title: A Prospective Observation Study of Medical Toxicology Consultation in a U.S. Combat Theater.
abstract: Since 2001, U.S. military personnel and active duty, uniformed physicians providing medical support have been deployed to Afghanistan. Medical toxicologists are among the physicians deployed. There is a paucity of information present in the literature that has documented cases treated by toxicologists in theater. This prospective observational study describes 15 male patients treated in theater by a military medical toxicologist.
  
  
  
  We performed a prospective observational study in which a medical toxicologist consulted and reported on deployed toxicology cases occurring during a 5-month deployment to Bagram, Afghanistan.
  
  
  
  Fifteen toxicology cases were collected during the 5-month period. The patients included three Afghan civilians, three U.S. civilians, and nine U.S. military personnel. Eight cases were attempts at recreational euphoria, two were self-harm attempts, two were from performance-enhancing supplements, two were accidental occupational exposures and one was alcohol withdrawal. Methanol was the most common exposure followed by dextromethorphan, supplements, opiates, and chlorine gas.
  
  
  
  In our study, we found that toxic alcohols and nonprescription medications were the most common exposures. In addition, this is the first study to describe bedside toxicology consults for U.S. combat forces in theater and the use of an observation unit for critically ill patients.
authors.affiliation: San Antonio Military Medical Center, 3551 Roger Brooke Drive, Joint Base San Antonio, San Antonio, TX 78234.
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Maddry
authors.affiliation: San Antonio Military Medical Center, 3551 Roger Brooke Drive, Joint Base San Antonio, San Antonio, TX 78234.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Ng
authors.affiliation: San Antonio Military Medical Center, 3551 Roger Brooke Drive, Joint Base San Antonio, San Antonio, TX 78234.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sessions
authors.affiliation: University of Colorado Denver-Anshutz Medical Campus, Leprino Office Building, 12401 East 17th Avenue, Aurora, CO 80045.
authors.forename: Vikhyat S
authors.initials: VS
authors.lastname: Bebarta
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D000701:Analgesics, Opioid / Q000633:toxicity; D003915:Dextromethorphan / Q000633:toxicity; D005260:Female; D006801:Humans; D008297:Male; D000432:Methanol / Q000633:toxicity; D008889:Military Personnel / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014116:Toxicology / Q000706:statistics & numerical data*; D014481:United States / Q000208:ethnology; D014857:Warfare
chemical_list: D000701:Analgesics, Opioid; D003915:Dextromethorphan; D000432:Methanol