Does getting high hurt? Characterization of cases of LSD and psilocybin-containing mushroom exposures to national poison centers between 2000 and 2016

2018 ◽  
Vol 32 (12) ◽  
pp. 1286-1294 ◽  
Author(s):  
James B Leonard ◽  
Bruce Anderson ◽  
Wendy Klein-Schwartz
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Clinical Effects ◽  
Medical Outcomes ◽  
Critical Care Units ◽  
Large Populations ◽  
Emergency Department Management ◽  
Poison Centers ◽  
Psychiatric Conditions

Background: Lysergic acid diethylamide (LSD) and psilocybin are serotonergic hallucinogens that are used primarily for recreational abuse. Small studies evaluated the efficacy of LSD and psilocybin for several psychiatric conditions. There are limited safety or toxicity data for either of these substances, especially in large populations. Methods: This was a retrospective analysis of single-substance exposures of LSD or psilocybin-containing mushrooms (PcMs) reported to United States poison centers from 1 January 2000 to 31 December 2016. The study describes the most frequent toxicities, management sites, and medical outcomes. Results: A total of 5883 PcM and 3554 LSD exposures were included. Most patients were between 13 and 29 years of age (83.9% PcM, 88.9% LSD) and primarily male (77.9% PcM, 74.1% LSD). Most common clinical effects were hallucinations (45.8% PcM, 37.4% LSD), agitation (24.1% PcM, 42.4% LSD), and tachycardia (18.0% PcM, 38.6% LSD). Serious clinical effects were infrequent, but included hyperthermia, seizures, coma, increased serum creatinine, and cardiac arrest. Most patients were treated and released from the emergency department. More LSD patients were admitted to critical care and non-critical care units than PcM patients. Moderate effect was the most frequent outcome for both substances (61.0% PcM, 62.3% LSD). Conclusion: These data find that LSD and PcM use occurs primarily in adolescents and young adults, who experience mild to moderate adverse effects. Serious effects are infrequent but can occur. While most LSD and PcM users require only emergency department management, LSD use is more likely to require medical admission.

scholarly journals Characterization of Bacterial Etiologic Agents of Biofilm Formation in Medical Devices in Critical Care Setup

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Sangita Revdiwala ◽  
Bhaumesh M. Rajdev ◽  
Summaiya Mulla
Keyword(s):  
Critical Care ◽  
Medical Devices ◽  
Biofilm Formation ◽  
Medical Implants ◽  
Bacterial Isolates ◽  
Critical Care Units ◽  
Etiologic Agents ◽  
Bacterial Drug Resistance ◽  
Biofilm Development

Background. Biofilms contaminate catheters, ventilators, and medical implants; they act as a source of disease for humans, animals, and plants.Aim. Critical care units of any healthcare institute follow various interventional strategies with use of medical devices for the management of critical cases. Bacteria contaminate medical devices and form biofilms.Material and Methods. The study was carried out on 100 positive bacteriological cultures of medical devices which were inserted in hospitalized patients. The bacterial isolates were processed as per microtitre plate. All the isolates were subjected to antibiotic susceptibility testing by VITEK 2 compact automated systems.Results. Out of the total 100 bacterial isolates tested, 88 of them were biofilm formers. A 16–20-hour incubation period was found to be optimum for biofilm development. 85% isolates were multidrug resistants and different mechanisms of bacterial drug resistance like ESBL, carbapenemase, and MRSA were found among isolates.Conclusion. Availability of nutrition in the form of glucose enhances the biofilm formation by bacteria. Time and availability of glucose are important factors for assessment of biofilm progress. It is an alarm for those who are associated with invasive procedures and indwelling medical devices especially in patients with low immunity.

Environmental Emergencies

2019 ◽  
pp. 136-147
Author(s):  
Michael A. Darracq
Keyword(s):  
Emergency Department ◽  
Environmental Change ◽  
Clinical Effects ◽  
Lightning Strikes ◽  
Know How ◽  
First Response ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Large Populations ◽  
Extremes Of Temperature

Although environmental emergencies are not the most common presentations to the emergency department (ED), as humans continue to explore more remote areas of the planet and as large populations encounter environmental change at increasing rates, it is important for emergency clinicians to know how to manage these conditions. From extremes of temperature, to extremes of pressure, to drownings and lightning strikes, to a myriad of possible envenomations, environmental emergencies are interesting and diverse. This chapter presents questions related to the diagnosis, clinical effects, best first response in the ED, and most appropriate treatment of a wide range of these environmental emergencies.

Characterization of severe hypoglycemia episodes evaluated in the emergency department of a central hospital

2014 ◽  
Author(s):  
Cesar Esteves ◽  
Manuel Celestino Neves ◽  
Rui Baldaia ◽  
Joao Sa ◽  
Davide Carvalho
Keyword(s):  
Emergency Department ◽  
Severe Hypoglycemia ◽  
Central Hospital

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

Data-Driven Optimization Methodology for Admission Control in Critical Care Units

2016 ◽  
Author(s):  
Amirhossein Meisami ◽  
Jivan Deglise-Hawkinson ◽  
Mark Cowen ◽  
Mark P. Van Oyen
Keyword(s):  
Critical Care ◽  
Admission Control ◽  
Data Driven ◽  
Critical Care Units ◽  
Optimization Methodology

Embodied Spatial Practices and the Power to Care

2019 ◽  
pp. 360-377
Author(s):  
Elise Paradis ◽  
Warren Mark Liew ◽  
Myles Leslie
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Ethnographic Study ◽  
Spatial Practices ◽  
Critical Care Units ◽  
Interprofessional Care ◽  
The Social

Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.

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