ABSTRACT
We describe a patient who experienced dystonia coincident with the administration of an i.v. contrast agent. Dystonic reactions are not well known outside of the fields of Emergency Medicine, Neurology, and Psychiatry. They have not been previously reported as a reaction to i.v. contrast material. Prompt consideration and treatment of this condition may prevent unnecessary patient discomfort and interventions.
Subject(s)
Contrast Media/adverse effects , Dystonia/chemically induced , Adult , Contrast Media/administration & dosage , Female , Hernia, Ventral/diagnostic imaging , Humans , Injections, Intravenous , Tomography, X-Ray ComputedSubject(s)
Analgesics/therapeutic use , Emergency Medicine/standards , Pain/drug therapy , Refusal to Treat , Aged , Clinical Competence , Female , Humans , Informed Consent , Male , Middle Aged , Pain/etiology , Transportation of Patients/standards , United States , Wounds and Injuries/complicationsABSTRACT
Hydrogen sulfide is a colorless irritant and asphyxiant gas with a noxious odor of "rotten eggs." Acute hydrogen sulfide exposure may cause, depending on the level and duration of toxicity, symptoms ranging from mild mucous membrane irritation to permanent neurologic impairment and cardiopulmonary arrest. We present a case of an oil refinery worker exposed to a typically fatal concentration of hydrogen sulfide gas (>1000 ppm) while working on top of a 20-foot ladder. The "knockdown" effect of exposure to high concentrations of hydrogen sulfide caused him to lose consciousness and fall from the top of the ladder. He was transported to the Emergency Department as a major trauma victim. Ironically, this 20-foot fall saved his life and possibly those of the rescuers by immediately removing him from the source of the hydrogen sulfide. Treatment of hazardous materials incidents and the pathophysiology and treatment options for hydrogen sulfide poisoning are discussed.
Subject(s)
Accidental Falls , Accidents, Occupational , Explosions , Hydrogen Sulfide/poisoning , Adult , Gas Poisoning/diagnosis , Gas Poisoning/physiopathology , Gas Poisoning/therapy , Humans , MaleABSTRACT
The integration of an honor code in medical school curricula might be a means to enhance the moral education of medical students. In recent years, the subject of medical ethics has seen a rebirth; not only is the literature replete with material but the training of physicians is centered in no small way upon the inculcation of a core set of values that will accompany students throughout their careers. However, medical ethics as currently taught remains abstract and, often, intangible for young physicians in training. This article will address the means by which the use of an honor code in modern medical schooling might foster a more virtuous and ethical individual and, in turn, physician.
