J Emerg Med
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Currently, there is no one drug that is the agent of choice for induction in rapid sequence intubation in the emergency department (ED). All agents currently used as induction agents in the ED offer distinct advantages for various clinical conditions, but each has a significant side effect profile and specific contraindications that limit its use in many common clinical settings. ⋯ Disadvantages include a lack of blunting of sympathetic response to intubation, a high incidence of myoclonus, prominent nausea and vomiting, potential activation of seizures in patients with epileptogenic foci, and impaired glucocorticoid response to stress. Further studies are needed to evaluate the advantages and disadvantages of the use of etomidate for rapid sequence intubation in the ED.
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Review Historical Article
Surgical glove lubricants: from toxicity to opportunity.
In most emergency departments, surgical gloves are coated with surface powders that act as lubricants to facilitate donning. Cornstarch powder is an absorbable powder employed as a donning agent on most powdered gloves. ⋯ These powders are foreign bodies that elicit inflammatory responses, leading to a wide number of symptoms and complications. The best method of preventing clinical complications from glove powder is to use powder-free gloves.
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A 16-yr-old male attempted suicide by ingesting approximately 4000 mg of flecainide. He developed coma, hypotension, and ventricular tachycardia. ⋯ The patient's QRS narrowed immediately following sodium bicarbonate infusion. Sodium bicarbonate may be useful in the treatment of widened QRS and ventricular ectopy resulting from flecainide toxicity.