The American journal of emergency medicine
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A case of an unusual caustic ingestion involving Compound W, an over the counter wart remover is presented. Chemical burns of the tongue, pharynx and larynx developed. The active ingredient in this preparation: salicylic acid in a flexible collodion vehicle produces caustic injury through a keratolytic action, which may be enhanced by the presence of collodion.
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The case of a man who injected turpentine intravenously in an attempt to kill himself is reported. The patient developed immediate pulmonary edema and hypoxia, followed later by cellulitis at the site of injection. Although only one death to date has been attributed to this form of chemical abuse, extensive local reactions, pulmonary involvement, central nervous system depression, and febrile reactions should be anticipated, and such patients should be admitted to the hospital. Patients should be observed for local reactions and myonecrosis around the site of injection, especially as these occur 12-24 hours later.
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The two new uses for the nasopharyngeal airway include facilitation of nasogastric intubation and nasotracheal intubation. First this technique takes advantage of the nasopharyngeal airway's unique ability to traverse the nasopharynx atraumatically and serve as a conduit for the smaller nasogastric tube. This technique also utilizes the nasopharyngeal airway to dilate the nasopharyngeal passage atraumatically, thus facilitating the passage of an endotracheal tube during nasotracheal intubation.
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Pediatric cardiopulmonary resuscitation drug therapy is based upon body weight, a statistic that often requires estimation. Using two current techniques of estimating body weight and the devised weight-estimating method (DWEM), the authors estimated the weights of 258 children. ⋯ Using height, habitus, sex, and age in a multiple regression analysis, habitus and height--two readily available measurements--were the best predictors of body weight. The DWEM, based on these two measurements, is a simple method of estimating children's weights and is more accurate than currently used body-weight estimations.
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This is a descriptive and evaluative report regarding a clinical pharmacy residency in-house on-call program that facilitates the provision of 24-hour clinical pharmacy consultative services within the emergency department. During the two-year evaluation period, clinical pharmacy residents completed 3.1 consultations per 14-hour call period. ⋯ These consultations were usually solicited by internal medicine physicians within the emergency department, involved patient-specific drug therapy recommendations, and required about 100 minutes (mean per consultation) of the clinical pharmacist's time. Thus, clinical pharmacy consultative services can be a useful addition to health care within the emergency department in teaching hospitals.