Benzocaine-Induced Methemoglobinemia: A Case Report.

Topical anesthetics, such as benzocaine, have been reported to cause methemoglobinemia, in which hemoglobin is unable to release oxygen effectively to body tissues. The pathophysiology, symptoms, and treatment of a 46-year-old patient are examined.

Hospital emergency preparedness: Push-POD operation and pharmacists as immunizers.

OBJECTIVE: To describe Montefiore Medical Center's participation in a point-of-distribution (POD) exercise in which pharmacists were drilled on the ability to provide immunizations in the face of an emergency. SETTING: New York City on October 9, 2007. SUMMARY: Rapid and appropriate response to a terrorism event can limit morbidity and mortality. After the events of September 11, 2001, the New York City Department of Health and Mental Hygiene (DOHMH) recognized the need to develop a uniform procedure in the case of a potential health disaster. During the fiscal year occurring between September 1, 2006, and August 31, 2007, DOHMH requested that all citywide hospitals participate in a POD drill. All participating hospitals were required to have a team of five health professionals, including one pharmacist, one physician, two nurses, and another member of the institution. The drill was to be conducted within a 4-hour interval to simulate a situation of mass prophylaxis using influenza as a surrogate vaccine or pharmaceutical agent needed in the event of a public health emergency. MAIN OUTCOME MEASURE: Number of health care workers immunized in 4-hour period. RESULTS: During the 4-hour period, the team was able to immunize 942 heath care workers. Predicting a 24/7 operation in the event of a biological terrorism event, the Push-POD operation would have the capacity to immunize 12,000 health care workers-the approximate population of the hospital-in 48 hours. This exercise was replicated for the 2008 influenza program, and the results were identical. CONCLUSION: By allowing pharmacists to expand their scope of practice, New York State will inevitably see a drastic improvement in its adult immunization rates for influenza and pneumococcal vaccinations through greater public awareness and expanded vaccine access.