ALiEM

MARCH 5, 2024

How can people become poisoned with willow bark? Pharmacokinetics of salicin after oral administration of a standardised willow bark extract. Pharmacokinetics of salicin after oral administration of a standardised willow bark extract. The Aspirin Story – from Willow to Wonder Drug. British Journal of Haematology.

Hyperthermia / Hypothermia 114

Hyperthermia / Hypothermia Anaphylaxis Administration Poisoning 114

ALiEM

FEBRUARY 20, 2024

Here is the patient’s EKG after administration of a 300 mEq sodium bicarbonate showing significant improvement of the cardiac sodium channel blockade as evidenced by a narrower QRS complex. Poisoning by sodium channel blocking agents. Flecainide poisoning and prolongation of elimination due to alkalinization. Crit Care Clin.

Shock 73

Shock EKG/ECG Poisoning Burns 73

EMDocs

JUNE 7, 2023

2,7 Organophosphate poisonings in agriculturally-centered communities are of public health concern in developing countries. Millions are poisoned, and hundreds of thousands die each year worldwide. Millions are poisoned, and hundreds of thousands die each year worldwide. 7 May lead to respiratory failure.

Poisoning 81

Poisoning Airway Management Seizures PPE 81

Northwestern EM Blog

MARCH 28, 2022

Clinical Findings of Methanol Poisoning CNS sedation Seizures Rapid, Deep Breathing Hypotension Ocular findings: Blindness Afferent pupillary defect Optic disk hyperemia Mydriasis Ethylene Glycol Toxicity Similarly, the toxic metabolites of ethylene glycol cause end-organ damage at levels greater than 20mg/dl.

Poisoning 52

Poisoning Seizures Administration Pediatrics 52

EMDocs

AUGUST 15, 2023

What are the indications for antivenom administration? Treatment of snakebite poisoning. link] Antivenom administration North American Crotalinae snakebites – UpToDate. He was admitted to the pediatrics service for further management. Questions: What are the primary clinical manifestations of crotalid envenomation?

Poisoning 79

Poisoning Administration CDC EMS 79

EMDocs

FEBRUARY 15, 2024

Diagnosis: Clinical exam findings, in combination with a thorough history help to make the diagnosis of anticholinergic plant poisoning. 7 Administer this antidote slowly via intravenous route over several minutes (5-10 minutes), as rapid administration is associated with seizures and bradycardia. Jimson weed poisoning – a case report.

Hyperthermia / Hypothermia 88

Hyperthermia / Hypothermia Poisoning Seizures COPD 88

ALiEM

NOVEMBER 29, 2023

Food and Drug Administration for veterinary use, specifically for its muscle relaxant, sedative, and analgesic effects [1]. Consider xylazine co-intoxication if a patient presenting with an opioid toxidrome has persistent sedation despite escalating naloxone administration. Xylazine Poisoning: A Systematic Review.

Forensics 67

Forensics Administration Poisoning Emergency Department 67

ACEP Now

JULY 8, 2023

The authors mention that “CRS were not associated with intravenous antibiotics administration, SBI [ serious bacterial illness ], or admission.” In regard to abnormally prolonged capillary refill, the positive likelihood ratio for identifying organ dysfunction within 24 hours was average, at 0.5. References Scott HF, et al.

Pediatrics 52

Pediatrics Poisoning Emergency Department Sepsis 52

EMDocs

JULY 19, 2023

Diagnosis and Management: Whole blood mercury concentrations are the most useful for diagnosis of organic mercury poisoning, as organic mercury undergoes little urinary excretion. 6 The neurotoxicity caused by organic mercury poisoning is permanent, thus, you must act fast. Food and Drug Administration. Resources: S. Winship KA.

Poisoning 65

Poisoning Fluid Resuscitation Administration Seizures 65

Cook County EM Blog

MAY 29, 2023

Early consultation with the poison center is prudent. Analysis of benzonatate overdoses among adults and children from 1969-2010 by the United States Food and Drug Administration. Food and Drug Administration (FDA). Authored by Sumeet Sandhu, DO Faculty reviewer: Jenny Lu, MD References: Sandra C. Bishop-Freeman, Erin M.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

Taming the SRU

SEPTEMBER 1, 2023

Shewakramani Sepsis is associated with 20-40% mortality Screening tools for detecting patient at risk for sepsis in the ED SIRS Criteria (more sensitive tool) Temp <36C (96.8F) or >38C (100.4F) HR >90 RR >20 WBC <4k or >12k (or >10% bands) qSOFA Score GCS <15 RR >22 SBP <100mmHg Overall, SIRS Criteria remains (..)

Sepsis 84

Sepsis Administration Documentation/Coding Fractures 84

ACEP Now

MARCH 6, 2024

The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome. N Engl J Med. 2023;389(2):127-136.

Research 52

Research Airway Management Stroke Outcomes 52

EMDocs

APRIL 10, 2024

While not specifically reviewed in this post, check out the methemoglobinemia tox card for more information about one of the other known events that can occur with local anesthetic administration. Poisoning & Drug Overdose. Epidemiology Most common cause: inadvertent intravascular injection. Regional Anesthesia and Pain Medicine.

Advances Cardiac Life Support (ACLS) 91

Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 91

Resus Review

APRIL 6, 2015

Following the initial dose administration, if symptoms are not improving, continuing to administer up to 10 mg/kg is also recommended. Sterile phlebitis may follow administration of dantrolene, and should be infused through the largest possible vein. Dantrolene may also be useful in life-threatening cases of dinitrophenol poisoning.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning Administration 52

ALiEM

AUGUST 16, 2023

Adverse Effects of Methylene Blue Pain at infusion site Blue discoloration of urine and serum Interferes with pulse oximetry, resulting in falsely low readings after administration. Chemically induced methemoglobinemia from aniline poisoning. Interference with laboratory studies that use light absorption. Am J Emerg Med. 2009.10.014.

Poisoning 52

Poisoning Seizures Administration Pediatrics 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

The SGEM Bottom Line was that the routine administration of supplemental oxygen in patients with suspected or confirmed acute myocardial infarction who are not hypoxic does not appear to provide a patient-oriented benefit. In acutely ill adults, this same concept is not yet as widespread and liberal administration is still common place.

Administration 52

Administration Poisoning Hospitals Outcomes 52

ACEP Now

FEBRUARY 11, 2024

Regulatory and pharmaceutical availability barriers have even resulted in changing of such medications while in treatment, incomplete usage, and alternative patterns of administration. Poison centers see nearly 1,500% increase in calls related to injected weight-loss drugs as people accidentally overdose. Diabetes Care. 2018;41:258–66.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

EB Medicine

SEPTEMBER 1, 2018

Nachi: And don’t forget our peer reviewers this month, Dr. Daniel Sessions, a medical toxicologist working at the South Texas Poison Center, and our very own editor-in-chief, Dr. Andy Jagoda, who is also Chair of the Department of Emergency Medicine at Mount Sinai in New York City. Jeff: What a team! But, let’s get back to the snakes.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

ACEP Now

MAY 8, 2023

8 A retrospective study of acetaminophen-poisoned patients found that when using a threshold of 3.5 Population-based incidence and outcome of acetaminophen poisoning by type of ingestion. Updated guidelines for the management of paracetamol poisoning in Australia and New Zealand. for death. NAC should be given immediately.

Poisoning 52

Poisoning Outcomes Administration EMS 52

Thinking Critical Care

MAY 18, 2023

In the UK the Committee for Safety of Medicines merely drew attention to potential hazards of etomidate administration. Should regulatory authorities have done more to prevent the continued use of this poison? There are post scriptums to this story.

Shock 40

Shock Research Sepsis Resuscitation 40

Intensive Blog

FEBRUARY 9, 2023

Show answer In this case, the history pointed towards mushroom poisoning. Most cases of mushroom poisoning are self-limiting episodes of gastrointestinal upset. There are many different syndromes associated with mushroom poisoning in Australia including cholinergic, hallucinogenic, glutaminergic, disulfram-like and hepatotoxic 3.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

EMDocs

AUGUST 3, 2023

IV is usually recommended due to faster onset, ease of administration, and shorter protocol duration. These local protocols vary from the labeled dosing; contacting and using your local poison center’s protocol is recommended. Extracorporeal treatment for acetaminophen poisoning: recommendations from the EXTRIP workgroup.

Poisoning 80

Poisoning Seizures Administration Pediatrics 80

EB Medicine

AUGUST 1, 2018

Also, be aware that there are various formulations of cannabis that allow for different routes of administration. Basically, any way you can imagine, it seems like a route of administration has been explored. On the longer end, rectal cannabis administration can take up to 8 hours to reach peak plasma concentrations.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

AUGUST 31, 2023

Approximately 12 hours following F(ab’) 2 antivenom administration, the child is noted to have progressive swelling, firmness, tension, and pain of the right calf. Poison Control: The F(ab2)ulous Expanded Indication of Anavip | FCEP. link] Blue Ridge Poison Center, University of Virginia Health. Accessed May 7, 2022.

Allergic Reactions 70

Allergic Reactions Anaphylaxis Poisoning Hospitals 70

Taming the SRU

APRIL 10, 2023

1] OAHL has been reported after various dosages, administration routes, and lengths of opioid use. [5] 5] There are reports of OAHL occurring after oral, intranasal, intravenous, and transdermal administration, as well as one case of intra-arterial administration. Journal of Medical Toxicology. 2013;9(2):179-183.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Administration Emergency Department 52

Advanced Emergency Nursing from AENJ

MAY 27, 2014

Even after no longer having a role in resuscitation, CO2 was advocated for accelerating clearance of carbon monoxide poisoning into the 1950s and 1960s. Davies reported in the British Medical Journal of " A simple portable apparatus for the therapeutic administration of carbon dioxide." In 1927, H.W. DAVIES, H. pp 526-528.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

EB Medicine

MAY 3, 2019

Since commonly prescribed antidepressants take up to 6-8 weeks to have a clinical effect, the administration of psychotropic medications is not routinely initiated in the ED. Jeff: As always, the team approach is preferred. Alright so the last treatment to discuss is actual pharmacotherapy. More on that in a few minutes though.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EB Medicine

FEBRUARY 1, 2019

Jeff: Do consider adding on a venous or arterial carboxyhemoglobin in the right clinical scenario, as CO poisoning represents an important cause of headache you wouldn’t want to miss. Nachi: In addition to monitoring ABCs, early care involves the administration of analgesics and anti-emetics.

Emergency Department 40

Emergency Department Stroke Outcomes Wellness 40