Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2022
ReviewToxin-Induced Seizures ∗Adapted from "Toxin-Induced Seizures" in Neurologic Clinics, November 2020.
New toxins are constantly emerging within society. We review common toxins that cause seizure, their mechanisms, associated toxidromes, and treatments. Stimulants, cholinergic agents, gamma-aminobutyric acid (GABA) antagonists, glutamate agonists, histamine and adenosine antagonists, and withdrawal states are highlighted. Understanding current mechanisms for common toxin-induced seizures can promote understanding of future toxins and predicting if seizure may occur as a result of toxicity.
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Emerg. Med. Clin. North Am. · May 2022
ReviewUpdates on the Evaluation and Management of Caustic Exposures.
In the 2019 annual report by the American Association of Poison Control Centers, there were more than 180,000 single substance exposures involving household cleaners, making these products the second most common exposure reported to poison control centers. Little controversy exists in the general management following dermal or ocular caustic exposure. ⋯ This article provides a thorough review of diagnosis, management and prevention of gastrointestinal caustic exposures and their sequelae. Hydrofluoric acid, which requires special consideration compared to other acids, is also explored.
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Emerg. Med. Clin. North Am. · May 2022
ReviewMetabolic Acidosis: Differentiating the Causes in the Poisoned Patient.
Numerous drugs and toxins can cause metabolic acidosis. The treating clinician should be aware of the many compounds that can produce metabolic acidosis following an accidental exposure, an overdose, or with therapeutic use. Awareness and comprehension of those substances associated with metabolic acidosis will facilitate the diagnosis and treatment of poisoned patients.
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The most common chemicals used in riot control agents are chlorobenzylidene malononitrile, chloroacetophenone, dibenz[b,f]-[1,4]-oxazepine, and oleoresin capsicum. They cause ocular, respiratory, and dermal effects usually within seconds to minutes of exposure, but delayed effects have been reported. ⋯ Although most effects are mild, some may be serious, especially in those with preexisting respiratory disease. Treatment consists of removing the patient from the source of exposure, removing contaminated clothes, and copiously irrigating the affected areas with water.