Publication Date 17 Implementation of a Flow Nurse to Increase Emergency Department Space Utilization

Chiu Dt, Hyde, Joseph, Sanchez Ld, Beth Israel
2017 unpublished
S9 Western Journal of Emergency Medicine MEMC-GREAT Abstracts Issue 2017 (i.e., sales). These studies failed to distinguish among the multiple unique products characterized as "energy drinks" (beverages, shots, and concentrates) and are confounded with caffeine-containing supplements (caffeine tablets, workout powders). Energy beverages dominate the market. Design and Method: We performed a five-year database query of single-substance exposures to products described as "energy drinks" on the
more » ... as Poison Center Network's database. We analyzed the data for product type, multiples of recommended serving size consumed (dose), adverse outcomes, management site, and demographics. Individual case report forms were reviewed for moderate or major outcomes or death. We obtained five years of Texas sales data for "energy beverages." Results: From 01/01/10-12/31/14, we recorded 855 exposures to all products characterized as energy drinks (excluding those with ethanol or without caffeine). Of those exposures, 291 (34%) resulted in no or minimal effects and 417 (49%) were judged to be nontoxic or minor exposures not followed to a known outcome. Sixty-four (7.5%) were coded as moderate, and four (0.5%) major with no deaths. Serious complications included two self-limited seizures and one brief episode of ventricular tachycardia. Of the moderate and major cases, 32 (47%) occurred in children and adolescents. Common findings included nausea, tachycardia, and tremors. Energy beverages were associated with three moderate and no major cases, none in children less than 17 years. For all energy beverages, incidence rates of calls to Texas poison centers for moderate and major outcomes were 0.58 and 0.053 per hundred million units sold, respectively. Conclusion: Serious toxicity can occur after excessive use of caffeine-containing products. With substantial variability of products described as "energy drinks" in poison center data, misperceptions of toxicity in post-marketing surveillance exist. Readers must consider the limitations and potential errors inherent in the data collection and coding of aggregate poison center data.