Quantitative analysis of high plasma lactate concentration in ED patients after alcohol intake Tomohiro Sonoo, Satoshi Iwai, Ryota Inokuchi, Masataka Gunshin, Susumu Nakajima, Naoki Yahagi
DOI: http://dx.doi.org/10.1016/j.ajem.2016.01.021
The American Journal of Emergency Medicine , Vol. 34 , Issue 5 ,
Published online: January 22 2016
x Plasma lactate concentration is known to increase after alcohol intake. However, this increase has rarely been analyzed quantitatively in emergency department (ED) settings. Evaluating plasma lactate elevation in ED patients after alcohol intake is important because it can affect patients' evaluation based on the plasma lactate level.
The role of alcohol in asthma: A review of clinical and experimental studies Robin Cuddy, Guohua Li
DOI: http://dx.doi.org/10.1053/ajem.2001.27171
The American Journal of Emergency Medicine , Vol. 19 , Issue 6 ,
Published in issue: October 2001
x Asthma is among the most common ED diagnoses. Asthma exacerbations are generally treated by medications that cause bronchodilation and those that reduce airway inflammation. The effect of alcohol on asthma has been studied by investigators with mixed results. Some studies have reported that alcohol has a beneficial effect on asthma; others report worsening of symptoms. It has been suggested in some quarters that additives in alcoholic drinks cause bronchoconstriction and that pure ethanol has a salutary effect on asthma.
Child injuries and fatalities from alcohol-related motor vehicle crashes. Call for a 0-tolerance policy. Editorial: Guohua L. JAMA, 2000;283:2291–2292.
DOI: http://dx.doi.org/10.1016/S0735-6757(01)80169-8
The American Journal of Emergency Medicine , Vol. 19 , Issue 5 ,
Published in issue: September 2001
Alcohol, the elderly, and motor vehicle crashes James P Higgins, Seth W Wright, Keith D Wrenn
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90172-2
The American Journal of Emergency Medicine , Vol. 14 , Issue 3 ,
Published in issue: May 1996
x To document the prevalence of alcohol or drug use among elderly drivers admitted to a Level 1 trauma center after motor vehicle crashes, charts from 180 drivers age 60 years or older who were admitted to an urban Level 1 trauma center after motor vehicle crashes were retrospectively reviewed. Overall, 14% of the patients had a positive blood alcohol screen; among men, 21% had a positive screen. Only 55% of the patients were discharged to home. Only one patient (<1%) had a toxicology screen positive for another drug of abuse.
The relationship between alcohol consumption and injury in ED trauma patients Choi Yoonhee, Jung Kooyoung, Eo Eunkyung, Lee Donghoon, Kim Junsig, Shin Dongwun, Kim Sungeun, Lee Mijin
DOI: http://dx.doi.org/10.1016/j.ajem.2008.07.035
The American Journal of Emergency Medicine , Vol. 27 , Issue 8 ,
Published in issue: October 2009
x Alcohol-related injuries are significantly more serious than non–alcohol-related injuries. However, there have been few data on the relationship between alcohol consumption and injury in the Korea. This study was designed to determine the absence or presence of alcohol consumption at the time of injury and the relationship between the quantity of alcohol and the extent of injury.
Alcohol misuse and report of recent depressive symptoms among ED patients Shahrzad Bazargan-Hejazi, Mohsen Bazargan, Tommie Gaines, Michael Jemanez
DOI: http://dx.doi.org/10.1016/j.ajem.2007.08.019
The American Journal of Emergency Medicine , Vol. 26 , Issue 5 ,
Published in issue: June 2008
x This study examined the magnitude of association between alcohol misuse and recent depressive symptoms.
Fluid loading: Neither safe nor efficacious in the treatment of the alcohol-intoxicated patient in the ED James R Roberts, Michael I Greenberg
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90071-8
The American Journal of Emergency Medicine , Vol. 18 , Issue 1 ,
Published in issue: January 2000
Feasibility of screening and intervention for alcohol problems among young adults in the ED Daniel W. Hungerford, Janet M. Williams, Paul M. Furbee, William G. Manley III, James C. Helmkamp, Kimberly Horn, Daniel A. Pollock
DOI: http://dx.doi.org/10.1053/ajem.2003.50004
The American Journal of Emergency Medicine , Vol. 21 , Issue 1 ,
Published in issue: January 2003
x This study evaluates the feasibility of screening and brief intervention (SBI) for alcohol problems among young adults (18-39 years) in a rural, university ED. Research staff screened a convenience sample of patients waiting for medical treatment with the Alcohol Use Disorders Identification Test (AUDIT), used motivational interviewing techniques to counsel screen-positive patients (AUDIT ≥ 6) during the ED visit, and referred patients to off-site alcohol treatment as appropriate. Patients were interviewed again at 3 months.
First-order alcohol elimination in severe alcohol intoxication in an adolescent: a case report Anne Lamminpää, Kalle Hoppu
DOI: http://dx.doi.org/10.1016/j.ajem.2008.04.012
The American Journal of Emergency Medicine , Vol. 27 , Issue 1 ,
Published in issue: January 2009
x We report a case of severe ethanol intoxications in a 14-year-old boy whose starting blood alcohol concentration was 490 mg/dL. The intoxication led to coma with hypoventilation, hypoxemia, hypothermia, and a life-threatening situation. Elimination of ethanol followed nonlinear first-order concentration-dependent pharmacokinetics. Fluid balance was disturbed because of marked diuresis, and respirator treatment was needed. The treatment of fluid balance and the risk of hypoxemia in severe alcohol poisoning are emphasized.
A visual schematic for clarifying the temporal relationship between the anion and osmol gaps in toxic alcohol poisoning Mark B Mycyk, Steven E Aks
DOI: http://dx.doi.org/10.1016/S0735-6757(03)00079-2
The American Journal of Emergency Medicine , Vol. 21 , Issue 4 ,
Published in issue: July 2003
x Delayed treatment of ethylene glycol or methanol poisoning can result in life-threatening complications, but obtaining quantitative levels is delayed by several hours in most hospitals. Calculating the anion gap and the osmol gap are recommended to hasten identification and treatment in cases of suspected toxic alcohol poisoning. However, relying on the anion and osmol gap calculations without understanding the temporal relationship between these 2 gaps can lead to delayed identification and increased morbidity in cases of toxic alcohol poisoning.
Alcohol intoxication increases morbidity in drivers involved in motor vehicle accidents Hsin-Chin Shih, Sheng-Chuan Hu, Chih-Chieh Yang, Tun-Jen Ko, Jer-Kan Wu, Chen-Hsen Lee
DOI: http://dx.doi.org/10.1053/ajem.2003.50025
The American Journal of Emergency Medicine , Vol. 21 , Issue 2 ,
Published in issue: March 2003
x We prospectively examined the correlation of alcohol intoxication with injury severity, morbidity, and mortality in drivers involved in motor vehicle accidents in a prospective cohort study. The study enrolled 923 injured patients, of whom 421 were legally intoxicated (blood alcohol concentration [BAC] ≥ 50 mg/dL) and 502 were nonintoxicated (BAC < 50 mg/dL). The intoxicated drivers had a significantly higher injury severity score (ISS), lower Glasgow Coma Score, lower systolic blood pressure; higher rate in old age, male sex, greater rate of habitual drinking, greater lack of use of safety gear, and greater accident-related morbidity.
Serum determinations in toxic isopropanol ingestion David Jerrard, Vincent Verdile, Donald Yealy, Edward Krenzelok, James Menegazzi
DOI: http://dx.doi.org/10.1016/0735-6757(92)90208-F
The American Journal of Emergency Medicine , Vol. 10 , Issue 3 ,
Published in issue: May 1992
x A toxic dose of isopropyl alcohol was ingested by six male mongrel dogs to evaluate the relationship between acetone production and isopropyl degradation. Maximal serum isopropyl levels were achieved approximately 2 to 3 hours after ingestion of 60 mL of 70% isopropyl alcohol. Acetonemia occurred rapidly in the serum (within 15 minutes of ingestion) and continued to rise after isopropanol levels plateaued. The levels of acetone and isopropanol correlated positively throughout the study model with an r of .54 (P < .001).
The management of severe toxic alcohol ingestions at a tertiary care center after the introduction of fomepizole Robert Green
DOI: http://dx.doi.org/10.1016/j.ajem.2007.01.017
The American Journal of Emergency Medicine , Vol. 25 , Issue 7 ,
Published in issue: September 2007
x Ethylene glycol and methanol ingestions are relatively uncommon but potentially lethal poisonings. Recent trials have demonstrated that fomepizole effectively blocks alcohol dehydrogenase (ADH) in toxic alcohol overdoes, and may eliminate the need for emergent hemodialysis and intensive care unit admission. However, controversy remains in the role of fomepizole in clinical practice. The purpose of this study was to describe the presentation, management and clinical course of toxic alcohol ingestions at a tertiary care referral center after the introduction of fomepizole to hospital formulary.
Acute multiple organ failure with imidacloprid and alcohol ingestion I-Jeng Yeh, Tzeng-Jih Lin, Daw-Yang Hwang
DOI: http://dx.doi.org/10.1016/j.ajem.2009.05.006
The American Journal of Emergency Medicine , Vol. 28 , Issue 2 ,
Published in issue: February 2010
x Imidacloprid [1-(6-chloro-3-pyridylmethyl)-N -nitroimidazolidin-2-ylideneamine] belongs to a relatively new class of insecticidal chemistry, the chloronicotinyl neonicotinoid compounds. Animal studies indicate relatively low toxicity to mammals due to nicotinic receptor resistance. Human poisoning is usually mild, and reports are quite limited. Here, we report a case of ingestion of alcohol with an insecticide containing imidacloprid. Clinical manifestation included mild disorientation, followed by bradycardia, ventricular arrhythmia, and cardiopulmonary arrest.
Alcohol, bicycling, and head and brain injury: a study of impaired cyclists' riding patterns R1 Patrick Crocker, Omid Zad, Truman Milling, Karla A. Lawson
DOI: http://dx.doi.org/10.1016/j.ajem.2008.09.011
The American Journal of Emergency Medicine , Vol. 28 , Issue 1 ,
Published online: October 9 2009
x The aim of the study was to examine the interactions between alcohol, bicycle helmet use, experience level, riding environment, head and brain injury, insurance status, and hospital charges in a medium-sized city without an adult helmet law.
Prevalence of folate deficiency in emergency department patients with alcohol-related illness or injury Robert A. Schwab, Robert D. Powers
DOI: http://dx.doi.org/10.1016/0735-6757(92)90209-G
The American Journal of Emergency Medicine , Vol. 10 , Issue 3 ,
Published in issue: May 1992
x To assess the prevalence of folate deficiency in emergency department patients with alcohol-related illness or injury, a prospective, nonconsecutive case series with nonrandomized controls was used. All patients presenting to a 60,000-visit public hospital emergency department with alcohol-related illness or injury were ellgible; patients were excluded if they had received folate in our health care facility within the previous 4 months. An alcohol and brief dietary history was obtained, and a complete blood cell count and red blood cell folate level was pertormed on each palient.
Physiologic effects of prolonged conducted electrical weapon discharge in ethanol-intoxicated adults Ronald Moscati, Jeffrey D. Ho, Donald M. Dawes, James R. Miner
DOI: http://dx.doi.org/10.1016/j.ajem.2009.02.010
The American Journal of Emergency Medicine , Vol. 28 , Issue 5 ,
Published online: February 8 2010
x This study examines the physiologic effects of prolonged conducted electrical weapon (CEW) exposure on alcohol-intoxicated adult subjects.
Repeated ambulance use by patients with acute alcohol intoxication, seizure disorder, and respiratory illness Jennifer Brokaw, Lenora Olson, Lynne Fullerton, Dan Tandberg, David Sklar
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90031-6
The American Journal of Emergency Medicine , Vol. 16 , Issue 2 ,
Published in issue: March 1998
x Three chronic conditions were examined—acute alcohol intoxication, seizure disorder, and respiratory illness—to quantify the extent of repetitive emergency medical services (EMS) use in a defined population. Urban EMS system ambulance data from 1992 to 1994 were analyzed for the three designated conditions with respect to transports by condition and individual patient. Analysis by χ 2 was used for comparing proportions. Analysis of variance after square root transformation was used to evaluate differences among means.
Cofactors of alcohol-related trauma at a rural trauma center Raymond N Ankney, James Vizza, James A Coil, Stanley Kurek, Richard DeFrehn, Holly Shomo
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90089-4
The American Journal of Emergency Medicine , Vol. 16 , Issue 3 ,
Published in issue: May 1998
x To analyze the cofactors of alcohol-related trauma at a rural, Level II trauma center, 127 admitted trauma patients were interviewed about psychological problems, social factors, and medical histories. Patients were divided into two groups, blood alcohol content (BAC) positive and BAC negative, for analysis. Seventy-one patients (56%) were BAC negative; 56 (44%) were BAC positive. Forty-three of the 82 males (52%) had positive BAC tests, compared with 13 of the 45 females (29%) (P = .01). Fifty-one of the 56 BAC-positive patients (91%) were aged 21 to 50 years, compared with 29 of the 71 BAC-negative patients (41%) (P = .0001).
Refractory hyperdynamic shock associated with alcohol and disulfiram Serge Motte, Jean-Louis Vincent, Jean-Bernard Gillet, Jean-Paul Deguate, Robert J. Kahn
DOI: http://dx.doi.org/10.1016/0735-6757(86)90301-3
The American Journal of Emergency Medicine , Vol. 4 , Issue 4 ,
Published in issue: July 1986
x After massive alcohol intake, a patient under disulfiram therapy developed a severe cardiovascular collapse unresponsive to dopamine but successfully reversed with norepinephrine. Resistance to dopamine could be related to norepinephrine depletion caused by disulfiram. Norepinephrine could, therefore, represent the treatment of choice of these life-threatening conditions.
