Can J Emerg Med
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This paper outlines some of the ethical and practical dilemmas of securing true informed consent in resuscitation research in the prehospital or emergency department setting. Possible substitutes to such consent are discussed and evaluated. The Canadian Tri-Council Policy Statement guidelines for emergency medicine research are compared to the US Food and Drug Administration rules, and the former are assessed and critiqued. Modifications to the current Tri-Council guidelines are suggested.
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Atenolol, a selective beta(1)-adrenergic antagonist, is commonly used to treat hypertension, ischemic heart disease and cardiac dysrhythmias. Few cases of severe atenolol intoxication have been described, and only one of these reports discussed the use of calcium chloride as a treatment. We present a case of atenolol overdose associated with shock and first-degree heart block, in which administration of calcium chloride led to dramatic improvement after failure of conventional treatment. In addition, we discuss the pharmacokinetics, toxicology and management of beta-blocker overdose, focusing on the possible role of calcium chloride.
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To assess the current level of development of emergency medicine (EM) systems in the world. ⋯ Basic emergency medicine components now exist in the majority of countries surveyed. These include many specialty, academic, patient care and administrative systems. The foundation for further EM development is widely established throughout the world.