Don’t Eat That!

As someone who works as an EMT for Emory’s Emergency Medical Services (EEMS), I found our class excursion to the Musée Service de Santé des Armées really intriguing. There were many tools and displays detailing how emergency medicine existed in the past. I was actually surprised to see displays and models of how surgical rooms were set up and how similar they all were to the type of Operation Rooms we have nowadays. It was quite surprising to me to realize how although medical knowledge has very obviously changed and improved in the past couple hundred years, medical treatments and medications are still very similar. There’s a clear foundation in transportation measures and drug administration. For example, people still pack wounds with gauze, syringes are still used to administer some medications, and stretchers and wheelchairs in the current day and age are pretty similar to what we were shown in the museum. Even something like autoinjectors that quickly give a dose of epinephrine to someone having an anaphylaxis episode was around way longer than I had originally imagined. It was quite incredible to see how even though medications and the compounds within them change over time, the method of administering them is still very much the same.

Makeshift operating room

Me at the chapel in the museum (excuse the poor contrast)
Emergency medicine in 1870

 

Further, as I was walking around, I came across an “atropine autoinjector” and because this is a drug we talk about in the emergency medical setting, I thought I would look into its effects on the Central Nervous System and how it might play into the brain’s chemistry. Atropine is “given before anesthesia to decrease mucus secretions, such as saliva” and during surgery, is used to “keep the heart beat normal” (https://www.myvmc.com/drugs/atropine-injection-bp/). In the emergency setting, it can be used to reverse the effects of organophosphate (OP) poisoning that result from insecticide use. Atropine has a tendency to cross the Blood Brain Barrier (BBB) and distribute inside the brain, stimulating the medulla and cerebral centers to induce a fight or flight response. Oftentimes, OPC poisoning occurs due to accidental exposure. However, it’s become apparent that oftentimes individuals living in an area with easy accessibility to said insecticides utilize them in an attempt to commit suicide. When this happens, a rare neurological condition can result, termed “OP-induced Parkinsonism”. In one specific case study, this condition resulted in “coarse resting tremors with cog-wheel rigidity, and signs of dyskinesia affecting both the upper and lower limbs” (Kalyanam, Narayana, & Kamarthy, 2013).

Atropine autoinjector

References:

Kalyanam, B., Narayana, S., & Kamarthy, P. (2013). A Rare Neurological Complication of Acute Organophosphorus Poisoning. Toxicology International, 20(2), 189–191. https://doi.org/10.4103/0971-6580.117270

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