Abstract:
STUDY OBJECTIVE:Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-of-hospital ethanol in patients treated during a methanol outbreak in the Czech Republic between 2012 and 2014. METHODS:This was an observational case-series study of 100 hospitalized patients with confirmed methanol poisoning. Out-of-hospital ethanol as a "first aid antidote" was administered by paramedic or medical staff before the confirmation of diagnosis to 30 patients; 70 patients did not receive out-of-hospital ethanol from the staff (12 patients self-administered ethanol shortly before presentation). RESULTS:The state of consciousness at first contact with paramedic or medical staff, delay to admission, and serum methanol concentration were similar among groups. The median serum ethanol level on admission in the patients with out-of-hospital administration by paramedic or medical staff was 84.3 mg/dL (interquartile range 32.7 to 129.5 mg/dL). No patients with positive serum ethanol level on admission died compared with 21 with negative serum ethanol level (0% versus 36.2%). Patients receiving out-of-hospital ethanol survived without visual and central nervous system sequelae more often than those not receiving it (90.5% versus 19.0%). A positive association was present between out-of-hospital ethanol administration by paramedic or medical staff, serum ethanol concentration on admission, and both total survival and survival without sequelae of poisoning. CONCLUSION:We found a positive association between out-of-hospital ethanol administration and improved clinical outcome. During mass methanol outbreaks, conscious adults with suspected poisoning should be considered for administration of out-of-hospital ethanol to reduce morbidity and mortality.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Zakharov S,Pelclova D,Urban P,Navratil T,Nurieva O,Kotikova K,Diblik P,Kurcova I,Belacek J,Komarc M,Eddleston M,Hovda KEdoi
10.1016/j.annemergmed.2016.01.010subject
Has Abstractpub_date
2016-07-01 00:00:00pages
52-61issue
1eissn
0196-0644issn
1097-6760pii
S0196-0644(16)00011-1journal_volume
68pub_type
杂志文章abstract:STUDY OBJECTIVE:We examine the availability of follow-up appointments for emergency department (ED) patients without established primary care by insurance and clinical condition. METHODS:We used "secret shopper" methodology, employing 2 black men to telephone all 53 primary care practices in greater New Haven, posing ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2017.08.045
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abstract::A retrospective review of all patients admitted to an urban teaching hospital emergency department with the complaint of overdose, poisoning, or ingestion during a 10-month period was conducted. Analysis of these 82 episodes involving 69 individuals revealed: 1) a preponderance of women in the 20- to 40-year old range...
journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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abstract::In 1976 an independent department was established for the emergency treatment of patients in the county hospital in Szolnok, Hungary. The new system changed the traditional structure of patient flow and the work plan of other departments, and it influenced the curing and nursing activities of the departments. The reor...
journal_title:Annals of emergency medicine
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abstract:STUDY OBJECTIVE:Glottic visualization with video is superior to direct laryngoscopy in controlled operating room studies. However, glottic exposure with video laryngoscopy has not been evaluated in the emergency department (ED) setting, where blood, secretions, poor patient positioning, and physiologic derangement can ...
journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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doi:10.1067/mem.2001.118865
更新日期:2001-12-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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更新日期:2010-07-01 00:00:00