Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 1989
ReviewCarbon monoxide poisoning: a review epidemiology, pathophysiology, clinical findings, and treatment options including hyperbaric oxygen therapy.
Carbon monoxide (CO) poisoning is the leading cause of poisoning deaths (accidental and intentional) in the United States. While confirmation of CO poisoning is easily obtained via assessment of carboxyhemoglobin (COHgb) levels, evaluation of the severity of intoxication is both difficult and inconsistent. Acute intoxication most commonly results in neurologic dysfunction and/or myocardial injury. ⋯ Based on the body of clinical, basic and scientific information currently available, patients who manifest signs of serious intoxication (i.e., unconsciousness or altered neurologic function, cardiac or hemodynamic instability) should be considered candidates for hyperbaric oxygen therapy (HBO) in addition to other appropriate supportive and intensive care. Any patient who has suffered an interval of unconsciousness, regardless of the patient's clinical exam on arrival, warrants HBO therapy. Treatment plans based on any specific COHgb level are not well founded.
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J. Toxicol. Clin. Toxicol. · Jan 1989
Review Comparative StudyPharmacologic effects on thermoregulation: mechanisms of drug-related heatstroke.
In summary, a number of pharmacologic agents interfere with the body's ability to maintain normal body temperature during exercise or under conditions of environmental heat stress. Life threatening elevation of body temperature may occur. Regardless of the predisposing cause of heatstroke, the final common pathway is heat injury to tissues causing cell death. Rapid cooling of the patient must take precedence and elucidation of the pathophysiologic disturbance is secondary to the accomplishment of this goal.
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J. Toxicol. Clin. Toxicol. · Jan 1988
Case ReportsTreatment of aniline poisoning with exchange transfusion.
A case of aniline poisoning with methemoglobinemia unresponsive to methylene blue is described. Exchange transfusion proved successful. A rationale for the failure of methylene blue under these circumstances is described.
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J. Toxicol. Clin. Toxicol. · Jan 1988
A registry for carbon monoxide poisoning in New York City. Hyperbaric Center Advisory Committee Emergency Medical Service, City of New York.
In 1983 the North American Hyperbaric Center (affiliated with Bronx Municipal Hospital Center) was designated to provide Hyperbaric oxygen (HBO) for carbon monoxide (CO) patients meeting Emergency Medical System (EMS) criteria: 1. Unconscious or CNS derangement, any carboxyhemoglobin level [( COHb]); 2. [COHb] 25% or more; 3. Pregnant, any [COHb]. ⋯ HBO typically was 46 min at 3ATA (2 [COHb] half lives), presented few problems, and gave rapid clinical improvement. 13 of 19 patients comatose before HBO were responsive after HBO (mean [COHb] was 1.8%). Four pediatric deaths occurred; brain damage was noted in two other patients. EMS efforts to make HBO available for CO is a success.
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J. Toxicol. Clin. Toxicol. · Jan 1987
Case ReportsCocaine intoxication: hyperpyrexia, rhabdomyolysis and acute renal failure.
Cocaine has become the recreational drug of abuse of the eighties. The prevalence of cocaine has been manifesting increases in intoxications and poisonings. ⋯ Treatment consisted of cooling via iced intravenous fluids, nasogastric lavage with ice water, and benzodiazepine sedation. To our knowledge, there is no case report which supports the allusions that cocaine intoxication may cause rhabdomyolysis and acute renal failure.