Toxicology

Characterization of Regional Poison Center Utilization Through Geospatial Mapping

Olives, TD.

Penetrance is the annual rate of human exposure calls per 1000 persons, a measure that historically describes poison center (PC) utilization. Penetrance varies by sociodemographic characteristics and by geography. Our goal in this study was to characterize the geospatial distribution of PC calls and describe the contribution of geospatial mapping to the understanding of PC utilization.

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Response to: “Management of Chloroquine and Hydroxychloroquine Poisoning: Do Not Miss the Time of Tracheal Intubation and Mechanical Ventilation”

Lebin, JA.

We thank Drs. Megarbane and Schicchi for their thoughtful comments on our manuscript and efforts to highlight pertinent in vitro and in vivo literature. As stated in our manuscript, we agree that aggressive supportive care is the mainstay of treatment for acute chloroquine and hydroxychloroquine toxicity, including management of the airway with appropriate ventilation, if necessary.

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Management of Chloroquine and Hydroxychloroquine Poisoning: Do Not Miss the Time of Tracheal Intubation and Mechanical Ventilation

Megarbane, B.

We would like to comment on Lebin and LeSaint’s overview of chloroquine/hydroxychloroquine (CQ/HoCQ) toxicity and management.1 The authors focused on the indications and administration modalities of hypertonic sodium bicarbonate, diazepam, and epinephrine. Surprisingly, they did not consider the role and indications of tracheal intubation and mechanical ventilation, while representing the mainstay of treatment.

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Telephonic Medical Toxicology Service in a Low-Resource Setting: Setup, Challenges, and Opportunities

Hitti, E.

Poisoning and envenomation are a global health problem for which the mortality burden is shouldered heavily by middle- and low-income countries that often lack poison prevention programs and medical toxicology expertise. Although telehealth or teleconsult services have been used to bridge the expertise gap between countries for multiple specialties, the use of medical toxicology teleconsult services across borders has been limited. We aim to describe the use of a United States-based medical toxicology teleconsult service to support patient care at a hospital in a middle-income country that lacks this expertise. This report outlines the logistics involved in setting up such a service, including the challenges and opportunities that emerged from establishing medical toxicology teleconsult service in a low-resource setting.

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Cannabis in Homes with Children: A Survey on Use, Storage, and Attitudes

Gimelli, A.

The recent legalization of cannabis in California has the potential to affect cannabis prevalence in households with children. This eventuality, combined with suboptimal cannabis storage practices, could lead to adverse effects such as unintentional pediatric ingestion, which occurred in Colorado after legalization. Our objective was to assess prevalence and storage practices of cannabis in households with children, and attitudes on use and storage education in a state that has legalized cannabis.

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Toxicologic Exposures in California Emergency Departments in 2011 and Its Risk Factors

Loftipour, S.

Toxicologic exposures (TE) are a major preventable public health issue, with most cases due to unintentional causes. Although these cases are well documented and reported via the National Poison Data System, there is little information regarding toxicologic exposure cases in the emergency department (ED). The aim of this study was to identify demographic groups at risk for potential poisoning.

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Transaminase and Creatine Kinase Ratios for Differentiating Delayed Acetaminophen Overdose from Rhabdomyolysis

Radke, MD, et al.

Establishing the cause of elevated transaminases may be especially difficult because of limited or inaccurate histories of acetaminophen ingestion. We hypothesized that the comparative ratios of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatine kinase (CK) can differentiate acetaminophen hepatotoxicity from rhabdomyolysis.

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WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

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ISSN: 2474-252X

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Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.