Evidence of Methamphetamine Exposure in Children Removed From Clandestine Methamphetamine Laboratories

From Pediatric Emergency Care:

Objective: To determine whether asymptomatic children removed from clandestine methamphetamine laboratories have evidence of exposure to methamphetamine.

Methods: Retrospective chart review of children removed from law enforcement-certified clandestine methamphetamine laboratories in the Tulsa area of Oklahoma and Sacramento County, California. Exposure was determined by positive urine toxicology for methamphetamine.

Results: One hundred four children were evaluated after removal from clandestine methamphetamine laboratories. Forty-eight children (46%) tested positive for methamphetamine. Timed urine results were known for 68 of 104, with no child testing positive after 6.5 hours from being removed from the laboratory. No child required emergency medical treatment at the time urine samples were obtained.

Conclusions: Almost half of the children in this sample had evidence of exposure to methamphetamine soon after removal from methamphetamine manufacturing environments. Further research is indicated to determine the health effects of subclinical methamphetamine exposure.

Benefit of immobilizing trauma victims questioned

From the Baltimore Sun:

Shooting and stabbing victims immobilized to protect their spines might be twice as likely to die because of the delay in transporting them to the hospital, Johns Hopkins researchers conclude in a new study that could trigger a review of treatment protocols used by Maryland paramedics.

Immobilization is standard procedure for paramedics in Maryland and many communities across the country, and the study could have particular significance in Baltimore, where 218 people were fatally shot or stabbed last year.

Immobilization “shouldn’t be applied to every single patient who is shot or stabbed because it uses up precious time and doesn’t necessarily benefit the patient,” said Dr. Elliott R. Haut, lead author of the study published today in the Journal of Trauma.

Haut, an assistant professor of surgery at the Johns Hopkins University School of Medicine, plans to seek a change in the statewide protocol.

Myth #7: Therapeutic hypothermia is too expensive & unsubstantiated

From Emergency Physicians Monthly (part of a “Rethinking Resuscitation” article)

Myth #7: Therapeutic hypothermia is too expensive & unsubstantiated
Although there are many critics of therapeutic hypothermia, this concept has been endorsed for years by the International Liaison Committee on Resuscitation (ILCOR). While the data is limited, it is still fairly compelling. (New England Journal of Medicine. 2002 Vol. 346, No. 8). In patients with a primary v-fib arrest who have spontaneous return of circulation, but do not regain consciousness, their chances for a better neurological outcome may be enhanced by doing this. Hey, if they survive in the ED, we’re sending them to the ICU anyway. Why don’t we give them every possible chance at survival? The only strong argument against this modality is cost. If you keep the medical device companies out of this and stick to the basics, this can be a bit messy, but not expensive. Ice is cheap!