scholarly journals Experiences of substance-using suicidal males who present frequently to the emergency department

CJEM ◽  
2008 ◽  
Vol 10 (04) ◽  
pp. 339-346 ◽  
Author(s):  
Julia M. Spence ◽  
Yvonne Bergmans ◽  
Carol Strike ◽  
Paul S. Links ◽  
Jeffrey S. Ball ◽  
...  
Keyword(s):  
Emergency Department ◽  
Substance Abuse ◽  
Suicidal Behaviour ◽  
Group Identification ◽  
High Risk Group ◽  
Staff Members ◽  
Care Workers ◽  
History Of ◽  
Seeking Help ◽  
Iterative Coding

ABSTRACTObjective:This qualitative study investigated the repeated use of the emergency department (ED) by men with a history of suicidal behaviour and substance abuse to understand the needs and barriers to care for this high-risk group. Identification of common themes from interviews with patients and health care workers can serve as a basis for improved ED-based interventions.Methods:Using semistructured interviews, patients, ED staff and family physicians were asked about needs of the aformentioned group. Twenty-five patients were interviewed and completed questionnaires regarding their substance use, aggression, parasuicidal behaviour, alexithymia and childhood trauma. In addition, 27 staff members were interviewed. Interviews were tape-recorded, transcribed and qualitatively analyzed using an iterative coding process.Results:Of the 25 patients, 23 (96%) had a mood or anxiety disorder and 18 (75%) had borderline personality disorder. One-half of the patients scored high and another quarter scored moderate on alexithymia testing. The ED was viewed as a last resort despite seeking help. Frustration was felt by both patients and staff regarding difficult communication, especially during an acute crisis.Conclusion:The ED plays an important role in the provision of care for men with recurrent suicidal behaviour and substance abuse. Some of the diagnoses and problems faced by these patients are beyond the purview of the ED; however, staff can identify mutual goals for crisis interventions, allow for frequent communication and seek to de-escalate situations through the validation of the stress patients are experiencing.

Hospital Experience with Varicella-Zoster Virus

1986 ◽  
Vol 7 (6) ◽  
pp. 312-316 ◽  
Author(s):  
Keith Krasinski ◽  
Robert S. Holzman ◽  
Rita LaCouture ◽  
Alfred Florman
Keyword(s):  
Infection Control ◽  
Varicella Zoster Virus ◽  
Hospital Staff ◽  
Control Measures ◽  
Varicella Zoster ◽  
Staff Members ◽  
Infection Control Measures ◽  
Serologic Testing ◽  
Care Workers ◽  
History Of

AbstractVaricella-zoster virus (VZV), one of the most common highly communicable agents of disease, stimulates aggressive infection control measures. In a 1-year period, at one hospital, at least 93 inpatients (82 adult patients, 11 pediatric patients) and 2 hospital staff with active varicella-zoster infections served as potential sources of nosocomial infection. Six incidents of exposure to the virus that occurred without the protection of standard infection control precautions were investigated by the infection control surveillance team. One hundred fifty-six patients and 353 hospital staff were exposed. Fifty-one patients had no history of varicella-zoster infection, but only five were susceptible by serologic testing. One hundred one staff members had no history of varicella-zoster, but only 11 were susceptible by serologic testing. These exposures resulted in three secondary varicella-zoster infections, six courses of varicella-zoster immune globulin prophylaxis and furlough of 13 staff members. Epidemiologic investigation consumed approximately 356 hours of staff time, and management of exposed persons cost approximately $41,500. Prospective knowledge of the immune status of health care workers would vastly decrease the time and effort required to control hospital VZV exposures.

scholarly journals The Role of Acetyl Cysteine in Cocaethylene (Non-Acetaminophen) Acute Liver Failure

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Getaw Worku Hassen ◽  
Amaninder Dhaliwal ◽  
Catherine Ann Jenninigs ◽  
Hossein Kalantari
Keyword(s):  
Emergency Department ◽  
Substance Abuse ◽  
Liver Failure ◽  
Liver Transplant ◽  
Acute Liver Failure ◽  
Active Substance ◽  
Vital Signs ◽  
Normal Limits ◽  
History Of ◽  
Acetyl Cysteine

Background.Acute liver failure can result from acetaminophen overdose, viral infection, toxins, and other disease conditions. Liver transplant is available in limited fashion and the criteria are strict as to who should get an available liver. N- Acetyl Cysteine (NAC) has been used in non-acetaminophen induced liver failure with success. Here we report a case of acute liver failure from cocaethylene that was reversed with NAC along with other medical therapy.Case Presentation.A 50-year-old female patient presented to the Emergency Department (ED) with a two-day history of coffee ground vomiting and hematemesis. She reported occasional substance abuse and heavy alcoholism. She reported shortness of breath and chest pain from the recurrent forceful vomiting. The rest of the review of systems was unremarkable except a fall from intoxication. Physical examination revealed anicteric conjunctiva and nontender abdomen and her vital signs were within normal limits. Initial blood work revealed acute liver and renal failure. The patient was started with general medical management and liver transplant service rejected the case due to active substance abuse. She underwent brief hemodialysis and was started on NAC. Over the course of her hospital stay her liver function and kidney function improved significantly and patient was discharged to home.Conclusion.In cases where liver transplant is not an option for various reasons including active substance abuse, a trial of N-Acetyl Cysteine may be beneficial and should be considered in the Emergency Department.

Substance-induced Psychotic Disorders in an Emergency Department

2017 ◽  
Vol 41 (S1) ◽  
pp. S203-S203
Author(s):  
A. Fernandez-Quintana ◽  
A. Novo-Ponte ◽  
C. Quiroga-Fernandez ◽  
M.D.C. Garcia-Mahia
Keyword(s):  
Emergency Department ◽  
Substance Abuse ◽  
Psychotic Disorders ◽  
Drug Misuse ◽  
Psychotic Symptoms ◽  
First Year ◽  
Time Interval ◽  
History Of ◽  
Competing Interest ◽  
Urine Testing

IntroductionSubstance abuse has been correlated with psychotic disorders albeit more accurate details on causality remain to be assessed. Furthermore, the prevalence and prognosis of substance-induced psychotic disorders have not been clearly established.MethodRetrospective study performed in 124 patients assessed in an Emergency Department (ED) due to psychotic symptoms over a 6-month period. Medical records were reviewed to obtain clinical and socio-demographic variables.Objectives(1) To analyse substance abuse patterns among ED psychotic patients; (2) to estimate the prevalence of substance-induced psychotic disorders in ED; (3) to underpin the socio-demographic and clinical variables associated.ResultsPersonal history of substance abuse: THC 31.5%, alcohol 29%, cocaine 18.5%, benzodiazepines 18.5%, opiates 6.5%, MDMA 4%, amphetamines 3.2%, hallucinogens 2.4%. Accumulated time interval of substance abuse prior to psychotic onset: 0–5 years 15% (3.9% developed psychosis during the first year of cannabis use), 5–10 years 9.2%, more than 10 years 20.8%. Urine testing for drug misuse undertaken in 80.6% of cases: positives 53%, negatives 47%. Among positive urine test results: THC 16.5%, benzodiazepines 16.5%, cocaine 6.1%, opiates 5.1%, alcohol 0.9%, amphetamines 0.8%, hallucinogens 0.8%. Substance-induced psychotic disorder (F19.15) was diagnosed among 20.4% of patients. This diagnosis was 1.5 times more prevalent among males. Forty-eight percent of patients were single, 36% married, 12% divorced, 4% widowers. Habitat: 68% urban, 34% rural. Highest prevalence group 36 – 50 year olds.ConclusionsBoth substance abuse and substance-induced psychotic disorders are highly prevalent in our sample. Their socio-demographic and clinical profile is similar to that found in schizophrenia. Further refinements of these findings are warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Meaning of Age: In a Context of Eldercare and Substance Use

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 227-227
Author(s):  
Tove Harnett ◽  
Hakan Jonson
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Social Problems ◽  
Multiple Failures ◽  
Staff Members ◽  
History Of ◽  
Age Limit

Abstract Some people age with substance abuse and social problems and several countries provide members of this population with a type of arrangement referred to as “wet” eldercare facilities. These facilities provide care for people who are judged as unable to become sober, in some cases with a lower age-limit at 50 years. The aim of this study was to investigate the meaning of age for judging the fit between the person and the arrangement. The study was based on interviews with 42 residents, 10 case workers and 21 staff members at five facilities in Sweden. Respondents were asked about the relevance of age and if the facility should include younger people as well. Some staff argued that younger people should be excluded since they could not have the history of multiple failures in treatment that was a prerequisite for admission. Regarding the low age-limit, substance abuse was said to accelerate the process of ageing so that a person aged 50 could be considered 20 years older and in need of eldercare. Residents had a tendency to equate age with activity and argued that people below the age of 50 were active and energetic and the inclusion of younger people would lead to disturbance of the calm pace of the facilities. Given that facilities have been described as “end-stations”, it was puzzling that few respondents linked the question of admitting younger person to the matter of giving up ambitions to make the person sober.

scholarly journals Prevalence of SARS CoV-2 infection among Health Care Workers of a hybrid tertiary COVID 19 hospital in Kerala

2021 ◽  
Author(s):  
Jessy S J ◽  
Shamha Beegum ◽  
Genga Gopakumar ◽  
Bindu G ◽  
Chntha S ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Risk Group ◽  
Previous History ◽  
High Risk Group ◽  
Low Risk ◽  
Risk Category ◽  
Care Workers ◽  
History Of

Back ground and objectives- This study was undertaken to estimate the prevalence of SARS-CoV-2 infection among Health care workers [HCWs] of a hybrid COVID treatment hospital in Kerala. Methods- The study was conducted during 3rd week of January 2021. Among 3550 HCWs, 979 subjects were selected by stratified random sampling and grouped into high risk and low risk category based on job setting. Demographic details and clinical information regarding previous history of COVID 19 were collected at the time of SARS-CoV-2 IgG testing. Results: From 979 subjects, the data with respect to 940 health care workers were analysed. SARS-CoV-2 IgG was detected in 19.1% of HCWs. Seroprevalence among high risk group was 20.3% and that in low risk group was 7.4% [p=0.005]. In high-risk group, seropositivity was noted in 30.54 % of nurses, 19% hospital attenders, 18.9% resident doctors and 6.4% consultant doctors. In those with past history of SARS-CoV-2 infection, seropositivity was 75.4%. In those who were COVID positive during July2020, 33.3% were still IgG reactive. Interpretation and conclusion- The study reported 19.1% SARS CoV-2 IgG reactivity among health care workers in our hospital. Seropositivity was significantly higher in high risk group compared to low risk group. Antibody decay kinetics in our study is comparable to that in published literature. Infection control challenges in hybrid hospitals account for higher seropositivity in this study compared to overall seroprevalence among HCWs in Kerala.

SUICIDAL BEHAVIOUR AMONG SCHIZOPHRENIA SPECTRUM IN-PATIAENTS WITH A HISTORY OF SUBSTANCE ABUSE

2010 ◽  
Vol 117 (2-3) ◽  
pp. 308-309
Author(s):  
Nada B. Djordjevic ◽  
Suzana M. tosic Golubovic ◽  
Violeta V. Slavkovic
Keyword(s):  
Substance Abuse ◽  
Suicidal Behaviour ◽  
Schizophrenia Spectrum ◽  
History Of

No So Sunny

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 801-802
Author(s):  
Carole L. Mangrem ◽  
Robert J. Leggiadro
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Risk Group ◽  
Medical Center ◽  
White Male ◽  
High Risk Group ◽  
Infant Feeding Practices ◽  
Regional Medical ◽  
Regional Medical Center ◽  
History Of

We recently cared for a young patient who we believe represents a serious example of egg-associated salmonellosis in a member of a high-risk group because of his young age. His case serves to remind pediatricians to discuss infant feeding practices with parents and to warn them of the potential hazards of eggs related to salmonellosis. This previously healthy 5-month-old white male was brought to the emergency department of a Mississippi regional medical center with a 1-day history of fever and irritability.

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