J Emerg Med
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Carbon monoxide (CO) remains the leading cause of death due to poisoning in the United States. CO produces toxicity by binding to hemoglobin, thereby reducing oxygen-carrying capacity, and by binding to myoglobin, which may impair cardiac output and result in cerebral ischemia. Severe CO poisoning results in coma or encephalopathy, but milder intoxication may occur with nonspecific symptoms suggestive of hysteria, hyperventilation, psychosis, or viral syndrome. ⋯ Hyperbaric oxygen can shorten the half-life of carboxyhemoglobin and can carry oxygen independent of hemoglobin. However, it is not known if either 100% oxygen or hyperbaric oxygen can actually alter mortality or improve neurologic outcome in survivors. Carefully controlled prospective studies should be carried out to assess the potential value of hyperbaric oxygen in CO poisoning.
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Biography Historical Article
Ivan Magill: forceps for intratracheal anesthesia.
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Accidental hypothermia is defined as an environmentally induced reduction of the core body temperature to 35 degrees C or below, where there is no primary endocrine or preoptic anterior hypothalmic dysfunction. We report a survivor of 12 episodes of accidental hypothermia. ⋯ Multiple predisposing factors contributed to the repeated episodes of hypothermia. Anatomic causes of repeated nonaccidental hypothermia were excluded.
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Delirium and dementia frequently pose a diagnostic dilemma for clinicians in the emergency department. The overlap of symptoms between organic brain syndrome and functional psychiatric illness, coupled with a dramatic presentation, often leads to a premature psychiatric diagnosis. In this paper, the authors discuss those symptoms of organic brain syndrome that most frequently generate diagnostic confusion in the emergency department and result in a misdiagnosis of functional illness.