J Emerg Med
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The number of reported cases of skeletal muscle relaxant ingestion has been increasing in the United States, although fatalities are rare. A 30-year-old women ingested 300 mg of baclofen and ethanol. She was able to ambulate into the Emergency Department (ED) 50 min later, but within 30 min post-arrival had a Glasgow Coma Score of 3. ⋯ Her neurologic status returned to her previous state. Coma may occur rapidly after baclofen overdose, and the respiratory depression may be exacerbated by the co-ingestion of ethanol. Primary importance in the treatment of such ingestions should be placed on maintenance of an airway and respiratory support.
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Serum amylase and lipase levels are commonly obtained in the emergency department for the diagnosis of acute pancreatitis. The role of these enzymes has frequently been the subject of confusion and controversy. This article comprehensively reviews the history, biochemistry, clinical, and laboratory literature on both enzymes as used in the evaluation of pancreatitis. Specific guidelines are presented to assist the Emergency Physician in the appropriate use and interpretation of these clinical laboratory tests.
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Comment Letter Review
Cricothyrotomy technique: standard versus the rapid four step technique.
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Toxins have had major roles in our societies for thousands of years. Interactions between surgeons, both generalists and subspecialists, and those caring for poisoned patients have been extensive throughout history. The advancement of the science of toxicology, the development of regional poison control centers, the development of emergency medicine, and the development of the subspecialty of medical toxicology have led to more appropriate and creative interactions between medical toxicologists, emergency physicians, and surgeons. This article will review the diverse interfaces between the medical toxicologist and the surgeon.