Neonicotinoid insecticide exposures reported to six poison centers in Texas

2014 ◽  
Vol 33 (6) ◽  
pp. 568-573 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Minor Effect ◽  
Clinical Effects ◽  
Dermal Irritation ◽  
Flea Control ◽  
Neonicotinoid Insecticide ◽  
Poison Centers

Neonicotinoids are a relatively newer class of insecticide. Used primarily in agriculture, neonicotinoids are also used for flea control in domestic animals. Information on human exposures to neonicotinoids is limited. Neonicotinoid exposures reported to Texas poison centers during 2000–2012 were identified and the distribution by selected factors examined. Of 1,142 total exposures, most products contained imidacloprid (77%) or dinotefuran (17%). The exposures were seasonal with half reported during May–August. The most common routes of exposure were ingestion (51%), dermal (44%), and ocular (11%). The distribution by patient age was 5 years or less (28%), 6–19 years (9%), 20 years or more (61%), and unknown (2%); and 64% of the patients were female. Of all, 97% of the exposures were unintentional and 97% occurred at the patient’s own residence. The management site was on-site (92%), already at/en route to a health care facility (6%), and referred to a health care facility (2%). The medical outcomes included no effect (22%), minor effect (11%), moderate effect (1%), not followed judged nontoxic (14%), not followed minimal effects (46%), unable to follow potentially toxic (1%), and unrelated effect (4%). The most commonly reported adverse clinical effects were ocular irritation (6%), dermal irritation (5%), nausea (3%), vomiting (2%), oral irritation (2%), erythema (2%), and red eye (2%). The most frequently reported treatments were dilution/wash (85%) and food (6%). In summary, these data suggest that the majority of neonicotinoid exposures reported to the poison centers may be managed outside of health care facilities with few clinical effects expected.

Pattern of ziprasidone exposures reported to Texas poison centers, 2001–2005

2008 ◽  
Vol 27 (4) ◽  
pp. 355-361 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Poison Control Centers ◽  
Poison Centers ◽  
The Mean

Information on potentially adverse exposures to the atypical antipsychotic drug ziprasidone is limited. This study described the pattern of exposures involving only ziprasidone (isolated exposures) reported to Texas poison control centers during 2001–2005. The mean dose was 666 mg. The patient age distribution was ≤5 years (11%), 6–19 years (30%), and ≥20 years (60%). The exposures were intentional in 53% of the cases. Seventy-five percent of the exposures were managed at health care facilities. The final medical outcome was classified as no effect for 39% of the cases and minor effects for 40% of the cases. Adverse clinical effects were listed for 53% of the patients; the most frequently reported being neurological (42%), cardiovascular (13%), and gastrointestinal (5%). The most frequently listed treatment was decontamination by charcoal (34%) or cathartic (28%). Potentially adverse ziprasidone exposures reported to poison control centers are likely to involve management at a health care facility and involve some sort of adverse clinical effect. With proper treatment, the outcomes of such exposures are generally favorable.

Adult metaxalone ingestions reported to Texas poison control centers, 2000-2006

2009 ◽  
Vol 29 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Mathias B Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Poison Control Centers ◽  
Few Data

Few data exist on potentially adverse metaxalone (Skelaxin®) ingestions in adults. All metaxalone ingestions involving patients aged ≥20 years during 2000-2006 were retrieved from Texas poison control centers. Exclusion criteria were lack of follow-up or multiple substance ingestion. Cases were analyzed for selected demographic and clinical factors. Of the 142 patients, 66.2% were female. Dose ingested was reported for 61 patients. Of those cases with a reported dose, distribution by management site was 29.5% on-site, 59.0% already at/en route to health care facility, and 11.5% referred to health care facility. Final medical outcome was ‘no effect’ for 50.8% cases, ‘minor effect’ for 31.1%, and ‘moderate effect’ for 18.0%. The more common adverse clinical effects reported were drowsiness (27.9%), tachycardia (6.6%), agitation (6.6%), nausea (4.9%), dizziness (4.9%), slurred speech (4.9%), and tremor (4.9%). A moderate medical outcome occurred in 13.6% of ingestions of ≤2400 mg and 20.5% of ingestions of >2400 mg. Management involved a health care facility in 18.2% of ingestions of ≤2400 mg and 100.0% of ingestions of >2400 mg. This study found that adult ingestions of higher doses of metaxalone, particularly >2400 mg, were associated with more serious medical outcomes and were managed at health care facilities. This study also proposes triage guidelines for when ingestions can be safely managed at home.

Redotex ingestions reported to Texas poison centers

2010 ◽  
Vol 29 (9) ◽  
pp. 789-791
Author(s):  
Mathias B Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Minor Effect ◽  
Poison Center ◽  
Clinical Effects ◽  
Clinical Factors ◽  
Poison Centers ◽  
Moderate Effect

Although the multi-component weight loss supplement Redotex is banned in the United States, the supplement can be obtained in Mexico. The intent of this report was to describe the pattern of Redotex calls received by a statewide poison center system. Cases were all Redotex calls received by Texas poison centers during 2000—2008. The distribution of total calls and those involving ingestion of the supplement were determined for selected demographic and clinical factors. Of 34 total Redotex calls received, 55.9% came from the 14 Texas counties that border Mexico. Of the 22 reported Redotex ingestions, 77.3% of the patients were female and 45.5% 20 years or more. Of the 17 ingestions involving no coingestants, 52.9% were already at or en route to a health care facility, 41.2% were managed on site, and 5.9% was referred to a health care facility. The final medical outcome was no effect in 23.5% cases, minor effect in 5.9%, moderate effect in 11.8%, not followed but minimal clinical effects possible in 47.1%, and unable to follow but judged to be potentially toxic in 11.8%. Most Redotex calls to the Texas poison center system originated from counties bordering Mexico.

An 11-year retrospective review of venlafaxine ingestion in children from the California Poison Control System

2015 ◽  
Vol 35 (7) ◽  
pp. 767-774 ◽  
Author(s):  
S Doroudgar ◽  
PJ Perry ◽  
GD Lackey ◽  
NG Veselova ◽  
HM Chuang ◽  
...  
Keyword(s):  
Health Care ◽  
Control System ◽  
Care Facility ◽  
Health Care Facility ◽  
Altered Mental Status ◽  
The United States ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Phone Calls

Venlafaxine is commonly used in the United States for approved and non-Food and Drug Administration–approved indications in adults. It is used off-label to treat children for psychiatric diagnoses. The aim of the study was to describe venlafaxine toxicities in children and to identify the venlafaxine dose per weight that correlates with toxicities. An 11-year retrospective study of venlafaxine ingestion in children was performed using the California Poison Control System (CPCS) database. Data was extracted from phone calls received by CPCS clinicians and follow-up phone calls made to assess the patient’s progress in a health-care setting. Inclusion criteria were venlafaxine ingestion cases reported to CPCS between January 2001 and December 2011, children aged 20 years and under, venlafaxine as the only ingested substance, managed in a health-care facility, and followed to a known outcome. Two hundred sixty-two cases met the study criteria. Common presentations included gastrointestinal (14.9%), altered mental status (13.7%), and tachycardia (13.4%). The majority of the cases resulted in no effect (51.5%) or minor effect (19.9%). The average estimated dose per weight was 18.3 mg/kg in all patients and 64.5 mg/kg in those experiencing moderate-to-severe adverse effects. Seizures occurred in only 4 of the 262 cases at doses ranging from 1500 to 7500 mg. Although the estimated dose per weight exceeded 10 mg/kg for the majority of the cases, only 12 cases resulted in moderate or severe outcomes. The majority of venlafaxine ingestion cases in children resulted in either no clinical effects or minor clinical effects.

Human exposures to pentobarbital–phenytoin combination veterinary drugs

2016 ◽  
Vol 36 (7) ◽  
pp. 755-761 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Lethal Effect ◽  
Major Effect ◽  
Veterinary Drug ◽  
Minor Effect ◽  
Exposure Site ◽  
Poison Centers ◽  
Exposure Routes

A combination of pentobarbital and phenytoin is used as a veterinary euthanasia drug. Because of its lethal effect, this study described pentobarbital–phenytoin combination veterinary drug human exposures reported to Texas poison centers during 2000–2015. Of 66 exposures, 73% involved female and 27% male patients. The distribution by patient age was 3% 0–5 years, 5% 6–19 years, 91% 20+ years, and 2% unknown. The most common routes were ocular (41%), ingestion (32%), injection (23%), and dermal (18%). The exposure reasons were unintentional (77%) and intentional (23%). The exposure site was the workplace (52%), patient’s own residence (38%), health-care facility (2%), and other/unknown (9%). The management site was managed on site (48%), at/en route to health-care facility (45%), referred to health-care facility (5%), and other (2%). The medical outcomes were no effect (23%), minor effect (30%), moderate effect (8%), major effect (8%), not followed nontoxic (3%), not followed minimal effects (24%), unable to follow potentially toxic (2%), and unrelated (3%). The most common adverse effects were ocular irritation/pain (18%), drowsiness/lethargy (15%), and coma (9%). The most common treatments were dilution/irrigation (70%), intravenous fluids (21%), and oxygen (14%). This study found few pentobarbital–phenytoin combination veterinary drug exposures were reported to Texas poison centers during a 16-year period. Although meant to be administered intravenously, the most common exposure routes were ocular and ingestion. Many of the exposures appeared to be unintentional and occurred at the workplace.

The Great Awakening - Digitalization in Dental Healthcare during the pandemic COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 380-384
Author(s):  
Priyanka Paul Madhu ◽  
Yojana Patil ◽  
Aishwarya Rajesh Shinde ◽  
Sangeeta Kumar ◽  
Pratik Phansopkar
Keyword(s):  
Health Care ◽  
Task Force ◽  
Care Service ◽  
Health Care Service ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
World Health ◽  
Record System ◽  
The World

disease in 2019, also called COVID-19, which has been widely spread worldwide had given rise to a pandemic situation. The public health emergency of international concern declared the agent as the (SARS-CoV-2) the severe acute respiratory syndrome and the World Health Organization had activated significant surveillance to prevent the spread of this infection across the world. Taking into the account about the rigorousness of COVID-19, and in the spark of the enormous dedication of several dental associations, it is essential to be enlightened with the recommendations to supervise dental patients and prevent any of education to the dental graduates due to institutional closure. One of the approaching expertise that combines technology, communications and health care facilities are to refine patient care, it’s at the cutting edge of the present technological switch in medicine and applied sciences. Dentistry has been improved by cloud technology which has refined and implemented various methods to upgrade electronic health record system, educational projects, social network and patient communication. Technology has immensely saved the world. Economically and has created an institutional task force to uplift the health care service during the COVID 19 pandemic crisis. Hence, the pandemic has struck an awakening of the practice of informatics in a health care facility which should be implemented and updated at the highest priority.

A Web-Based Interactive Map to Promote Health-Care Facility Flood Preparedness

2021 ◽  
pp. 1-4
Author(s):  
Elena Grossman ◽  
Michelle Hathaway ◽  
Amber Khan ◽  
Apostolis Sambanis ◽  
Samuel Dorevitch
Keyword(s):  
Health Care ◽  
Emergency Preparedness ◽  
Online Survey ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Interactive Map

Abstract Objectives: Little is known about how flood risk of health-care facilities (HCFs) is evaluated by emergency preparedness professionals and HCFs administrators. This study assessed knowledge of emergency preparedness and HCF management professionals regarding locations of floodplains in relation to HCFs. A Web-based interactive map of floodplains and HCF was developed and users of the map were asked to evaluate it. Methods: An online survey was completed by administrators of HCFs and public health emergency preparedness professionals in Illinois, before and after an interactive online map of floodplains and HCFs was provided. Results: Forty Illinois HCFs located in floodplains were identified, including 12 long-term care facilities. Preparedness professionals have limited knowledge of whether local HCFs were in floodplains, and few reported availability of geographic information system (GIS) resources at baseline. Respondents intended to use the interactive map for planning and stakeholder communications. Conclusions: Given that HCFs are located in floodplains, this first assessment of using interactive maps of floodplains and HCFs may promote a shift to reliable data sources of floodplain locations in relation to HCFs. Similar approaches may be useful in other settings.

scholarly journals The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.

2020 ◽  
Author(s):  
Corinna Vossius ◽  
Estomih Md ◽  
Robert Moshiro ◽  
Paschal M ◽  
Jan Terje Kvaløy ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Low Birthweight ◽  
Care Facility ◽  
Health Care Facility ◽  
Skilled Birth Attendance ◽  
Health Care Facilities ◽  
Birth Attendance ◽  
Vaginal Deliveries ◽  
The Impact

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.

scholarly journals REVIEWING CLINICAL WASTE MANAGEMENT UNDER THE LEGISLATIVE FRAMEWORK IN PAKISTAN: PRACTICES AND CHALLENGES

2021 ◽  
Vol 3 (2) ◽  
pp. 69-76
Author(s):  
Um e Hani ◽  
Ilyas Hussain Sarfaraz
Keyword(s):  
Health Care ◽  
Waste Management ◽  
Hazardous Waste ◽  
Treatment Strategies ◽  
Care Facility ◽  
Health Care Facility ◽  
Review Article ◽  
Health Care Facilities ◽  
International Standards ◽  
Control Treatment

The waste generated at healthcare facilities has two distinct categories: hazardous and non-hazardous waste. 10- 15% of the total waste generated at hospitals is hazardous which is termed as clinical waste. This review article has reported and reviewed the practices of clinical waste management in Pakistan’s major cities. Researches demonstrated that about 1.35 Kg / bed waste has been produced by the tertiary health care facilities in Pakistan. Studies for review process are selected through an iterative process. More than 100 research articles, National legislations, international protocols and newspaper reports are consulted and reviewed to extract the data of interest. Clinical waste management in Pakistan is the responsibility of the individual health care facility producing it under Hospital Waste Management Rules, 2005. Due to lack of proper checks and weak implementation of legislations many gaps have been identified in this review article like lack of segregation, inappropriate vehicles for transportation, poor storage and no advanced pollution control treatment strategies. Most of the hospitals lack documented waste management plan. Staff was mostly untrained and under educated. International standards for safe hazardous waste disposal are not being followed resulting in spread of diseases like hepatitis and AIDS. Cases of poor recycling and reuse of used clinical instruments is also documented. However, the condition is much satisfactory in big cities. There is an understanding to focus on the proper implementation of clinical waste management rules with strict checks. Establishment of incineration facility at major hospitals with proper maintenance, safe transportation to secure landfills and utilization of proper SOPs are suggested improvements towards safe management of clinical waste.

Surge Capacity Concepts for Health Care Facilities: The CO-S-TR Model for Initial Incident Assessment

2008 ◽  
Vol 2 (S1) ◽  
pp. S51-S57 ◽  
Author(s):  
John L. Hick ◽  
Kristi L. Koenig ◽  
Donna Barbisch ◽  
Tareg A. Bey
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Management Training ◽  
Health Care Facilities ◽  
Incident Management ◽  
Conceptual Tool ◽  
Surge Capacity ◽  
Incident Command ◽  
Facility Level

ABSTRACTFacility-based health care personnel often lack emergency management training and experience, making it a challenge to efficiently assess evolving incidents and rapidly mobilize appropriate resources. We propose the CO-S-TR model, a simple conceptual tool for hospital incident command personnel to prioritize initial incident actions to adequately address key components of surge capacity. There are 3 major categories in the tool, each with 4 subelements. “CO” stands for command, control, communications, and coordination and ensures that an incident management structure is implemented. “S” considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations. “TR” comprises tracking, triage, treatment, and transportation: basic patient care and patient movement functions. This comprehensive yet simple approach is designed to be implemented in the immediate aftermath of an incident, and complements the incident command system by aiding effective incident assessment and surge capacity responses at the health care facility level. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S51–S57)

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