Antipsychotics in the ER
Since the 1950's, antipsychotics have become effective treatment for positive and negative symptoms of psychosis. With the introduction of second generation antipsychotics there was some decrease in the extrapyramidal effects associated with these medications, however side effects, including potentially deadly, are still commonly seen in the ER.
Antipsychotics bind and inhibit dopamine receptors, causing the varying effects of these medications. This is also the source of many of the adverse effects of the medications.
Hydrofluoric Acid Treatment
Burns of dilute hydrofluoric acid are difficult to distinguish from other chemical burns and can appear as minimally erythematous areas of skin without blistering. Over 12-24 hours, however, this can progress to severe burns and blistering, progressing to necrosis requiring debridement. Highly concentrated acids may present with severely reddened, swollen areas with blanched regions which rapidly progress to necrosis. Even burns without impressive physical appearance may cause severe pain due to nerve ending irritation. HF is unique in that it does not spontaneously dissociate from hydrogen ions, causing it to penetrate through the skin and cause deeper, even systemic damage and hypocalcemia and hypomagnesemia.