Anesthesia Implications of Patient Use of Electronic Cigarettes.

Electronic cigarettes are essentially electronic nicotine delivery systems (ENDS). Use of ENDS has increased sharply in the United States in recent years, particularly among youth. We reviewed the literature on ENDS use, based on a PubMed search, with a focus on effects that could influence anesthetic and surgical outcomes. We also included a meta-analysis of articles published between 2016 and 2018 reporting injuries from exploding ENDS. These devices deliver nicotine, which is addictive and a cardiac stimulant. The nicotine in ENDS has been linked to increased risk of heart disease and myocardial infarction. Also, ENDS deliver vapors of solvents, flavorings, and other chemicals that can cause chronic and acute respiratory diseases. Furthermore, ENDS use may pose a cancer risk. However, ENDS are somewhat less dangerous than cigarettes and are used as smoking cessation devices. From the literature review, we identified 15 articles reporting injuries from ENDS fires and explosions to 93 patients. Most of these patients were young (mean age = 31.6 years) and male (91%). The most common injury sites were the thigh (62%) and hand (33%). Because the anesthetist will likely encounter increasing numbers of ENDS users in the future, it is important to identify these patients and to understand the risks of ENDS use.

[Management of phenol burn cases combined with poisoning].

OBJECTIVE: To explore the therapeutic processing and nursing for phenol burn patients combined with poisoning. METHODS: The clinical data of 42 phenol burn cases admitted in our hospital from 1998 to 2010 were reviewed retrospectively. The general clinical manifestations, treatment and nursing methods, and the treatment results of these cases were analysed. RESULTS: Out of 42 phenol burns patients, the total burn surface area (TBSA) of 22 cases were ≤ 5%, 10 cases' TBSA were 6% ∼ 10%, and 5 cases' > 20%. 36 patients showed systemic poisoning symptoms 1 ∼ 2 hours after injury, the severity and enduring period of which correlated with TBSA. Patients whose TBSA > 10% appeared obviously dysfunction of the liver and kidney. The therapeutic methods included wound management, compensation of fluid, diuresis, alkalized urine, large dose of vitamin C and glucocorticoid, early surgery, blood purification, etc. 39 of 42 cases were successful cured, while the other 3 cases died. CONCLUSIONS: Phenol burn often complicates systemic poisoning. In the treatment of patients with this special chemical burn, it is key scheme to block phenol absorption and promote elimination of already absorbed poison as early as possible. The comprehensive management and nursing should be necessary for supporting functions of important organs.