The Role of a Regional Poison Center in Assessing and Managing Disaster Risk.

The United States constantly faces the threat of large-scale disasters caused by natural and human factors. Emergency medical services, other first responders, and emergency department professionals are responsible for triaging and caring for victims of mass casualty incidents that include biological, chemical, and radiological agents. These providers need immediate access to individuals with expertise in infectious disease, medical toxicology, and biological, chemical, and radiological exposure who are readily available or easily accessible in the event of an emergency.

Nomogram line crossing after acetaminophen combination product overdose.

Background: The Rumack-Matthew nomogram predicts the risk of hepatotoxicity following acute acetaminophen overdose based on a serum concentration obtained ≥ 4-hour post-ingestion. Some patients with low-risk concentrations at 4 hours may have subsequent values indicating increased risk (above the nomogram treatment line), especially if coingestants that slow gastrointestinal motility are involved. The treatment line currently used to identify low risk patients in the United States, Canada, and Australia begins at 150 mcg/mL (993 μmol/L) and intersects at 18.

Organic dust toxic syndrome: a review.

Because of differences in presentation, clinical course, diagnostic testing, treatments, prognosis, followup requirements and prevention strategies between ODTS, hypersensitivity pneumonitis, oxides of nitrogen and other pulmonary exposure-related illnesses, it is important for poison centers and clinicians to obtain appropriate elements of history, physical examination, and laboratory data that will allow an accurate diagnosis.

Pharmacy prescription dispensing errors reported to a regional poison control center.

Objectives: To identify the incidence, types, associations, and outcomes of pharmacy prescription dispensing errors reported to a regional poison control center.

Methods: Retrospective chart review over a 35-month period.

Results: Of 77,992 drug exposures reported, there were 6450 unintentional therapeutic exposures.

[Efficacy of low doses of heparin to postoperative changes of blood gases after abdominal surgery (author's transl)].

Arterial hypoxaemia near critical values may occur during the postoperative period after surgery under general anaesthesia. Mainly alterations of ventilation/perfusion ratio seem to be the cause for this disorder. In this study we examined the effect of low-dose-heparin in improving pulmonary perfusion and consequently reduction of postoperative hypoxaemia.

[A new treatment method for hydrochloric acid burns of the hand].

The progression of hydrofluoric acid corrosion on the hands, which cannot be arrested by other means and leads to crippling or amputation, can be stopped by one single or several repeated intra-arterial perfusions of 10 ml 20% calcium-gluconate solution in 40 ml normal saline over 4 hours as close to the defect as possible via the brachial artery or one of the forearm arteries. In 4 patients, with corrosion of a severity judged to be between first and third degree, spontaneous healing resulted after this treatment. Based on our experience we advise the use of intra-arterial perfusion and show its advantages over subcutaneous injections or intravenous infusion of calcium.

[A new treatment method of hydrofluoric acid burns of the extremities].

A new method to arrest the unremitting progression of hydrofluoric acid burns, which occurs in the absence of appropriate therapy, is described. The treatment consists of repeated perfusions of calcium gluconate into one of the arteries supplying the affected areas. To date 11 patients have been treated in the described manner, and the therapy brought about recovery in all cases, with little loss of tissue or function.

[Three different tumors in a case of synovial sarcoma of the hand].

Examining a 74 year old female patient with a nodular goiter, a tumor of the left thenar eminence with a concurrent radiolucent swelling in the adjoining second metacarpal was found. The diagnosis was a struma nodosa with regressive marginal changes, a hypervascularized monophasic synovial sarcoma of the wrist joint, and an enchondroma of the second metacarpal bone. Following the amputation of the forearm, no radiotherapy or cytotoxic therapy was performed.

[Postoperative changes of blood gases after uncomplicated abdominal surgery in geriatric patients (author's transl)].

In 34 elderly male and female patients undergoing upper abdominal surgery under general anaesthesia we investigated duration and degree of postoperative hypoxaemia. In this study only patients with no signs and symptoms of pulmonary or cardiac diseases, verified by normal lung function--vital capacity and FEV1, X-ray and electrocardiographic findings were considered. Postoperative development was free of complications and temperature rises in all cases.

[Haemodynamic effects after rapid infusion of dextrane in geriatric patients (author's transl)].

In 85 geriatric premedicated patients haemodynamic effects were investigated following rapid infusion of 500 ml dextrane. The data measured one day preoperative revealed typical age-related changes of the cardiovascular system: decrease of cardiac output, stroke volume and heart rate; increase of peripheral vascular resistance and mean arterial pressure. After infusion of dextran central venous pressure rose by 4.

[Computer-supported basic documentation at the accident-surgical clinic of the Hannover Medical School].

On the example of the computer-aided basic documentation at the Department of Traumatology Hannover, the necessity of constructive cooperation between the clinic staff and the medical data processors is shown. The system of basic documentation is primarily explained in its conception as far as the clinic is concerned. The fundamental principles, daily routine, and clinical application of this system are described, as are the tasks assigned to the clinical staff within the framework of medical data processing.

[Documentation and physician's letter by means of modern data processing].

When starting our surgical out-patient department at the Hannover Medical School we were forced to computerize our medical correspondence as far as possible. In cooperation with the department of biometrics of the Hannover Medical School, a set of three computerized forms was established which in addition to facilitating medical correspondence enabled systematic documentation. The FTSS system generally used in the computer language PL/1 was used for computerization of our forms.