J R Suchard

Good Samaritan Medical Center, West Palm Beach, Florida, United States

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Publications (10)24.06 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Pyridoxine hydrochloride, the antidote for isonicotinic acid hydrazide (INH)--induced seizures, is available in solution at a concentration of 100 mg/mL at a pH of less than 3. Pyridoxine is often infused rapidly in large doses for INH-induced seizures. Effects of pyridoxine infusion on base deficit in amounts given for INH poisoning have not been studied in human subjects. We hypothesized that this infusion would result in transient worsening of acidosis. We conducted a randomized, controlled crossover trial in human volunteers. Five healthy volunteers (mean age, 35 years; range, 29 to 43 years) were randomized to receive intravenous placebo (50 mL of normal saline solution) or 5 g of pyridoxine (50 mL) over 5 minutes. A peripheral intravenous catheter was established in each arm, and a heparinized venous blood sample was obtained for base deficit at baseline and 3, 6, 10, 20, and 30 minutes after infusion. After at least a 1-week washout period, the volunteers were assigned to the alternate arms of the experiments, thus acting as their own control subjects. Data were analyzed by using the 2-tailed paired t test, controlling for multiple comparisons. No difference was noted between groups at baseline. A statistically significant increased base deficit was noted after the pyridoxine infusion versus control at 3 to 20 minutes but not at 30 minutes (P =.1). Maximal mean increase in base deficit (2.74 mEq/L) was noted at 3 minutes. A transient increase in base deficit occurs after the infusion of 5 g of pyridoxine in normal volunteers.
    Annals of Emergency Medicine 08/2001; 38(1):62-4. · 4.33 Impact Factor
  • K L Wallace, J R Suchard, S C Curry, C Reagan
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    ABSTRACT: We sought to assess physicians' ability to accurately determine the presence or absence of sodium fluorescein (SF) in urine at a concentration corresponding to that present after ingestion of a toxic amount of commercial automotive antifreeze. We studied 2 different urine specimen evaluation formats--one presenting isolated specimens, and the other presenting specimens grouped for comparison--to determine whether the visual clues afforded by grouped comparison aided the accuracy of the evaluation. On each study day, 3 urine specimens (1 control specimen obtained before SF administration and 2 specimens obtained after SF administration) were obtained from each of 9 or 10 volunteers. Each of these 27 or 30 urine specimens were presented sequentially and in random order to 2 emergency physicians during separate evaluation time periods. Each physician was asked to classify each specimen as fluorescent or nonfluorescent (sequential format). After a rest period, each physician, again separately, was asked to look at the same 27 or 30 urine specimens, this time all together in a test tube rack so that grouped comparisons were possible. The physicians again classified each sample as either fluorescent or nonfluorescent (grouped format). We assessed sensitivity, specificity, and accuracy of the evaluation by each presentation format (sequential or grouped). Mean examiner sensitivity, specificity, and accuracy for detecting the presence of SF in urine using the sequential presentation format were 35%, 75%, and 48%, respectively, whereas the same test performance indices were 42%, 66%, and 50%, respectively, when the grouped format was used. Wood's lamp determination of urine fluorescence is of limited diagnostic utility in the detection of SF ingestion in an amount equivalent to toxic ingestion of some ethylene glycol--containing automotive antifreeze products.
    Annals of Emergency Medicine 08/2001; 38(1):49-54. · 4.33 Impact Factor
  • J R Suchard, R Hilder
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    ABSTRACT: BACKGROUND: Systemic scorpion envenomation may be associated with hypersalivation and respiratory distress. Atropine can dry secretions, but is not recommended for stings from many foreign scorpions, since it exacerbates adrenergic toxicity to the cardiopulmonary system. Serious adrenergic effects, however, are rare with Centruroides sculpturatus envenomation. CASE SERIES: Five cases of Grade IV C. sculpturatus envenomation whose treatment included atropine were found on retrospective review at one poison control center located in a scorpion-endemic area. No clinically significant adverse effects of atropine were noted. In 3 cases, atropine's reversal of hypersalivation and respiratory distress obviated the need for further interventions.
    Journal of toxicology. Clinical toxicology 02/2001; 39(6):595-8; discussion 599.
  • A M Ruha, D A Tanen, J R Suchard, S C Curry
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    ABSTRACT: A 40-year-old man with a history of schizophrenia and inflammatory soft tissue lesions after self-injection of elemental mercury presented to the Emergency Department. Multiple skin abscesses associated with fever required operative debridement. An incidental finding of oral mercury ingestion was followed clinically and did not result in complications. Exposure to elemental mercury through injection or ingestion is an uncommon event, but one the Emergency Physician may encounter. Subcutaneous mercury injection should be managed with local wound debridement, whereas ingestions are rarely of clinical significance.
    Journal of Emergency Medicine 02/2001; 20(1):39-42. · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 40-year-old man with a history of schizophrenia and inflammatory soft tissue lesions after self-injection of elemental mercury presented to the Emergency Department. Multiple skin abscesses associated with fever required operative debridement. An incidental finding of oral mercury ingestion was followed clinically and did not result in complications. Exposure to elemental mercury through injection or ingestion is an uncommon event, but one the Emergency Physician may encounter. Subcutaneous mercury injection should be managed with local wound debridement, whereas ingestions are rarely of clinical significance.
    Journal of Emergency Medicine - J EMERG MED. 01/2001; 20(1):39-42.
  • K L Wallace, J Suchard
    Otolaryngology Head and Neck Surgery 04/2000; 122(3):467-8. · 1.73 Impact Factor
  • J R Suchard, S C Curry
    Pediatric Emergency Care 09/1999; 15(4):306. · 0.89 Impact Factor
  • J R Suchard, K L Wallace, R D Gerkin
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    ABSTRACT: A 41-year-old woman ingested apricot kernels purchased at a health food store and became weak and dyspneic within 20 minutes. The patient was comatose and hypothermic on presentation but responded promptly to antidotal therapy for cyanide poisoning. She was later treated with a continuous thiosulfate infusion for persistent metabolic acidosis. This is the first reported case of cyanide toxicity from apricot kernel ingestion in the United States since 1979.
    Annals of Emergency Medicine 01/1999; 32(6):742-4. · 4.33 Impact Factor
  • Source
    J R Suchard
    Academic Emergency Medicine 09/1998; 5(8):813-4, 835-8. · 2.20 Impact Factor
  • Journal of the American Academy of Dermatology 06/1998; 38(5 Pt 1):784-5. · 4.91 Impact Factor