Clinical Toxicology
Preface
Silas W. Smith, MD, FACEP Daniel M. Lugassy, MD Editors
In the intervening years since the last issue of Emergency Medicine Clinics of North America dedicated to the topic of Medical Toxicology, poisoning has risen to become the leading cause of injury-related death in the United States. Poisoning surpassed deaths from motor vehicle crashes and further exceeds deaths from firearms, falls, and drowning. According to the Centers for Disease Control and Prevention, unintentional poisoning death rates in the United States have steadily increased each year since 1999. Despite the limitations of a spontaneous, voluntary self-reporting structure, National Poison Data System data reveal that over 2.3 million human exposure cases are managed by the nation’s Poison Control Centers annually. These sad statistics highlight the clear and pervasive threat to the nation’s public health posed by medications, household substances, environmental agents, occupational chemicals, drugs of abuse, and other toxic substances and should prompt rededicated efforts toward poisoning prevention, care, and research. Tasked with selecting topics for inclusion, we were presented with the nearinexhaustible range of potentially toxic substances, as well as the possibility of mixed exposures, which confront the emergency practitioner and our own practice. We elected to focus less on particular toxins (although they are reviewed within the articles) and to shift the approach to toxic presentations in several specific organ systems, while recognizing that global dysfunction may be evident. We have also included a few selected topics that may initially seem outside of the scope of emergency medicine, but may either take on a more prominent role or require key initial critical actions by emergency practitioners. We hope that the dedicated work of our contributors will assist emergency practitioners challenged with the care of patients with potential poisoning. Silas W. Smith, MD, FACEP Department of Emergency Medicine Assistant Professor and Section Chief Quality, Safety, and Practice Innovation New York University School of Medicine Bellevue Hospital Center 462 First Avenue, Room A 345-A New York, NY 10016, USA
Emerg Med Clin N Am 32 (2014) xvii–xviii http://dx.doi.org/10.1016/j.emc.2013.10.004 0733-8627/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
emed.theclinics.com
xviii
Preface
Daniel M. Lugassy, MD Department of Emergency Medicine Director of Medical Student Medical Toxicology Education New York University School of Medicine Bellevue Hospital Center 462 First Avenue, Room A 345-A New York, NY 10016, USA E-mail addresses: [email protected] (S.W. Smith) [email protected] (D.M. Lugassy)
Preface
Silas W. Smith, MD, FACEP Daniel M. Lugassy, MD Editors
In the intervening years since the last issue of Emergency Medicine Clinics of North America dedicated to the topic of Medical Toxicology, poisoning has risen to become the leading cause of injury-related death in the United States. Poisoning surpassed deaths from motor vehicle crashes and further exceeds deaths from firearms, falls, and drowning. According to the Centers for Disease Control and Prevention, unintentional poisoning death rates in the United States have steadily increased each year since 1999. Despite the limitations of a spontaneous, voluntary self-reporting structure, National Poison Data System data reveal that over 2.3 million human exposure cases are managed by the nation’s Poison Control Centers annually. These sad statistics highlight the clear and pervasive threat to the nation’s public health posed by medications, household substances, environmental agents, occupational chemicals, drugs of abuse, and other toxic substances and should prompt rededicated efforts toward poisoning prevention, care, and research. Tasked with selecting topics for inclusion, we were presented with the nearinexhaustible range of potentially toxic substances, as well as the possibility of mixed exposures, which confront the emergency practitioner and our own practice. We elected to focus less on particular toxins (although they are reviewed within the articles) and to shift the approach to toxic presentations in several specific organ systems, while recognizing that global dysfunction may be evident. We have also included a few selected topics that may initially seem outside of the scope of emergency medicine, but may either take on a more prominent role or require key initial critical actions by emergency practitioners. We hope that the dedicated work of our contributors will assist emergency practitioners challenged with the care of patients with potential poisoning. Silas W. Smith, MD, FACEP Department of Emergency Medicine Assistant Professor and Section Chief Quality, Safety, and Practice Innovation New York University School of Medicine Bellevue Hospital Center 462 First Avenue, Room A 345-A New York, NY 10016, USA
Emerg Med Clin N Am 32 (2014) xvii–xviii http://dx.doi.org/10.1016/j.emc.2013.10.004 0733-8627/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
emed.theclinics.com
xviii
Preface
Daniel M. Lugassy, MD Department of Emergency Medicine Director of Medical Student Medical Toxicology Education New York University School of Medicine Bellevue Hospital Center 462 First Avenue, Room A 345-A New York, NY 10016, USA E-mail addresses: [email protected] (S.W. Smith) [email protected] (D.M. Lugassy)
