Emergency medicine clinics of North America
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Toxic overdose can present with various clinical signs and symptoms. These may be the only clues to diagnosis when the cause of toxicity is unknown at the time of initial assessment. ⋯ Usually the drug or toxin can be quickly identified by a careful history, a directed physical examination, and commonly available laboratory tests. Once the patient has been stabilized, the physician must consider how to minimize the bioavailability of toxin not yet absorbed, which antidotes (if any) to administer, and if other measures to enhance elimination are necessary.
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Emerg. Med. Clin. North Am. · May 2007
ReviewEmergency department management of the salicylate-poisoned patient.
Salicylate toxicity continues to be encountered commonly in emergency medicine. This article portrays the signs and symptoms of salicylate toxicity, reviews the erratic absorption and elimination kinetics, describes the devastating physiologic effects of overdose, and illustrates the potentially subtle manifestations of chronic aspirin toxicity.
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Emerg. Med. Clin. North Am. · May 2007
ReviewManagement of beta-adrenergic blocker and calcium channel antagonist toxicity.
State-of-the-art therapy for beta-adrenergic receptor blocker and calcium channel antagonist toxicity is reviewed in the light of new insights into drug-induced shock. A brief discussion of pathophysiology, including cardiac, hemodynamic, and metabolic effects of cardiac drug toxicity, provides a foundation for understanding the basis of therapy. The major focus of this review is a critical evaluation of antidotal use of calcium, glucagon, catecholamines, insulin-euglycemia, and other novel therapies based on investigational studies and cumulative clinical experience.
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Emerg. Med. Clin. North Am. · Feb 2007
ReviewPrinciples of basic wound evaluation and management in the emergency department.
The primary objectives of basic wound management center around promoting optimal wound healing and cosmesis. These objectives may be achieved through the systematic assessment, preparation, and repair of the laceration supplemented with appropriate patient care instructions. The meticulous and methodical management of traumatic wounds described in this article will assist the emergency physician in decreasing overall complication rates and help improve patient satisfaction.
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Many lacerations seen in the emergency department setting require specific management based on anatomic location. Lacerations of the fingertip, ear, nose, lip, tongue, and eyelid can be complex and require advanced management techniques. Many can be primarily treated by emergency clinicians; however, it is important for the clinician to know when consultation is appropriate for treatment by a specialist. Current literature recommendations are presented for initial management, methods of repair, technical tips to facilitate repair, appropriate consultation, and postoperative care for these complex lacerations.