Emergency medicine journal : EMJ
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A short cut review was carried out to establish whether gastric lavage is of use after an overdose of ionic compounds. Altogether 74 papers were found using the reported search but none answered the question posed.
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Case Reports Comparative Study
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Intravenous bolus or infusion of naloxone in opioid overdose.
A short cut review was carried out to establish whether intravenous boluses of naloxone are better than intravenous infusion in opioid overdose. Altogether 188 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper is tabulated. A clinical bottom line is stated.
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Colchicine overdose is uncommon but potentially life threatening. It is a safe drug when used according to established therapeutic guidelines but causes serious systemic effects if ingested in doses that exceed the recommendations. ⋯ A fatal case of colchicine overdose caused by inappropriate self medication is reported and to the best of the authors' knowledge, there has been no report of fatal accidental overdose in the United Kingdom. The pharmacology of colchicine, the clinical features associated with overdose, and the options for treatment are discussed.
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In accidental hypothermia the underlying physiological mechanisms responsible for poor outcome during rewarming through 32 degrees C remain obscure, although possible associations include changes in acid-base balance, divalent cations, and inflammatory markers. This study investigated the metabolic and inflammatory changes that occur during the rewarming of hypothermic patients. ⋯ During rewarming pH remains unchanged until patient temperature approaches 32 degrees C. Ca(2+) and Mg(2+) decline is associated with the pH increase above 32 degrees C. Poor outcome is associated with presentation temperature (<32 degrees C), non-physiological correlation between IL6-PTH-Ca(2+), and age (>or=84 years).