Emergency Medicine Cases

NOVEMBER 30, 2021

Sarah Reid on differentiating septic arthritis from transient synovitis in pediatric limp, Anand Swaminathan on managing tracheostomy complications in the ED, Nour Khatib on rural medicine and ethylene glycol poisoning, Justin Morgenstern on RCTs for ketamine in patients with severe agitation.

Poisoning 52

Poisoning EMS Pediatrics Resuscitation 52

ALiEM

NOVEMBER 15, 2023

Although poisoning by ingestion of cyanogenic foods is much more common in tropical countries, there have been reported cases in the US [1, 3]. What are the symptoms of cyanide poisoning? How to you treat cyanide poisoning? [1, grams (50 mL) Pediatrics: 250-412 mg/kg (1-1.65 mL/kg) not to exceed 50 mL or 12.5

Poisoning 67

Poisoning Pediatrics Seizures Administration 67

Emergency Medicine Cases

DECEMBER 8, 2020

In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an approach to hyperthermia, Brit Long on diagnosis and management of malignant otitis externa, Jesse McLaren on ECG diagnosis of occlusion MI in patients with BBB and Peter Brindley on prone CPR.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia CPR Poisoning EMS 52

EMDocs

JANUARY 17, 2024

8) Over the next 24 years, numerous peer reviewed publications on benzonatate poisoning appeared in the medical literature. (3, 8) Over the next 24 years, numerous peer reviewed publications on benzonatate poisoning appeared in the medical literature. (3, 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9)

Poisoning 66

Poisoning Seizures Pediatrics Administration 66

Pediatric EM Morsels

MARCH 17, 2023

Call your friends … at the Poison Center! Your state poison center and local toxicologists are a wealth of knowledge and help for management and treatment. Management of pediatric snake bites: are we doing too much? J Pediatr Surg. Pediatr Nephrol. But that puts them at risk for snake bites in some areas.

CDC 130

CDC Poisoning Pediatrics Shock 130

Don't Forget the Bubbles

JANUARY 17, 2024

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. Closer to home, the New South Wales Poisons Information Centre (NSWPIC) reported 129 incidents involving water-absorbing beads since 2004. BMC Pediatrics , 20 , pp.1-5. Arch Pediatr.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Sensible Medicine

NOVEMBER 10, 2023

Specifically, the COVID19 shot was added to pediatric schedule, as if it is a necessary vaccine, but it is not. The White House and FDA poisoned public perception of kids vaccines with this regulatory fiasco. Enter the CDC, the agency took the COVID19 shot and added it to the pediatric schedule, placing it alongside vaccines like MMR.

CDC 145

CDC Pediatrics Poisoning Hospitals 145

RebelEM

JUNE 7, 2023

Clinicians are encouraged to call their local regional toxicologist and poison control center whenever a caustic ingestion poisoning is suspected. Management Always consider calling your local toxicologist or regional poison control center, as even substances with a neutral pH may have caustic potential. Pediatr Emerg Care.

Poisoning 81

Poisoning Burns Resuscitation Pediatrics 81

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

EMDocs

SEPTEMBER 7, 2023

In mass poisoning cases, DEG has been substituted as a solvent in oral medications and in topical medicinal products. 4 Despite the policy changes in the United States, epidemic poisonings involving DEG continue to impact adults and children on a global scale with 14 mass poisonings occurring since the Sulfanilamide Disaster.

Poisoning 64

Poisoning CDC Administration Emergency Department 64

Taming the SRU

JUNE 7, 2023

CPC: Rheumatic Fever - Carbon Monoxide Poisoning - Pediatrics: Toxicology - Combined EM/IM: Competency CPC: Rheumatic Fever WITH Drs.

Poisoning 66

Poisoning EKG/ECG Pediatrics Burns 66

Taming the SRU

APRIL 17, 2023

Poison centers across the United States receive over 100,000 reports of exposures to toxic plants annually. The majority of ingestion cases occur in pediatric patients and are often minor due to low quantities of exposure. The majority of ingestion cases occur in pediatric patients and are often minor due to low quantities of exposure.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

ACEP Now

JULY 8, 2023

1 The authors evaluated four parameters for their ability to predict severe illness in the pediatric ED setting: altered mental status, abnormal capillary refill, abnormal peripheral pulses, and cold or mottled extremities. Dr. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington.

Pediatrics 52

Pediatrics Poisoning Emergency Department Sepsis 52

ACEP Now

OCTOBER 10, 2023

The patient’s urine was obtained and compared with the urine of his emergency physician using a Wood’s lamp, and the patient’s was found to be brightly fluorescent, supporting the presumptive diagnosis of EG poisoning. After resolution of EG poisoning, he was transferred to psychiatry and ultimately discharged home without complication.

Poisoning 52

Poisoning Pediatrics Research Wellness 52

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

ALiEM

NOVEMBER 1, 2023

Curr Opin Pediatr 2006;18(2):174-9.  PMID 24072332 Baranwal AK, Singhi SC: Acute iron poisoning: management guidelines. Indian Pediatr 2003;40(6):534-40.  In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. McGraw-Hill Education; 2019 Madiwale T, Liebelt E. Iron: not a benign therapeutic drug.

Shock 64

Shock Poisoning Pediatrics 64

Taming the SRU

MAY 1, 2023

Subsequent exposure results in a T-cell mediated response (Type IV hypersensitivity reaction) Plants: Toxicodendron species (poison ivy, poison oak, poison sumac) Also present in foods, including pistachio, cashew, and mango.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

EMDocs

AUGUST 15, 2023

He was admitted to the pediatrics service for further management. Treatment of snakebite poisoning. Vital signs are HR 142 bpm, BP 133/86 mmHg, RR 22 breaths/min, SpO 2 98% on room air, T 98.7°F. Laboratory testing demonstrated platelets 482 × 10 9 /L, fibrinogen 241 mg/dL, and INR 1.2. How do you manage crotalid envenomations?

Poisoning 79

Poisoning Administration CDC EMS 79

Pediatric Emergency Playbook

JULY 1, 2020

Traditional Approach: Secretory -- poisoned mucosal villi -- "the sieve" Cytotoxic -- destroyed mucosal villi -- "the shred" Osmotic -- malabsorption -- "the pull" Inflammatory -- edema, motility -- "the push" Lots of overlap, difficult to apply to clinical signs and symptoms. Pediatrics. Pediatrics 1980; 65:1125.

Poisoning 52

Poisoning Pediatrics Outcomes 52

PEMBlog

OCTOBER 19, 2023

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. Cannabinoid poisoning D. He was ultimately admitted to the general pediatric service for further management. Rev Paul Pediatr. This is the fourth of the four cases. Hepatic hemangioma C. PMID: 3296130.

Urgent Care 52

Urgent Care Pediatrics Poisoning Wellness 52

Pediatric Education

JUNE 18, 2023

The past medical history showed a history of poison ivy reaction the year before. You don’t seem to be having an allergic reaction to it, and it also doesn’t look like this is poison ivy or something else like that that you might have fallen into. J Pediatr Surg. Pediatr Dermatol. Pediatr Dermatol.

Allergic Reactions 40

Allergic Reactions Poisoning Pediatrics Infectious Diseases 40

Pediatric Education

NOVEMBER 12, 2023

Bull MJ, Engle WA, The Committee on Injury and Poison Prevention and the Committee on Fetus and Newborn. Pediatrics. Pediatrics. Pediatrics. D’Alessandro, MD Professor of Pediatrics, University of Iowa Safe Transportation of Preterm and Low Birth Weight Infants at Hospital Discharge. 2009;123(5):1424-1429.

Pediatrics 40

Pediatrics Hospitals Poisoning Documentation/Coding 40

Pediatric Education

MARCH 24, 2024

Entrance for young children can occur through the mother when in-utero or through breastfeeding, or through the environment including dermal, inhalation and ingestis to be inadequate studies of these potential contaminants in the pediatric age group. D’Alessandro, MD Professor of Pediatrics, University of Iowa

Pediatrics 40

Pediatrics Poisoning Research Wellness 40

PEMBlog

APRIL 26, 2023

Listen Gun Violence and Safety (2023) – Brad Sobolewski, MD, MEd – featuring Kit Carney, MD & Kristen Humphrey, MD – PEM Currents: The Pediatric Emergency Medicine Podcast [link] Subscribe Advocacy and education resources Be SMART Campaign Be SMART emphasizes the importance of responsible gun ownership and secure gun storage.

Pediatrics 52

Pediatrics Wellness Poisoning Research 52

ACEP Now

DECEMBER 10, 2023

5 Symptoms of milkweed poisoning may include abdominal discomfort, nausea, vomiting, diarrhea, weakness, lethargy, and confusion, progressing to seizures, heart rhythm changes, and bradycardia. corneal toxicity secondary to latex from Asclepias curassavica in a pediatric patient. J Chem Ecol. 2019;45(1):50-60. Yang JF, Beal CJ.

Poisoning 52

Poisoning Seizures Documentation/Coding Emergency Department 52

EB Medicine

MARCH 4, 2020

Literature Review: There is abundant literature on pediatric AGE but sparse research on AGE in adults. Therefore, many recommendations are extrapolated from the pediatric literature. not ED specific) Food poisoning is responsible for 5% of AGE but results in 30% of deaths. Salmonella, most common o 5.3% Fish tastes normal.

Emergency Department 40

Emergency Department Dehydration Poisoning Allergic Reactions 40

Cook County EM Blog

MAY 29, 2023

Early consultation with the poison center is prudent. J Pediatr Pharmacol Ther. Lipid emulsion therapy carries a theoretical benefit given similar structure and toxicity to local anesthetic agents, however, there have not yet been reports on the use of lipid emulsion therapy for benzonatate toxicity. Bishop-Freeman, Erin M.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

Pediatric EM Morsels

JULY 21, 2023

We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed head injuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. When is it useful and what does it tell us? Fun fact for animal lovers!-

Head Injuries 230

Head Injuries Pediatrics Outcomes Shock 230

ALiEM

AUGUST 16, 2023

Pediatr Rev. Chemically induced methemoglobinemia from aniline poisoning. Methemoglobinemia: a review and recommendations for management. J Cardiothorac Vasc Anesth. 2014;28(4):1043-1047. doi:10.1053/j.jvca.2013.02.005. 2013.02.005. PMID 23953868 Mack E. Focus on diagnosis: co-oximetry. 2007;28(2):73-74. doi:10.1542/pir.28-2-73.

Poisoning 52

Poisoning Seizures Administration Pediatrics 52

Pediatric Education

MAY 7, 2023

What are services that a poison center can offer? Pediatr Neurol. D’Alessandro, MD Professor of Pediatrics, University of Iowa Insidious Onset of Serotonin Syndrome in a 6-Year-Old Boy. J Am Acad Child Adolesc Psychiatry. 2021;60(2):201-202. doi:10.1016/j.jaac.2020.08.439 2020.08.439 French S, Wray C. 2019;90:66-67.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Infectious Diseases Pediatrics Poisoning 40

Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C cuffed ETT) preloaded and intubate through the stoma if PPV needed Infection (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Emergency Medicine Cases

MAY 21, 2019

In this EM Cases main episode podcast we have the director of the Burn Unit at Hospital for Sick Children, Dr. Joel Fish and EM educator Dr. Maria Ivankovic discuss dozens of pearls and pitfalls in the management of both pediatric and adult burn and inhalation injuries management with a special appearance by airway master George Kovacs to talk about (..)

Airway Management 52

Airway Management Burns Resuscitation Fluid Resuscitation 52

ACEP Now

MARCH 6, 2024

Effect of noninvasive airway management of comatose patients with acute poisoning: a randomized clinical trial. JAMA Pediatr.2023;177(8):782. Video versus direct laryngoscopy for tracheal intubation of critically ill adults. N Engl J Med. 2023;389(5):418-429. Freund Y, Viglino D, Cachanado M, et al. 2023;330(23):2267. JAMA Intern Med.

Research 52

Research Airway Management Stroke Outcomes 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 10, 2024

A recent 5-year retrospective study of 1,197 pediatric patients at a single institution studied 759 kids (63.4 A recent 5-year retrospective study of 1,197 pediatric patients at a single institution studied 759 kids (63.4 percent of ED pediatric patients compared to 92.9 So how successful are we at extracting the EAC FB?

Pediatrics 52

Pediatrics Emergency Department Poisoning Outcomes 52

Pediatric Emergency Playbook

JUNE 1, 2016

Hypovolemic Shock The most common presentation of pediatric shock; look for decreased activity, decreased urine output, absence of tears, dry mucous membranes, sunken fontanelle. Cold shock is the most common presentation in pediatric septic shock, and is treated with epinephrine. Is this in an infarction, an infection, a poisoning?

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Taming the SRU

SEPTEMBER 1, 2023

Can also extend this logic to those with TBI’s or trauma patients are inebriated Can attempt try to mitigate the risk and harm associated with iWBCT’s Future use of low-dose iWBCT Full-body MR imaging is already being used in pediatric patients Logistic regression in REACT-2 patient population identified 10 characteristics to warrant iWBCT in patients (..)

Sepsis 84

Sepsis Administration Documentation/Coding Fractures 84