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Specific Emergency Conditions in Forced Displacement Settings
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Natalie Roberts, Halfdan Holger Knudsen, Alvin Sornum, Taha Al-Taei, Barbara Scoralick Villela, Maryam Omar, Faith Traeh, Abdulkarim Ekzayez, Clare Shortall, Eric Weerts
Blood glucose should be established and monitored regularly. If a laboratory is available measuring lactate and electrolyte levels can help guide fluid treatment. A chest x-ray will help diagnose pulmonary oedema caused by smoke inhalation.
Burns
Published in Stephen M. Cohn, Alan Lisbon, Stephen Heard, 50 Landmark Papers, 2021
Brian Brisebois, Joyce McIntyre
Smoke inhalation injury should be considered in any patient with possible extended exposure to smoke. Bronchoscopic or laryngoscopic evidence of soot or injury below the vocal cords is diagnostic (Greenhalgh). Although highly specific, a negative inspection does not rule out the presence of smoke inhalation injury (Lundy). Individuals exposed to flash explosions (i.e., cigarette igniting supplemental oxygen) do not usually suffer smoke inhalation injury (Lundy, Greenhalgh). CO poisoning can be confirmed by elevated levels of carboxyhemoglobin (ABG and pulse oximeter won't be helpful). Suspected CO poisoning should be treated with 100% oxygen while carboxyhemoglobin levels are obtained (Greenhalgh).
Endogenous Cannabinoid Receptors and Medical Cannabis
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
In addition to varietal differences, the effects of cannabinoid medicines can be dramatically altered by their route of administration, including inhalation, mucosal absorption, oral ingestion, and topical application. Smoking is the method most commonly employed by cannabis users, not only because of tradition and ease of use, but also because inhalation’s speed of onset allows for quick symptom relief and effective titration management. It only takes a few seconds before the cannabis user perceives an initial effect, and up to a few minutes until its peak effects are realized. The byproducts of smoke inhalation nonetheless make it an undesirable method. However, by heating plant material to a temperature below combustion, but sufficient to aerosolize the volatile cannabinoid and terpene oils, vaporizing provides the benefits of inhalation’s speed of onset without smoking’s byproducts. Lessons learned from tobacco smoking’s combustion release of cancer-causing benzene and polycyclic aromatic hydrocarbons remain a concern, although epidemiological studies have failed to find an association between cannabis smoking and the health risks associated with tobacco smoking, such as lung cancer, emphysema, or chronic obstructive pulmonary disease.56–58
Methods and Implementation of the 2019 EMS Practice Analysis
Published in Prehospital Emergency Care, 2022
Ashish R. Panchal, Madison K. Rivard, Rebecca E. Cash, John P. Corley, Marjorie Jean-Baptiste, Kirsten Chrzan, Mihaiela R. Gugiu
Events that had a disposition where no patient interaction occurred (e.g., no patient found or cancelled) were excluded. Events that had both a primary and a secondary impression of a “not value” (not applicable, not recorded, not reporting, not known, or not available) were considered uninformative and, thus, also excluded. Events that had only a primary or a secondary impression of a “not value”, however, were retained. Inhalation injury (toxic gas) and smoke inhalation impressions were combined. Respiratory distress and respiratory arrest impressions were also combined due to encompassing similar domains. Events were classified into categories by impression, with an event being included in the respective category if the primary or secondary impression included that impression. After the exclusion of “not value” impressions, there were a total of 25 impressions that were considered informative.
Short-term effects of nicotine gum on facial detection in healthy nonsmokers: a pilot randomized controlled trial
Published in Journal of Addictive Diseases, 2020
Thiago P. Fernandes, Pamela D. Butler, Stephanye J. Rodrigues, Gabriella M. Silva, Marcos V. Anchieta, Jandirlly J. S. Souto, Giulliana H. V. Gomes, Natalia L. Almeida, Natanael A. Santos
As observed in past studies,9,12 tobacco misuse resulted in early-stage visual processing impairments. However, nicotine is only one of the numerous existing components of cigarettes and other products that contain tobacco. Many of these components are damaging to health. In addition, use of these products also involves the factor of smoke inhalation. In the mammalian brain, different types of nicotinic acetylcholine receptors (nAChRs) are located in pathways from the retina to the primary visual cortex. The visual cortex is involved in processing elementary visual stimuli (e.g., form), but also in more complex processes such as face detection (Silva et al., 2020). Factors other than expression of nAChRs in the brain may also be involved in improvement in face detection by nicotine gum. These include age, BMI, and gene expression which may alter the efficacy of nicotine gum.42,43 The efficacy of the 2-mg dose is in agreement with the association of nAChRs and nicotine, but the reason for lower performance in the 4-mg condition is not clear and needs further study. The 4-mg dose produces a maximum peak plasma level similar to that of one cigarette. Smoking impairs visual function8–10 so that this dose may impair visual function by producing effects similar to smoking one cigarette. The effects of smoking, with the many components in cigarettes including smoke versus the effects of nicotine itself (as seen in the gum) need further clarification as does the dose-response curve of nicotine.
Intramuscular sodium tetrathionate as an antidote in a clinically relevant swine model of acute cyanide toxicity
Published in Clinical Toxicology, 2020
Tara B. Hendry-Hofer, Alyssa E. Witeof, Patrick C. Ng, Sari B. Mahon, Matthew Brenner, Gerry R. Boss, Vikhyat S. Bebarta
Cyanide is a rapid-acting metabolic poison and a high threat agent as recognized by the US Department of Homeland Security (DHS) [1]. It is also widely used in industrial settings such as mining and in gold extraction from mineral ore [2]. Exposures can occur following smoke inhalation, dermal absorption, or ingestion resulting in adverse health effects within minutes [3]. A primary mechanism of cyanide toxicity is inhibition of cellular respiration by binding cytochrome C oxidase causing lactic acidemia, apnea, hypotension, coma, and death [4]. While there are efficacious cyanide antidotes such as hydroxocobalamin, sodium nitrite, and sodium thiosulfate, these antidotes must be administered intravenously in large volumes, making their use in a mass casualty scenario limited [5]. Moreover, there are additional limitations to these antidotes. For example, sodium nitrite can cause methemoglobinemia, cyanmethemogobinemia, and hypotension secondary to the release of nitric acid [6]. The use of thiosulfate is limited due to its slow onset of action and hydroxocobalamin is expensive and has known interference with lab test making some results uninterpretable or inaccurate [5,7]. Given the high risk for a large-scale exposure, a safe, cost effective, rapid acting, small volume, and easy to administer antidote is needed for acute cyanide toxicity in humans. [8].