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Biomedical subjects

E G Comstock

Publications and source records attributed to E G Comstock.

At least 19 recordsLinked to original sources
PubMed1982

Assessment of the efficacy of activated charcoal following gastric lavage in acute drug emergencies.

The efficacy of administering a slurry of 100 g of activated charcoal (AC) via the gastric tube following lavage was assessed in 25 treated and 37 control patients presenting to the emergency room with chemical evidence of sedative-hypnotics or aspirin in the blood. Efficacy was evaluated as the ability of AC to prevent further absorption as determined by subsequent blood drug concentration changes. Although fewer patients in the AC group showed increased blood drug concentrations, the differences were not statistically significant. Comparison of the mean percent change in blood drug concentrations at various times following treatment produced similar results. Comparisons using subgroups of patients based on the individual drugs, the treatment delay time, and entering functional decompensation showed significant benefit from AC only in the less symptomatic patients. Comparing these results with other studies demonstrating the unequivocal efficacy of early (e.g., 30 min) treatment, it is concluded that the use of AC following lavage may often be too late to benefit most patients. The authors suggest that AC be given in the home, emergency vehicle, or immediately upon admission.

Absorption↗
PubMed1981

Noninteractive emergency consultation for acute intoxication.

The delivery of consultation for treatment of acute intoxication encounters several obstacles. The physician must recognize the case with which he needs assistance; he must be aware that assistance is available; the help must be technically correct; the delivery system must maintain responsible professional continuity while providing consultation at the time and place where it is required. The consultation must be appropriate to the clinical problem at hand in that immediate life-threatening aspects are covered quickly while continuing care and principles are deferred. Availability of specialized equipment and drugs must be assured by some method of precrisis communication. A system for delivery of telephone consultation for the treatment of acute intoxication is described. The system is based on a collection of prepared tapes, providing consultation of 3 to 6 min duration, oriented toward specific topics such as etiologic substances, common clinical syndromes, and commonly encountered complications. The advantages and disadvantages of the program are discussed.

Acute Disease↗
PubMed1981

Studies on the efficacy of gastric lavage as practiced in a large metropolitan hospital.

The efficacy of gastric lavage as it is practiced in a major metropolitan hospital was evaluated. From a population of 76 patients with chemical evidence of sedative-hypnotic drugs in the blood, two or more therapeutic doses were recovered from 15.8% of the lavage samples, and 10 or more therapeutic doses were recovered from 6.6%. In a population consisting of patients with detectable quantities of drugs in the lavage sample, diazepam and amitriptyline are more adequately recovered than the sedative-hypnotic drugs. Very poor recoveries were obtained in patients lavaged more than 2 h after ingestion except in cases of amitriptyline overdose or massive sedative-hypnotic ingestion. The study indicates that inadequate criteria are employed in selecting patients most likely to benefit from lavage. Dose, time since ingestion, and symptomatology are discussed as criteria for selection of patients for lavage.

Amitriptyline↗
PubMed1979

The practice of medical toxicology.

Two hundred twelve consecutive cases presenting to a medical toxicologist related to chronic occupational exposure (49%), acute occupational exposure (24%), and nonoccupational exposure (27%). Chief complaints were respiratory (36%), behavioral (28%), neuropathy (17%), and organic brain syndrome (10%). In 90% of patients, litigation was in process or under consideration. Referrals were from plaintiff attorneys (37%), from employers, insurance compounds, and defense attorneys (26%), and from physicians (24%). Outcome of assessment revealed 55% to be unrelated to toxic substances, 39% probably related, and 6% positively related.

Environmental Exposure↗
PubMed1979

Dose-response studies on tolerance to multiple doses of secobarbital and methaqualone in a polydrug abuse population.

Patients from a polydrug abuse treatment program were titrated with either secobarbital or methaqualone, their primary drug of abuse, to a state of mild intoxication, consisting of lateral and vertical nystagmus, ataxia, slurred speech, and drownsiness. The mean dose required to produce each sign was compared to that determined in a similarly treated control group. Tolerance to secobarbital was more easily demonstrated than tolerance to methaqualone, and nystagmus was the least sensitive indicator of patient tolerance. The individual signs were also cumulated into a graded rating scale of central nervous system depression which would be related to the dose administered. Tolerence was easily demonstrated at the higher stages of toxicity for secobarbital in the overall patient population, but tolerance to methaqualone was only unequivocal in the subjects indicating a relatively high frequency of abuse. Tolerance to methaqualone occurred at the lower stages of toxicity, suggesting that there is a difference between tolerance to secobarbital and tolerance to methaqualone. There was no indication that patients who also abuse alcohol are more tolerant than their patient counterparts. The patients who also had a history of amphetamine abuse, however, were less tolerant than the nonusers of these drugs.

Adolescent↗