poisoning is aggressive supportive care, with control of the airway and ventilation and maintenance of cardiac output. Supportive care is often enhanced by the administration of specific antidotes.
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Emerg. Med. Clin. North Am. · Feb 2015
ReviewPersonal Protective Equipment and Decontamination of Adults and Children.
Accurate identification of the hazardous material is essential for proper care. Efficient hospital security and triage must prevent contaminated victims from entering the emergency department (ED) and causing secondary contamination. The decontamination area should be located outside the ambulance entrance. ⋯ Decontamination proceeds in a head-to-toe sequence. Run-off water is a hazardous waste. Hospital and Community Management Planning for these emergencies is essential for proper preparation and effective response to the hazardous materials incident.
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Emerg. Med. Clin. North Am. · Feb 2015
ReviewEmergency Department Management of Patients Internally Contaminated with Radioactive Material.
After a radiation emergency that involves the dispersal of radioactive material, patients can become externally and internally contaminated with 1 or more radionuclides. Internal contamination can lead to the delivery of harmful ionizing radiation doses to various organs and tissues or the whole body. ⋯ Estimating the amount of radioactive material absorbed into the body can guide the management of patients. Treatment includes, in addition to supportive care and long term monitoring, certain medical countermeasures like Prussian blue, calcium diethylenetriamine pentaacetic acid (DTPA) and zinc DTPA.
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Emerg. Med. Clin. North Am. · Feb 2015
ReviewMental Health Consequences of Chemical and Radiologic Emergencies: A Systematic Review.
This article reviews the literature pertaining to psychological impacts in the aftermath of technological disasters, focusing on the immediate psychological and mental health consequences emergency department physicians and first responders may encounter in the aftermath of such disasters. First receivers see a wide spectrum of psychological distress, including acute onset of psychiatric disorders, the exacerbation of existing psychological and psychiatric conditions, and widespread symptomatology even in the absence of a diagnosable disorder. The informal community support systems that exist after a natural disaster may not be available to communities affected by a technological disaster leading to a need for more formal mental health supportive services.
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Emerg. Med. Clin. North Am. · Feb 2015
ReviewResources for Toxicologic and Radiologic Information and Assistance.
Most approaches toward chemical and radiological/nuclear (CRN) incidents focus on the clinical skills of the first receiver. These skills are certainly important and are addressed throughout this article. ⋯ The following are basic competencies in information management for the emergency medicine physician to handle large-scale CRN incidents: planning information; incident management information; toxicant management; disposition/definitive care management; and recovery management. Information management and synthesis are crucial throughout the phases of the disaster cycle: planning, response, mitigation, and recovery.