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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

My Heart is Racing! Select Cardiac Arrhythmias and Practice Updates

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lunes, 5 de septiembre de 2016

N2O

NO Laughing Matter St.Emlyn's
St. Emlyn´s - By Richard Carden - September 4, 2016
..."It is mainly used for it’s euphoria-inducing effects, which are short-lived, lasting 1-5 minutes126. It is also a great analgesic, as we well know from the use of Entonox in acute pain. Due to its short-acting nature, recreational users frequently binge and will often see off a large number of the canisters. In the UK, it is estimated that around 7.6% of individuals aged between 16 and 24 have used nitrous oxide, and it has been responsible for 17 deaths between 2006 and 2012. These deaths, whilst publicised, have perhaps not gained the same recognition as the fatalities caused by other recreational drugs such as MDMA. I suspect that due to the short effects it is probably perceived as less dangerous by those who choose to use it. The deaths caused by nitrous oxide are predominantly due to asphyxiation, as the nitrous oxide dilutes the amount of available oxygen in the lungs thus causing fatally hypoxic sequelae.
It is evidently an emergency when someone presents with acute hypoxia as a result of nitrous oxide use, but that is not where the problem with the drug ends for emergency physicians. My ultimate take home point from this post is the following:
In young patients who present with any peculiar neurology or a new or unexplained B12 deficiency or macrocytic anaemia, have nitrous oxide use on your radar.
Subacute Cord