Síndrome serotoninérgica associada ao uso de paroxetina: relato de caso Serotonin syndrome associated to the use of paroxetine: case report

Relatamos um caso de síndrome serotoninérgica pelo uso de inibidor da recaptação da serotonina, a paroxetina. Tal síndrome por esta droga, sem combinações, ainda não tinha sido descrita na literatura.<br>We report on a case of serotonin syndrome associated to the use of the paroxetine, a serotonin reuptake inhibitor drug. Serotonin syndrome related to this drug not combined with other drugs had not yet been described in literature

Spinal Motion Restriction: An Educational and Implementation Program to Redefine Prehospital Spinal Assessment and Care

IntroductionPrehospital spine immobilization has long been applied to victims of trauma in the United States and up to 5 million patients per year are immobilized mostly with a cervical collar and a backboard.ObjectiveThe training of paramedics and emergency medical technicians on the principals of spine motion restriction (SMR) will decrease the use of backboards.MethodsThe training for SMR emphasized the need to immobilize those patients with a significant potential for an unstable cervical spine fracture and to use alternative methods of maintaining spine precautions for those with lower risk. The training addressed the potential complications of the use of the unpadded backboard and education was provided about the mechanics of spine injuries. Emergency medical services (EMS} personnel were taught to differentiate between the critical multisystem trauma patients from the more common moderate, low kinetic energy trauma patients. A comprehensive education and outreach program that included all of the EMS providers (fire and private), hospitals, and EMS educational institutions was developed.ResultsWithin 4 months of the policy implementation, prehospital care practitioners reduced the use of the backboard by 58%. This was accomplished by a decrease in the number of patients considered for SMR with low kinetic energy and the use of other methods, such as the cervical collar only.ConclusionThe implementation of a SMR training program significantly decreases the use of backboards and allows alternative methods of maintaining spine precautions