Secondary exposure of medical staff to sarin vapor in the emergency room.

Abstract:

OBJECTIVE:To clarify the risk of secondary exposure of medical staff to sarin vapor in the emergency room, and to warn emergency room staffs of the hazard. DESIGN:Retrospective observational survey. SETTING:Emergency department of a university hospital in a metropolitan area of Japan. PARTICIPANTS:Fifteen doctors treating victims of a terrorist attack with sarin in the Tokyo subways on the day of the attack. MEASUREMENTS AND RESULTS:Of the 15 doctors who worked in the emergency room treating the victims, 13 became simultaneously aware of symptoms during the resuscitation of two victims who were exposed to sarin. Among 11 doctors (73%) who complained of dim vision, the pupils were severely miotic (<2 mm) in 8 (73%). Other symptoms included rhinorrhea in eight (53%), dyspnea or tightness of the chest in four (27%), and cough in two (13%). Atropine sulfate was given to six, and pralidoxime was given to one of these six doctors. To decontaminate the emergency room of sarin vapor, ventilation was facilitated and all belongings of the patients were sealed up. None of the doctors noticed worsening of their symptoms thereafter. CONCLUSIONS:Careful attention to the risks of secondary exposure to toxic gas in the emergency room and prompt decontamination if such exposure should occur are necessary in the case of large-scale disasters caused by sarin.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Nozaki H,Hori S,Shinozawa Y,Fujishima S,Takuma K,Sagoh M,Kimura H,Ohki T,Suzuki M,Aikawa N

doi

10.1007/BF01700667

subject

Has Abstract

pub_date

1995-12-01 00:00:00

pages

1032-5

issue

12

eissn

0342-4642

issn

1432-1238

journal_volume

21

pub_type

杂志文章
  • Serum procalcitonin levels in critically ill patients colonized with Candida spp: new clues for the early recognition of invasive candidiasis?

    abstract:OBJECTIVE:Invasive candidiasis (IC) outcomes in intensive care units (ICUs) could be improved by the early administration of antifungals. The Candida Score (CS) prediction rule has been proposed for the selection of patients who could develop IC. Procalcitonin (PCT) levels allow prompt identification of sepsis, but the...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-009-1623-0

    authors: Charles PE,Castro C,Ruiz-Santana S,León C,Saavedra P,Martín E

    更新日期:2009-12-01 00:00:00

  • HMGB1 and LPS induce distinct patterns of gene expression and activation in neutrophils from patients with sepsis-induced acute lung injury.

    abstract:OBJECTIVES:Circulating levels of the proinflammatory mediator High Mobility Group Box Protein 1 (HMGB1) are increased in septic patients and may contribute to sepsis-induced organ dysfunction. Although HMGB1 has been shown to activate neutrophils from healthy volunteers, the responses of neutrophils from septic patient...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-007-0748-2

    authors: Silva E,Arcaroli J,He Q,Svetkauskaite D,Coldren C,Nick JA,Poch K,Park JS,Banerjee A,Abraham E

    更新日期:2007-10-01 00:00:00

  • Hemorrhagic shock with paradoxical bradycardia.

    abstract::Two hundred and seventy-three acute hemorrhagic shocks were treated in 1984 in a pre-hospital emergency care unit. Twenty patients (7%) had a paradoxical bradycardia: they were conscious, 9 of them had an undetectable systolic arterial pressure with the sphygmomanometric method but the femoral pulse was still present....

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00254705

    authors: Barriot P,Riou B

    更新日期:1987-01-01 00:00:00

  • Effect of cyclooxygenase inhibition in a canine model of unilateral pulmonary occlusion and reperfusion.

    abstract:OBJECTIVE:To assess the effects of the cyclooxygenase inhibitor diclofenac in a canine model of pulmonary occlusion and reperfusion of the left lower lobe (LLL). DESIGN:Twelve adult beagle dogs (13-17 kg) were randomly assigned to a control group (n = 6) and a diclofenac-treated group (n = 6). Animals in the treatment...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01700965

    authors: Segiet W,Krieter H,Stieber C,Albrecht DM,van Ackern K

    更新日期:1995-10-01 00:00:00

  • Enterococcus faecalis colonisation and endocarditis in five intensive care patients as late sequelae of selective decontamination.

    abstract:OBJECTIVE:To describe Enterococcus faecalis colonisation and endocarditis in 5 intensive care patients after treatment with selective decontamination (SDD). SETTING:Intensive care unit (ICU) in a general hospital. PATIENTS:The patients were admitted to the ICU because of adult respiratory distress syndrome, polytraum...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01701478

    authors: Sijpkens YW,Buurke EJ,Ulrich C,van Asselt GJ

    更新日期:1995-03-01 00:00:00

  • Influence of SIMV plus inspiratory pressure support on VA/Q distributions during postoperative weaning.

    abstract::Since the introduction of synchronized intermittent mandatory ventilation (SIMV) several advantages have been attributed to this ventilatory mode, one of them being a more homogeneous distribution of ventilation and perfusion than during controlled mechanical ventilation (CMV). Up to now no data are available to confi...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01704716

    authors: Santak B,Radermacher P,Sandmann W,Falke KJ

    更新日期:1991-01-01 00:00:00

  • Peripherally inserted central venous catheters and central venous catheters related thrombosis in post-critical patients.

    abstract:BACKGROUND:Peripherally inserted central venous catheters (PICC) have been proposed as an alternative to central venous catheters (CVC). The aim of this study was to determine the thrombosis rate in relation to PICC placement in patients discharged from the intensive care unit (ICU). METHODS:Data of patients admitted ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-010-2043-x

    authors: Bonizzoli M,Batacchi S,Cianchi G,Zagli G,Lapi F,Tucci V,Martini G,Di Valvasone S,Peris A

    更新日期:2011-02-01 00:00:00

  • Evaluation by polymerase chain reaction of cytomegalovirus reactivation in intensive care patients under mechanical ventilation.

    abstract:OBJECTIVE:The study was undertaken to determine if critically ill patients under mechanical ventilation could reactivate latent cytomegalovirus (CMV) in either lung or blood. DESIGN:Prospective study in critically ill patients was performed in a multidisciplinary intensive care unit in a university hospital. PATIENTS...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01709343

    authors: Stéphan F,Méharzi D,Ricci S,Fajac A,Clergue F,Bernaudin JF

    更新日期:1996-11-01 00:00:00

  • Dose-dependent benefit of nitroglycerin on microcirculation of patients with severe heart failure.

    abstract:INTRODUCTION:Microcirculatory abnormalities are frequently observed in patients with severe heart failure and correlate to worse outcomes. We tested the hypothesis that nitroglycerin dose-dependently improves perfusion in severe heart failure and that this could be monitored by measuring central-peripheral temperature ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-009-1591-4

    authors: den Uil CA,Caliskan K,Lagrand WK,van der Ent M,Jewbali LS,van Kuijk JP,Spronk PE,Simoons ML

    更新日期:2009-11-01 00:00:00

  • Analysis of costs in a pediatric ICU.

    abstract:OBJECTIVE:To analyze the actual cost of pediatric intensive care and its different components, particularly the differences between various patient groups, with special reference to the variable cost and the elements included in it. DESIGN:Prospective, observational study. SETTING:Multidisciplinary 12-bed pediatric i...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050320

    authors: García S,Ruza F,Alvarado F,Madero R,Delgado MA,Dorao P,Frias M

    更新日期:1997-02-01 00:00:00

  • Cytokeratin 19 fragments in patients with acute lung injury: a preliminary observation.

    abstract:OBJECTIVE:Cytokeratin 19 (CK19) is a specific cytoskeletal structure for alveolar epithelium. We hypothesized that the levels of CK19 fragments in bronchoalveolar lavage (BAL) fluid could serve as an index of epithelial injury and as a prognosis marker in patients with acute lung injury (ALI) or acute respiratory distr...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-006-0124-7

    authors: Stern JB,Paugam C,Validire P,Adle-Biassette H,Jaffré S,Dehoux M,Crestani B

    更新日期:2006-06-01 00:00:00

  • Patients with faecal peritonitis admitted to European intensive care units: an epidemiological survey of the GenOSept cohort.

    abstract:INTRODUCTION:Faecal peritonitis (FP) is a common cause of sepsis and admission to the intensive care unit (ICU). The Genetics of Sepsis and Septic Shock in Europe (GenOSept) project is investigating the influence of genetic variation on the host response and outcomes in a large cohort of patients with sepsis admitted t...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00134-013-3158-7

    authors: Tridente A,Clarke GM,Walden A,McKechnie S,Hutton P,Mills GH,Gordon AC,Holloway PA,Chiche JD,Bion J,Stuber F,Garrard C,Hinds CJ,GenOSept Investigators.

    更新日期:2014-02-01 00:00:00

  • Ultrasound-guided arterial catheterization: a narrative review.

    abstract::Arterial catheterization is the second most common invasive procedure performed in the intensive care unit. Despite the ubiquity of the procedure, complications including failure to place the catheter occur. While many clinicians are familiar with the use of ultrasound (US) guidance to decrease complication rates of c...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s00134-009-1699-6

    authors: Shiloh AL,Eisen LA

    更新日期:2010-02-01 00:00:00

  • Continuous arteriovenous haemodialysis during emergency hepatic retransplantation: two case reports.

    abstract::Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) devi...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01706360

    authors: Salord F,Bailly MP,Gaussorgues P,Workineh S,Pouyet M,Robert D

    更新日期:1990-01-01 00:00:00

  • Effects of early treatment with immunoglobulin on critical illness polyneuropathy following multiple organ failure and gram-negative sepsis.

    abstract:OBJECTIVE:The evaluation of incidences and relating factors of severe persisting critical illness polyneuropathy (CIP) in survivors of multiple organ failure (MOF). DESIGN:Prospective study with an entry period of 24 months. Electrophysiological studies for the diagnosis of CIP were performed 1 or 2 days before the pa...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050471

    authors: Mohr M,Englisch L,Roth A,Burchardi H,Zielmann S

    更新日期:1997-11-01 00:00:00

  • Changes of right ventricular function with positive end-expiratory pressure (PEEP) in man.

    abstract::The side effects of positive pressure ventilation on cardiovascular function are well known. However, in most clinical studies its influence on left ventricular function was examined. In the present study right ventricular (RV) performance was studied in 13 patients undergoing coronary artery bypass grafting during me...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00256962

    authors: Neidhart PP,Suter PM

    更新日期:1988-01-01 00:00:00

  • Emergency correction of coagulation for mitral valve replacement in an orally anticoagulated 17-year-old patient with pronounced hepatic dysfunction.

    abstract::A 17-year-old patient with Shone's disease had to be readmitted to the hospital 3 months after implantation of an artificial aortic valve because of extreme mitral insufficiency with consecutive pulmonary edema and hepatic dysfunction. He had been orally anticoagulated and presented with a high international normalize...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340051023

    authors: Rauch R,Hofbeck M,Ries M,Singer H,Klinge J

    更新日期:1999-10-01 00:00:00

  • Ultrasound evaluation of central veinsin the intensive care unit:effects of dynamic manoeuvres.

    abstract:OBJECTIVE:To determine: (1) the proportion of small (<5 mm) or thrombosed internal jugular veins (IJV) and femoral veins (FV) in which catheter placement would be difficult without ultrasound guidance; (2) which position increases central vein sizes and may facilitate cannulation of these vessels. DESIGN:Prospective s...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-007-0875-9

    authors: Samy Modeliar S,Sevestre MA,de Cagny B,Slama M

    更新日期:2008-02-01 00:00:00

  • Intratracheal administration of fentanyl: pharmacokinetics and local tissue effects.

    abstract:OBJECTIVE:To study the pharmacokinetics and local tissue effects resulting from the intratracheal administration of preservative-free fentanyl. DESIGN:Prospective, randomized, blinded and controlled animal study. SETTING:University research laboratory. SUBJECTS:Eighteen adult male New Zealand rabbits. INTERVENTIONS...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01720719

    authors: Irazuzta JE,Ahmed U,Gancayco A,Ahmed ST,Zhang J,Anand KJ

    更新日期:1996-02-01 00:00:00

  • Mortality in ICU patients with bacterial community-acquired pneumonia: when antibiotics are not enough.

    abstract:BACKGROUND:It remains uncertain why immunocompetent patients with bacterial community-acquired pneumonia (CAP) die, in spite of adequate antibiotics. METHODS:This is a secondary analysis of the CAPUCI database which was a prospective observational multicentre study. Two hundred and twelve immunocompetent patients admi...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-008-1363-6

    authors: Rodriguez A,Lisboa T,Blot S,Martin-Loeches I,Solé-Violan J,De Mendoza D,Rello J,Community-Acquired Pneumonia Intensive Care Units (CAPUCI) Study Investigators.

    更新日期:2009-03-01 00:00:00

  • Isoflurane for prolonged sedation in the intensive care unit; efficacy and safety.

    abstract:OBJECTIVE:To compare isoflurane with midazolam for prolonged sedation in ventilated patients. DESIGN:Randomised controlled study. SETTING:General intensive care unit in university teaching hospital. PATIENTS:Sixty patients aged 17-80 years who required mechanical ventilation for more than 24 h. INTERVENTIONS:Sedati...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF01694344

    authors: Spencer EM,Willatts SM

    更新日期:1992-01-01 00:00:00

  • High-frequency jet ventilation during oleic-acid induced pulmonary oedema.

    abstract::In oleic acid-induced pulmonary oedema (OAPO) sequential intrapulmonary fluid accumulation occurs leading to different expiratory flow pattern in dependent lung regions. The potential effects on efficacy of high-frequency jet ventilation (HFJV, f = 3 Hz, I: E = 0.43, FiO2 = 0.4) were studied and compared with continuo...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00295986

    authors: Hachenberg T,Wendt M,Hermeyer G,Ludwig E,Meyer J,Lawin P

    更新日期:1989-01-01 00:00:00

  • The ICM research agenda on critical care ultrasonography.

    abstract:PURPOSE:Critical care ultrasonography has utility for the diagnosis and management of critical illness and is in widespread use by frontline intensivists. As there is a need for research to validate and extend its utility, the Editor of Intensive Care Medicine included critical care ultrasonography as a topic in the IC...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s00134-017-4734-z

    authors: Mayo P,Arntfield R,Balik M,Kory P,Mathis G,Schmidt G,Slama M,Volpicelli G,Xirouchaki N,McLean A,Vieillard-Baron A

    更新日期:2017-09-01 00:00:00

  • Pulmonary capillary pressure and gas exchange after E. coli bacteremia in pigs.

    abstract::In 9 Goettingen minipigs we studied the effect of E. coli bacteremia on effective pulmonary capillary pressure and the longitudinal distribution of pulmonary vascular resistance. Precapillary pressure gradient (dPa) was calculated as the difference between mean pulmonary artery pressure (MPP) and effective pulmonary c...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01709400

    authors: Fretschner R,Klöss T,Guggenberger H,Heuser D,Schmid HJ,Widmann M

    更新日期:1990-01-01 00:00:00

  • Diagnostic yield and safety of CT scans in ICU.

    abstract:PURPOSE:Critically ill patients often require CT scans. Adverse events (AE) can occur during intra-hospital transport (IHT). The aim of this prospective study was to determine the diagnostic and therapeutic yield and the safety of CT scans in ICU patients. METHODS:All ICU patients having a CT scan for diagnostic purpo...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00134-014-3592-1

    authors: Aliaga M,Forel JM,De Bourmont S,Jung B,Thomas G,Mahul M,Bisbal M,Nougaret S,Hraiech S,Roch A,Chaumoitre K,Jaber S,Gainnier M,Papazian L

    更新日期:2015-03-01 00:00:00

  • Metabolic arrest.

    abstract::In hypoxia sensitive cells and tissues, the rates of glucose and O2 consumption are inversely related (Pasteur Effect). Under O2 limiting conditions the demands for glucose (glycogen) in such cells may drastically rise as a means for maintaining ATP turnover close to normoxic rates; nevertheless ion and electrical pot...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00254926

    authors: Hochachka PW

    更新日期:1986-01-01 00:00:00

  • Plasma exchange in rhabdomyolysis.

    abstract::The effect of plasma exchange (PE) was evaluated in 4 patients with rhabdomyolysis. A single 21 PE produced a transient fall of creatinine phosphokinase and did not prevent renal failure. Theoretically PE would need to be performed very frequently to remove toxins in appropriate amounts. Since renal failure in myoglob...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00273565

    authors: Cornelissen JJ,Haanstra W,Haarman HJ,Derksen RH

    更新日期:1989-01-01 00:00:00

  • Prognostic evaluation in meningococcal disease. A retrospective study of 115 cases.

    abstract::A retrospective study of the medical records of 115 consecutive cases of meningococcal disease with 11 fatalities was carried out in order to evaluate the power of 15 clinical and laboratory variables available on admission in predicting a fatal outcome. On linear discriminant analysis, six variables showed a signific...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00261740

    authors: Gårdlund B

    更新日期:1986-01-01 00:00:00

  • Focus on randomised clinical trials.

    abstract:: ...

    journal_title:Intensive care medicine

    pub_type: 社论

    doi:10.1007/s00134-018-5468-2

    authors: Perner A,Hjortrup PB,Pettilä V

    更新日期:2018-12-01 00:00:00

  • Dosing of medications in morbidly obese patients in the intensive care unit setting.

    abstract:OBJECTIVE:To derive recommendations for the dosing of commonly used medications in the morbidly obese patient in the ICU. DATA SOURCES:Articles were obtained through computerized searches involving MEDLINE. The bibliographies of retrieved publications and textbooks were reviewed for additional references. STUDY SELEC...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s00134-003-2059-6

    authors: Erstad BL

    更新日期:2004-01-01 00:00:00