Dr. Gustin's Blog

Intoxication and ER deaths from Synthetic Cannabinoids

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Published: Tuesday, 05 March 2019 09:49

Synthetic cannabinoids are part of a group of drugs called new psychoactive substances (NPS). NPS are unregulated mind-altering substances that have become newly available on the market and are intended to produce the same effects as illegal drugs. Some of these substances may have been around for years but have reentered the market in altered chemical forms, or due to renewed popularity.

Individuals reported acquiring the contaminated synthetic cannabinoid products (i.e., K2, spice, synthetic marijuana, and legal weed) from convenience stores, dealers, and friends, in counties across the state.

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Update on EMTALA Law

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Published: Wednesday, 27 February 2019 15:00

Randy Strickland walked into the ER at North Metro Medical Center burning with fever and trembling. He told the nurse at the triage desk that he was nauseated and felt like he needed to throw up. The emergency room was nearly empty. Randy waited in the waiting room, yet repeated visits by his wife and son to the triage desk didn't bring Randy any closer to getting care. Over the next 2 hours, he lost his ability to speak or respond to questions. His breathing became labored. Finally, on a trip to the bathroom, his legs buckled as he held onto his wife and son for support. No one came out to help them so they dialed 911 but were told that the ambulance will not respond to a hospital.The 911 dispatcher told them to get Randy out to his car in the parking lot, where paramedics could pick him up and bring him in the ambulance door of the hospital. 

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Drug Overdose Deaths vs. ER Management

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Published: Monday, 18 February 2019 18:49

Deaths from drug overdose in the United States increased by 54% from 2011 to 2016 — with opioids, benzodiazepines (benzos), and stimulants the most commonly used drug classes involved, a new report released today by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS), shows.

The report notes that there were 41,340 drug overdose deaths in 2011 vs 63,632 such deaths in 2016.

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Narcan Effectiveness in ED Treatment of Heroin Overdoses

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Published: Saturday, 05 January 2019 16:06

Recently published in the Acad. Emerg. Med. December 28, 2018

Most patients who overdose on opioids can be safely discharged from the emergency department (ED) as early as an hour after prehospital administration of the opioid antagonist naloxone, the study has found.

Opioid-related ED visits nearly doubled in the United States from 2005 to 2014. 

The researchers conducted a prospective study to validate the early discharge rule practiced at St. Paul's Hospital, Vancouver, Canada, which allows for discharge after 1 hour for those in whom the following six criteria are within normal limits: ambulation, oxygen saturation (> 95%), respiratory rate (>10 and <20 breaths/min), temperature (>35.0° C and <37.5° C), heart rate (>50 and <100 beats/min), and Glasgow Coma Scale score (15).

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Medication Errors are the 3rd Leading Cause of Death in the U.S.

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Published: Friday, 24 June 2016 00:01

Medical error is the third leading cause of death in the United States, after heart disease and cancer, according to findings published in a recent issue of the British Medical Journal.

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FDA Nixes Fluoroquinolones like Cipro and Levaquin

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Published: Saturday, 11 June 2016 23:58

Fluoroquinolones like Cipro, Avelox, and Levaquin are commonly used by clinicians to treat a host of bacterial infections including, urinary tract infections, pneumonia, diarrhea, sinusitis, bronchitis and others.  Because of common musculoskeletal complications the FDA recently made rulings.

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Hospital Medication Errors, Morbidity and Mortality

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Published: Saturday, 04 June 2016 19:04

Medical error is the third leading cause of death in the United States, after heart disease and cancer, according to findings in the British Medical Journal, 253:i2139, 2016.

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LEGAL LSD: a new dangerous hallucinogen

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Published: Wednesday, 20 April 2016 16:16

A novel psychoactive substance, or "legal high," that has hallucinogenic effects and potentially severe adverse effects is being sold to partygoers as lysergic acid diethylamide (LSD).

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SINGLE-PAYER System is not the Answer

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Published: Monday, 07 March 2016 00:19

A single-payer system—government-run healthcare for all—sounds like a noble ideal, but things quickly fall apart in the execution, according to its critics.

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