Accidental colchicine overdose. A case report and literature review.

Colchicine overdose is uncommon but potentially life threatening. It is a safe drug when used according to established therapeutic guidelines but causes serious systemic effects if ingested in doses that exceed the recommendations. Overdose must therefore be recognised early and treated appropriately to optimise the outcome. A fatal case of colchicine overdose caused by inappropriate self medication is reported and to the best of the authors' knowledge, there has been no report of fatal accidental overdose in the United Kingdom. The pharmacology of colchicine, the clinical features associated with overdose, and the options for treatment are discussed.

Conversion disorder presenting as a head injury.

A case of a conversion disorder which presented as a head injury is described. This is a rare problem and by definition a diagnosis of exclusion.

Successful out-of-hospital defibrillation for ventricular fibrillation complicating solvent abuse.

The Authors describe the case history of a child who suffered a cardiac arrest with ventricular fibrillation after deliberate inhalation of 1,1,1-Trichloroethane in typewriter correction fluid thinners. Successful out-of-hospital defibrillation was carried out and the patient made a full recovery. The literature relating to this particular form of volatile substance abuse is reviewed.

Femoral nerve block in the initial management of femoral shaft fractures.

The aim of this study was to demonstrate that the under-used technique of femoral nerve block (F.N.B.) (Berry, 1977) has excellent analgesic action for femoral shaft fractures when performed by junior staff. It had no recorded side effects and was used in all age groups for fractures at all levels along the femoral shaft. Twenty-seven consecutive patients were studied as they presented in an accident room, all received a femoral nerve block (10 ml 1% Lignocaine with 1:200,000 adrenaline) from unsupervised junior accident and emergency staff instructed in the technique. Each case was subsequently followed up, and both the delay before the onset of analgesia and total duration of analgesia, together with its efficacy, were assessed. A further F.N.B. using a different agent (10 ml 0.5% bupivacaine) was performed and the same parameters were assessed. Both agents gave effective analgesia of varying duration at all levels of fracture site.