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First aid recommendations should be intended for first responders and include specific treatment only when there is an antidote or intervention generally accepted as effective, and early administration could substantially improve outcome.

The first aid section should be developed under the supervision of a physician.

The American College of Medical Toxicology supports the intent of the Federal Regulations which requires Safety Data Sheets (formerly Material Safety Data Sheets) as part of communications to improve safety in the workplace.

It is the position of ACMT that the format of the SDS should not be expanded to serve as a mechanism to communicate to practitioners of medicine advice on treatment of the health effects of chemical exposure other than first aid measures.

Brain death is diagnosed clinically when an irreversible and proximate cause of brain injury is identified and no brain function is present upon clinical assessment [1, 2].

A prerequisite of the practice parameters for clinical testing is the absence of "drug intoxication or poisoning." The only evidence available regarding brain death determination in the setting of intoxication derives from case reports.

If one is not available, advice can be obtained from a poison control center.Mechanisms of metabolism may be saturated in overdose [14].As an example of prolonged half-life in overdose, many references indicate the half-life of baclofen is approximately 2–4 h, but in overdose, the duration of effect far exceeds the recommended five half-life calculation [3].If a patient was exposed to an exceedingly large quantity of drug or toxin, 3% of the original dose could potentially still have clinical effects.In addition, the pharmacokinetics of many drugs will be altered in patients with organ failure [12, 13].

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To determine the extent to which inaccurate brain death determination by clinical testing may occur in this setting, we conducted a review of the literature in MEDLINE and SCOPUS using the search terms "brain death mimic" and "brain death drug overdose" for the dates January 1, 1960 to June 10, 2015.