Management of chlorine gas-related injuries from the Graniteville, South Carolina, train derailment.

A widely produced chemical, chlorine is used in various industries including automotive, electronics, disinfectants, metal production, and many others. Chlorine is usually produced and transported as a pressurized liquid; however, as a gas it is a significant pulmonary irritant. Thousands of people are exposed to chlorine gas every year, and while large-scale exposures are uncommon, they are not rare.

Intravenous lipid emulsion for treatment of local anesthetic toxicity.

Clinical Question: Is intravenous lipid emulsion a safe and effective therapy for the reversal and treatment of local anesthetic toxicity?

Results: Systematic reviews, human case reports, and experimental animal studies have demonstrated the efficacy of intravenous lipid emulsion therapy in successfully reversing cardiac arrhythmias, cardiac arrest, and cardiac collapse seen with severe systemic local anesthetic toxicity. There are fewer data to support treatment of neurologic toxicities associated with local anesthetics.

Implementation: Intravenous lipid emulsion 20% should be available whenever patients receive large doses of local anesthetics in operating rooms and emergency departments.

Cost-benefit analysis of a regional poison center.

Background: Funding poison center (PC) operations has become a major challenge nationwide. Increasingly, state and federal budget cuts have resulted in diminished funding to PCs.

Objectives: In an effort to demonstrate the value of current PC phone services, a cost-benefit analysis of a regional center was completed.

Herbal drugs of abuse: an emerging problem.

Some herbal products are emerging as popular drugs for recreational abuse. Plant and herbal supplements used recreationally can have a wide spectrum of clinical effects ranging from euphoric and stimulant effects to hallucinogenic experiences. Despite the potential for abuse, addiction, and serious adverse effects, there may be a false perception that these products are all safe, legal, and organic.