Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2011
Case ReportsManagement of lercanidipine overdose with hyperinsulinaemic euglycaemia therapy: case report.
This case report describes the first reported overdose of the dihydropyridine calcium channel blocker (CCB) lercanidipine. A 49 yr old male presented to the Emergency Department 3 hrs after the ingestion of 560 mg of lercanidipine. In the department he had a witnessed seizure within 15 minutes of arrival attributed to the overdose. ⋯ Experimental animal data suggests that HIET is of benefit and potentially superior to fluid therapy, calcium, glucagon and potentially vasopressor therapy. HIET effectively and sustainably reverses hypotension, bradycardia and improves myocardial contractility and metabolism. Current advice in calcium channel blocker overdose is to begin therapy early in toxicity, starting with a 1.0 IU/kg insulin bolus followed by an infusion of 0.5 IU/kg/hr of insulin and dextrose as required titrated to clinical response.
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Scand J Trauma Resus · Jan 2011
The counterintuitive effect of multiple injuries in severity scoring: a simple variable improves the predictive ability of NISS.
Injury scoring is important to formulate prognoses for trauma patients. Although scores based on empirical estimation allow for better prediction, those based on expert consensus, e.g. the New Injury Severity Score (NISS) are widely used. We describe how the addition of a variable quantifying the number of injuries improves the ability of NISS to predict mortality. ⋯ In NISS, the same weight is assigned to the three worst injuries, although the contribution of the second and third to the probability of death is smaller than that of the worst one. An improvement of the predictive ability of NISS can be obtained adjusting for the number of injuries.
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Scand J Trauma Resus · Jan 2011
LetterNovel rapid infusion device for patients in emergency situations.
Rapid fluid administration is often required for resuscitation when patients are admitted in emergency department with hypovolemic shock or excessive blood loss. Various methods have been described earlier to increase the fluid administration speed. Larger vein size, larger bore cannula, height of fluid, pressure over fluid bottle etc. are some of methods described in such situations. We here describe a novel method to administer intravenous fluid rapidly and this method can be utilized in emergency and trauma settings.