The American journal of emergency medicine
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The purpose of this study was to evaluate the role of radiography in the assessment/treatment of toxic ingestions and to compare the radiopacity of extended-release formulations to their basic preparations using standard and digitized radiography in vitro. Medications were placed in an in vitro model of the human abdomen. Images were exposed at 80 kV, 20 MAS, with a tube to table distance of 101.6 cm. ⋯ Digital enhancement of a standard radiograph was shown to improve the detectability of the tested oral dosage forms in vitro. Sensitivity of digital radiography in vivo has not yet been established. Based on the data presented, however, further studies using digital radiography to document and to monitor acute toxic ingestions in-vivo are warranted.
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To improve the prognosis in patients with acute myocardial infarction (AMI) if treatment by early instituting treatment, we initiated a media campaign during 1 year with the intention to reduce delay times and increase ambulance use in patients with acute chest pain. This article describes the outcome during 3 years after the campaign was finished. ⋯ Ambulance use was not affected during or after the campaign. It can be concluded that a media campaign resulted in a reduction of delay times not only during the campaign, but also during 3 years after its performance, whereas ambulance use was not affected.
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A case of carbon monoxide (CO) poisoning with severe myonecrosis and acute renal failure (ARF) is presented with extremely high values of CPK but with preservation of myocardial tissue. A discussion of the broad effects of CO intoxication is undertaken with a review of the pertinent literature. Diagnostic and therapeutic mainstays are presented with some pitfalls and alternatives to their implementation. Computed tomography of affected muscles is presented as an alternative to muscle biopsy, and a unique modality of noninvasive diagnosis of myonecrosis.
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A 22-year-old man with heavy, generalized exposure to a toluene-based paint developed extensive chemical burns on approximately 71% of his total body surface area followed by acute renal failure and disseminated intravascular coagulation that led to death. Although the skin damage initially appeared mild, it was followed by blistering, extensive necrosis, and massive loss of fluid. ⋯ Although the most common toxic effects of toluene are depression of central nervous system activity, irritation of mucous membranes, and hepatic or renal dysfunctions, emergency physicians should be aware of the risk of skin toxicity. Therefore, it is important to irrigate the exposed skin immediately and vigorously.