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Animal and Plant Toxins
Published in Lorris G. Cockerham, Barbara S. Shane, Basic Environmental Toxicology, 2019
Jason S. Albertson, Frederick W. Oehme
These alkaloids all exert similar actions. Several fatal poisonings in the western U.S. have resulted from the ingestion of these plants, including wild flora in salads and wild tobacco leaves (Nicotininia sp.). Cystisine intoxication occurs when the seeds from the pea-like pods of the golden chain tree (Laburnum anagyroides) are eaten by humans. Coniine poisoning follows ingestion of the parsley-like leaves or the seeds of the poison hemlock (Conium maculatum). Socrates was allegedly executed by being forced to drink a solution of the extract of poison hemlock. Vomiting occurs within the hour (most commonly within 15 min), accompanied by profuse salivation. Abdominal cramping is minimal and diarrhea is rare. Headache, confusion, muscle weakness, incoordination, pyrexia, pupillary dilation, and elevated heart rate ensue. Death results from respiratory arrest.
Pesticides and Chronic Diseases
Published in William J. Rea, Kalpana D. Patel, Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
William J. Rea, Kalpana D. Patel
Nicotine sulfate (Black Leaf 40): This time-honored natural insecticide is still used in horticulture. The lethal dose in humans is about 60 mg. Nicotine preparations, especially those using the free alkaloid, are well absorbed across the gut wall, lung, and skin. Poisoning symptoms from excessive doses appear promptly. They are due to transient stimulation, then prolonged depression, of the CNS, autonomic ganglia, and motor end plates of skeletal muscle. Similar symptoms are seen in the chemically sensitive. CNS injury manifests as headache, dizziness, incoordination, and tremors, followed by clonic convulsions leading to tonic-extensor convulsions that are often fatal. In some instances, convulsive activity is minimal, and death by respiratory arrest occurs within a few minutes. Effects on autonomic ganglia give rise to sweating, salivation, nausea, abdominal pain, diarrhea, and hypertension. The heart is usually slow and often arrhythmic. Block of skeletal muscle motor endplates causes profound weakness, then paralysis. Death may occur from respiratory depression or shock. Nicotine can be measured in blood and urine to confirm poisoning.589
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Published in Jamie Bartram, Rachel Baum, Peter A. Coclanis, David M. Gute, David Kay, Stéphanie McFadyen, Katherine Pond, William Robertson, Michael J. Rouse, Routledge Handbook of Water and Health, 2015
Saxitoxins comprise a group of related carbamate alkaloids including non-sulphated (saxitoxin/neosaxitoxin), single sulphated (gonyautoxins) and double sulphated (C1 and C2 toxins) variants referred to as paralytic shellfish poisons (PSPs). PSPs are part of a larger group of associated shellfish-related poisons. These toxins occur during blooms of eukaryotic (dinoflagellate) algae – so called ‘red tide’ events – in marine coastal regions that are responsible for seasonal closures of shellfish harvesting. Specifically, the dinoflagellate algae Alexandrium fundyense produces saxitoxin, but other species can produce different toxic compounds (e.g. Karenia brevis produces brevetoxin, as known as neurotoxic shellfish poison; the diatom Pseudonitzschia, produces domoic acid, as known as amnesic shellfish poison). Interestingly, within freshwaters these PSPs are produced by several cyanobacteria including Aphanizomenon, Dolichospermum, Lyngbya and Cylindrospermopsis (Table 9.1) and not eukaryotic algae. Saxitoxin inhibits nerve impulse propagation along axons by blocking sodium ion entry into nerve cells through sodium channels. This effectively suppresses stimulation of muscles. Mild PSP intoxication causes slight tingling and numbness of the lips. With higher doses, tingling and numbness moves to the extremities, leading to loss of control and flaccid paralysis, leaving the affected individuals calm and conscious through the progression of symptoms. Like other cyanobacterial neurotoxins, death from respiratory arrest can occur. Saxitoxin is water-soluble and heat-stable (boiling water and cooking won’t destroy it) and like anatoxin-a(s) is more persistent in acidic environments compared to alkaline environments. Reported half-lives for saxitoxin vary from 9 to 28 days and closely related gonyautoxins may persist beyond three months in natural waters (Jones and Negri, 1997). Commercial standards of saxitoxin are available and screening tests and quantitative analyses of water and food are common.
A Four-Stage Method for Optimizing and Standardizing a Crash Cart Configuration
Published in IISE Transactions on Occupational Ergonomics and Human Factors, 2018
Shaunna Milloy, Katherine Bubric
An initial review of the draft configuration was conducted by the clinical committee and changes were made based on their feedback. The configuration was then evaluated through usability testing to determine ease of use and to identify improvement opportunities. Usability testing involved observing front-line staff completing simulated clinical scenarios to assess the configuration under realistic conditions (Nielsen, 1993). For this testing, a code team of two senior emergency room nurses and three acute care nurses who respond to code blues participated in two simulated code blue scenarios; they worked through two scenarios by accessing items on the crash cart and working together as they would during a real cold blue. In the first scenario, a 65 year old male was found collapsed and required multiple medications, defibrillation, suction, and intubation. In the second scenario, an infant presented in respiratory arrest followed by cardiac arrest. These scenarios were selected to test as many pieces of equipment and supplies as possible, assess workflow for multiple clinicians who must simultaneously access the cart, and evaluate the organization of different types of equipment within the cart. Following usability testing, participants provided their feedback and the cart was further refined by adding key pieces of equipment. Informed consent was obtained verbally from all individuals who participated in usability testing of the crash cart configuration. The A pRoject Ethics Community Consensus Initiative (ARECCI) Ethics Screening Tool was used to ensure that the testing protocol would result in minimal or no risk to participants and meet institutional requirements. Participants were informed they could withdraw from the evaluation at any point without any negative consequences and that data would be reported anonymously.