Another case of gamma hydroxybutyrate (GHB) overdose

Dear Editor.
The information p r e s e n t e d in the excellent c a s e review entitled, " G a m m a Hydroxybutyrate Overdose: Two Cases Illustrate the Unique A s p e c t s of This Dangerous Recreational Drug" (J Emerg Nurs 1995;21: 374-6) w a s informative and helpful. We have s e e n several p a t i e n t s who i n g e s t e d this drug. They were initially s e e n with seizures, d e c r e a s e d level of consciousness, or both, and then had a m a r k e d s u d d e n recovery. Since the article w a s written there w a s a d e a t h in O m a h a that was attributed to GHB (and alcohol). Unfortunately, I believe we will see more of t h e s e d e a t h s in the e m e r g e n c y department.--Charose

RN, Laurel Regional Hospital, Emergency Department, 7300 Van Dusen Rd., Laurel, MD 20707

Policy to control withdrawal symptoms of IV heroin users sought

Dear Editor.
Our e m e r g e n c y d e p a r t m e n t sees a significant n u m b e r of IV heroin users, some of whom require ad mission for complications of their addiction (endocarditis, cellulitis, sepsis). It m a y take up to 2 to 3 days before a p a t i e n t is seen by the hospital's addiction specialist for the prescription of methadone. We are considering i m p l e m e n t a t i o n of guidelines to give oral morphine to these p a t i e n t s in our e m e r g e n c y dep a r t m e n t to control their symptoms. I would like to hear from others who m i g h t have a similar program. Also, I w e l c o m e any d o c u m e n t a t i o n available in regard to nursing implications on this topic. Thank

James, RN, BSN, CEN, Methodist Hospital, Omaha, Nebraska

E d i t o r ' s N o t e : This letter w a s a c c o m p a n i e d by an article from the Council Bluffs, Iowa, newspaper, The Daily NonPareil. It reported the d e a t h of a 20-year-old w o m a n who drank GHB in combination with alcohol. The combination, the article noted, " p r o d u c e d respiratory d e p r e s s i o n and vomiting."

you.--Carole Richer, RN, CEN, St. Paul's Hospital, Emergency Department, 1081 Burrard St., Vancouver, BC V6Z 1Y6 Canada

More on Latter-day Saint patients

Dear Editor:
I enjoyed your article by Carol and Aric Cramer, "Caring for the Latter-day Saint Patient," (J Emerg Nurs 1995;21:503-4). I would like to add something. It has b e e n my experience that some people erroneously believe that Latter-day Saint p a t i e n t s are o p p o s e d to the administration of blood or blood products, and it m a y be worth mentioning that they are not. Thanks for this y e a r ' s p u s h for u n d e r s t a n d i n g people of the world! Gracias.--Sarilu Sosa-Sanchez,

Iced saline solution for burns and gastrointestinal lavage: Information and policies sought
Dear Editor.
Our e m e r g e n c y d e p a r t m e n t is in the process of r e v i e w i n g policies and procedures. There is some difference of opinion in the use of iced saline solution for burns and gastrointestinal lavage. We would be appreciative of any information sent to us concerning t h e s e areas. We would also like to see policies from various e m e r g e n c y departments.--Diane Liebestdnd, J Emerg Nurs 1996;22:97 Copyright 9 1996 by the Emergency Nurses Association. 0099-1767/96 $5.00 +0 18/64/71236

RN, BSN, CEN, Colorado Springs, Colorado

E d i t o r ' s N o t e : Thank you for dispelling an erroneous idea and thank you also for the additional opportunity to thank the g u e s t editor of the Cultural Diversity t h e m e issue, Sue Moore, for all of her hard work.

April 1996 97