AimTo evaluate the association of intravenous fluid (IVF) therapy on the length of time from arrival at the emergency department (ED) until awakening in cases of acute alcohol intoxication.MethodsThis single‐center, prospective, observational study was conducted in the ED of the Self‐Defense Forces Central Hospital during October 1, 2018 to July 31, 2019. Patients with 1,000 mL bolus of lactated Ringer's solution and those without bolus were compared. The primary outcome was the length of time until awakening. Secondary outcomes were the length of stay in the ED and occurrence of conditions requiring extra care. Predictors of the occurrence of any event requiring extra care were identified.ResultsWe included 201 patients, of whom 109 received IVF and 92 did not. No significant difference existed in the baseline characteristics between the groups. The median length of time until awakening did not significantly differ between the groups (P = 0.77). Multivariable regression analysis adjusted by age, sex, hemoglobin, blood alcohol concentration, and initial Glasgow Coma Scale (GCS) score demonstrated that the regression coefficient of IVF for length of time until awakening was −9.55 (95% confidence interval [CI], −36.2 to 17.2). Hemoglobin (regression coefficient, 10.1; 95% CI, 0.38–19.9) and initial GCS score (regression coefficient, −7.51; 95% CI, −10.8 to −4.21) were significantly associated with length of time.ConclusionIVF therapy was not associated with the length of time until awakening in patients with acute alcohol intoxication in the ED. Routine IVF administration was unnecessary.
Background Acute alcohol intoxication is a common condition observed in the emergency department (ED). Intravenous fluid therapy (IVF) is often administered to treat this condition, but its effectiveness remains unclear. We therefore conducted a study to evaluate the effect of IVF on length of time from arrival at the ED until awakening, which is a novel and more appropriate variable. Methods This single-center, prospective observational study was conducted in the ED of Self-Defense Forces Central Hospital, a secondary emergency hospital in Tokyo from October 1, 2018 to July 31, 2019. Patients were assigned to groups to receive either a 1,000-mL bolus of lactated Ringer’s solution or only cannulation. The primary outcome was length of until awakening. Secondary outcomes were length of stay in the ED and the occurrence of conditions requiring extra care. Univariate and multivariate regression analyses were performed. Predictors of the occurrence of any event that required extra care were identified using a statistical model. Results The final sample included 201 patients: 109 received IVF and 92 did not. There was no significant difference in baseline characteristics between the groups. Median length of time until awakening was 211 min (interquartile range [IQR], 119 min) in the IVF group and 208 min (IQR, 149 min) in the non-IVF group (p = 0.77). Multivariate regression analysis demonstrated that the regression coefficient of IVF for length of time until awakening was − 9.55 (95% confidence interval [CI], \(-\)36.2 to 17.2). However, hemoglobin (regression coefficient, \(10.1\); 95% CI, \(0.38\)-19.9) and initial Glasgow Coma Scale score (GCS) in the ED (regression coefficient, \(-\)7.51; 95% CI, \(-\)10.8 to \(-\)4.21) were significantly associated with length of time. Conclusions This is the first study to evaluate the effect of IVF therapy on the length of time until awakening. IVF therapy is not effective in shortening the length of time in patients with acute alcohol intoxication in the ED. Routine administration of IVF is unnecessary in these patients. Further research is warranted to investigate who benefit from IVF therapy. A significance difference in Hb and GCS in this study also would give useful tips for the next study.
Background When snake breeders are bitten by rare snakes, deciding whether to administer snake antivenom can be challenging. Case Presentation A 50‐year‐old man was bitten on the right finger by Boiruna maculata . The next day, his right upper limb exhibited pronounced local manifestations of envenomation. At the first consultation, a dark purple bleeding spot and a necrotic site were present under the fang marks at the bitten finger and his affected limb showed extensive swelling and redness. Snake antivenom was not administered because it was difficult to identify the snake and obtain the antivenom. We performed the pressure immobilization technique to his limb. The patient’s symptoms peaked in severity on the second day of illness. He was discharged with marked improvement. Conclusions We have experienced a case of snakebite envenomation by Boiruna maculata .
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