Recognition of a disulfiram ethanol reaction in the emergency department is not always straightforward.

Objectives: Disulfiram is an adjunct in the treatment of alcohol use disorders, but case reports indicate that disulfiram ethanol reactions are not always recognized in the emergency department. Our first aim is to remind of this risk with two case reports of life-threatening reactions not immediately considered by the emergency physician. The second aim is to estimate the probability that a disulfiram reaction goes unrecognized with the use of a retrospective study of patients admitted to the emergency department.

Hospital referrals of patients with acute poisoning by the Belgian Poison Centre: analysis of characteristics, associated factors, compliance and costs.

Objective: Aims were (1) to assess the characteristics, associated factors and compliance of patients with acute poisoning advised by the Belgian Poison Centre (BPC) to go (conditionally) to the hospital, (2) to assess the compliance and potential health-economic impact.

Methods: Three types of referrals to the hospital of patients who called the BPC between 1 January and 30 June 2018 were analysed: referrals in case of deterioration in the patient's condition (Hosp-watchful-wait), referrals (Hosp-referral) or urgent referrals (Hosp-urgent-referral). Factors associated with type of recommendation were registered.

Implementation of a protocol using ketamine-propofol ('ketofol') in a 1 to 4 ratio for procedural sedation in adults at a university hospital emergency department - report on safety and effectiveness.

: To test the feasibility of an evidence-based protocol for procedural sedation in adults at our emergency department, using a mixture of ketamine and propofol ('ketofol') in a 1 to 4 ratio. We hypothesize that the protocol is safe and effective and can facilitate procedural sedation.: During 14 months, adults in need of procedural sedation at our university hospital emergency department were included in a prospective convenience sample study.

Characteristics and costs in adults with acute poisoning admitted to the emergency department of a university hospital in Belgium.

Objective: The aims of this study were to assess the characteristics of all acute poisoning admissions among adult emergency department (ED) patients, to identify factors associated with admission and to calculate direct medical cost.

Methods: Data of 2017 (1st January to 31st December) were collected and analyzed retrospectively using patients' medical records and hospital invoices. Factors associated with type of hospitalization were identified using appropriate statistics.

Adults with acute poisoning admitted to a university hospital in Belgium in 2017: cost analysis benchmarked with national data.

Aims were to (1) analyse the direct cost charged by a university hospital to the government and the patient in case of an admission for acute poisoning, (2) identify the factors associated with the cost, and (3) compare the cost in the hospital studied with national data from the government. Patient records and invoices of all poisoning-related episodes of patients 14 years or older admitted to the Emergency Department (ED) of Ghent University Hospital (GUH) in 2017 were analysed. A generalised linear model with gamma loglink was applied to assess the variables associated with the cost.

Belgian Poison Centre impact on healthcare expenses of unintentional poisonings: a cost-benefit analysis.

Objectives: This study evaluates the impact of the Belgian Poison Centre (BPC) on national healthcare expenses for calls from the public for unintentional poisonings.

Methods: The probability of either calling the BPC, consulting a general practitioner (GP) or consulting an emergency department (ED) was examined in a telephone survey (February-March 2016). Callers were asked what they would have done in case of unavailability of the BPC.

Ingestion of white spirit resulting in perineal skin burns: a case report and review of the literature.

In the literature, possible systemic effects on health of inhalation or ingestion of white spirit are well described. Only a few case reports discuss the toxic skin effects that can occur following massive ingestion. Ingestion of large amounts of white spirit produces a watery diarrhoea with a high concentration of white spirit, resulting in perineal skin burns when there is prolonged contact.

Biomarkers in patients admitted to the emergency department after exposure to acrylonitrile in a major railway incident involving bulk chemical material.

Background: A railway incident with victims of exposure to the cyanogenic substance acrylonitrile (ACN).

Aims: We retrospectively (i)built an inventory of the clinical characteristics of individuals admitted to surrounding emergency departments (ED's) and (ii)studied the correlation between N-2-cyanoethylvaline (CEV), a biomarker used in a population study for evaluating exposure to ACN, with lactate and thiocyanate (SCN), biomarkers determined during emergency care.

Results: 438 patients from 11 ED's were included and presented with known symptoms of ACN poisoning but also with concern about the risks.

Combined acute inhalation of hydrofluoric acid and nitric acid: a case report and literature review.

We describe a nonlethal, delayed onset case of combined acute inhalation of hydrofluoric acid (HFA) and nitric acid (NA) together with a review of the literature. Our patient was exposed to fumes of a 12% HFA and 22% NA solution in a closed environment and suffered during several months after the incident from exertional dyspnoea but recovered completely. Since HFA and NA are dangerous and widely used substances, preparedness for exposure is mandatory.

Spontaneous tension pneumoperitoneum presenting as an out of hospital cardiac arrest: A case report and review of the literature.

Objectives: It is known that tension pneumoperitoneum (TPP) can lead to cardiopulmonary arrest but it does not figure in the advanced life support algorithms. Therefore we discuss a case of TPP together with the literature review of its aetiology and treatment.

Patient: We describe an out of hospital cardiac arrest due to a spontaneous TPP secondary to a perforated duodenal ulcer.

Disulfiram inhibition of cyanide formation after acetonitrile poisoning.

Context: Cyanide poisoning may be caused by acetonitrile, a common industrial organic solvent and laboratory agent.

Objective: To describe the potential use of disulfiram in treating acetonitrile poisoning in a human clinical case and to further study its effect in human liver microsomes in vitro.

Case Details: A 30-year-old man initially presented with a cholinergic toxic syndrome following ingestion of aldicarb.

Communication in healthcare: a narrative review of the literature and practical recommendations.

Objectives: Effective and efficient communication is crucial in healthcare. Written communication remains the most prevalent form of communication between specialised and primary care. We aimed at reviewing the literature on the quality of written communication, the impact of communication inefficiencies and recommendations to improve written communication in healthcare.

The impact of neighborhood deprivation on patients' unscheduled out-of-hours healthcare seeking behavior: a cross-sectional study.

Background: The use of unscheduled out of hours medical care is related to the social status of the patient. However, the social variance in the patient's preference for a hospital based versus a primary care based facility, and the impact of specific patient characteristics such as the travel distance to both types of facilities is unclear. This study aims to determine the social gradient in emergency care seeking behavior (consulting the emergency department (ED) in a hospital or the community-based Primary Care Center (PCC)) taking into account patient characteristics including the geographical distance from the patient's home to both services.

Presence of psychoactive substances in injured Belgian drivers.

Objective: To estimate the percentage of drivers involved in a traffic crash in Belgium who have alcohol and drugs in their blood.

Methods: Blood samples of the drivers injured in a traffic crash and admitted to the emergency departments of 5 hospitals in Belgium between January 2008 and May 2010 were analyzed for ethanol (with an enzymatic method) and 22 other psychoactive substances (with ultra-performance liquid chromatography with tandem mass spectrometry or gas chromatography-mass spectrometry).

Results: One thousand seventy-eight drivers were included in the study.

Drug interactions and adverse drug reactions in the older patients admitted to the emergency department.

Purpose: The aim of this study was to prospectively evaluate drug interactions and adverse drug reactions (ADRs) in the older patients admitted to the emergency department (ED) and to characterize risk factors.

Methods: In 80 patients aged 65 years and older medication history and ED drug administration were analysed. Medical records were analysed for ADRs by an expert panel which also evaluated their avoidability and causality.

Use of out-of-hours services: the patient's point of view on co-payment a mixed methods approach.

Introduction: In many countries out of hours (OOH) care is offered by different health care services. General practitioners (GP) tend to offer services in competition with emergency departments (ED). Patients behaviour depends on a number of factors.

An inquiry on pain management in the emergency department of training hospitals.

Introduction: Improving pain management in the ED might be attained by adequate teaching of medical students. We assessed the skills in pain treatment of ED physicians who teach the students.

Methods: All physicians working in an ED who provide elective training to undergraduate medical students from the Ghent University were asked to complete a questionnaire consisting of vignette patient cases concerning acute pain management of abdominal colic pain, and non-traumatic abdominal pain.

Disorders of consciousness induced by intoxication.

The prognosis of patients with altered consciousness is mainly determined by early diagnosis and appropriate therapeutic interventions and by the type of toxin. The potential causes of altered consciousness are many and may reflect systemic illness, isolated organ system dysfunction, drug intoxications or withdrawal, psychiatric illness, or neurologic disease. In this article, a comprehensive approach to patients with altered consciousness and suspected poisoning is discussed.

Nursing home residence is the main risk factor for increased mortality in healthcare-associated pneumonia.

Healthcare-associated pneumonia (HCAP) is considered to represent a category of disease distinct from community-acquired pneumonia (CAP). We describe the incidence and characteristics of HCAP compared with CAP in patients hospitalised through the emergency department (ED). Pneumonia diagnosed at the ED of Ghent University Hospital from 1 November 2006 to 31 October 2007 was retrospectively categorised as CAP or HCAP according to the definition of the American Thoracic Society/Infectious Diseases Society of America.

Out of hours care: a profile analysis of patients attending the emergency department and the general practitioner on call.

Background: Overuse of emergency departments (ED) is of concern in Western society and it is often referred to as 'inappropriate' use. This phenomenon may compromise efficient use of health care personnel, infrastructure and financial resources of the ED. To redirect patients, an extensive knowledge of the experiences and attitudes of patients and their choice behaviour is necessary.

A 50-year-old man with severe hypercalcemia: a case report.

Objective: We present this case to emphasize the importance of early diagnosis and treatment of an acute severe hypercalcemic syndrome due to primary hyperparathyroidism as a consequence of an undiagnosed adenoma of the parathyroid gland.

Case Report: A 50-year-old man presented at another hospital with non-specific symptoms such as anorexia, nausea, vomiting, polyuria, dehydration, abdominal pain, weight loss, fatigue, muscular weakness, irritability and lethargy. Serum levels of calcium and parathyroid hormone (PTH) were markedly increased to 23.

Should the general practitioner be prepared for the patient with decreased consciousness or coma?

Background: Data are scarce about the possible role for the general practitioner (GP) in patients with decreased consciousness (DC) or coma. We wanted to investigate how often a GP is confronted with DC or coma during out-of-hours service in an urban region and to compare the patients presented to primary care to those who were immediately treated by the emergency medical services (EMS).

Method: In a prospective observational study during 2 weekends in the city of Ghent, Belgium, which has 232 500 inhabitants, 724 patients were seeking emergency care, and DC or coma was the reason for encounter in 27 patients (3.

Abrupt awakening phenomenon associated with gamma-hydroxybutyrate use: a case series.

Case reports mention a sudden awakening from GHB-associated coma but do not specify its time course. The aim of the present case series was to investigate the time course of the awakening from GHB intoxication and the relationship to plasma concentrations of GHB and the presence of other drugs. Unconscious (GCS View Article and Find Full Text PDF