Preparing for Manchester’s 2018 festival season, this article explores the emergency consequences of MDMA and other recreational drugs, including hyperthermia and hyponatraemia. It connects clinical preparedness with harm reduction and the importance of responding to patients without judgement, rather than focusing only on the substances involved.
Party hard in the UK: Ecstasy and more in #Virchester. St Emlyn’s Read More
When does presumed alcohol intoxication conceal something more serious? Natalie May reviews two observational studies of altered consciousness, including patients without detectable alcohol and those with coexisting critical illness. The discussion explores diagnostic bias, the limits of alcohol testing and the importance of looking beyond the initial label.
How does repeated excess paracetamol taken for pain differ from other overdose presentations? This 2017 discussion explores therapeutic excess, risk assessment and the consequences for admission. It repeatedly stresses checking current TOXBASE or local toxicology guidance, rather than relying on the historical thresholds described in the post.
Management of paracetamol therapeutic excess in the ED. St.Emlyn’s. Read More
Synthetic cannabinoids can produce unpredictable and severe presentations in the emergency department. This 2017 overview explains their pharmacology, varied effects and uncertain composition, then discusses the difficulties of recognition and management and the role of specialist poisons advice.
Sugar and Spice…Not All Things Nice Read More
Recreational nitrous oxide use can be easy to overlook when taking a drug history. This 2016 overview examines acute hypoxia and the neurological and haematological consequences associated with disrupted vitamin B12 function, drawing attention to presentations that may initially seem unrelated.
Are emergency departments giving people with mental health problems the attention and compassion they need? This 2015 reflection challenges dismissive attitudes, considers assessment and follow-up for adults and children, and argues that stretched services do not remove the responsibility to treat patients with dignity and respect.
Are We Doing All We Can For Mental Health? St.Emlyn’s Read More
Iain Beardsell and Simon Carley discuss opioid overdose in this 2015 podcast and written review. They examine recognition beyond stereotyped presentations, resuscitation, the challenges of naloxone reversal and ongoing monitoring, while also considering co-ingestion, complications and patients’ wider mental health and social needs.
Opiate Overdose in the Emergency Department Read More
Do intravenous fluids shorten an emergency department stay for uncomplicated alcohol intoxication? This 2013 journal club reviews a randomised trial, examining its selected patient population, length-of-stay findings and uncertainty, and asks whether an impulse to intervene is supported by evidence.
JC: IV Fluids for alcohol intoxication. St.Emlyn’s Read More
