EMDocs

FEBRUARY 15, 2024

Diagnosis: Clinical exam findings, in combination with a thorough history help to make the diagnosis of anticholinergic plant poisoning. Physostigmine does not reverse seizures or dysrhythmias. Physostigmine does not reverse seizures or dysrhythmias. Jimson weed poisoning – a case report. 9 Physostigmine dosing: 0.5-2

Hyperthermia / Hypothermia 88

Hyperthermia / Hypothermia Poisoning Seizures COPD 88

ALiEM

MARCH 5, 2024

How can people become poisoned with willow bark? With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. Willow tree bark extract has been used as an herbal supplement for chronic lower back pain, joint pain, osteoarthritis, sports performance, and weight loss [3].

Hyperthermia / Hypothermia 114

Hyperthermia / Hypothermia Anaphylaxis Administration Poisoning 114

ACEP Now

APRIL 2, 2024

1 In severe cases altered mental status, seizures, coma, or even death have been observed. 8 Diagnosis and Treatment Food poisoning may result in a similar clinical manifestation as Toxic Hypoglycemic Syndrome. Poison control was consulted, and they concurred with the diagnosis of THS. References Katibi OS, Olaosebikan R, et al.

Poisoning 40

Poisoning Administration Documentation/Coding Urgent Care 40

EMDocs

APRIL 10, 2024

She reportedly received a landmark guided peripheral nerve block with bupivacaine and shortly thereafter developed generalized seizures. 1,5] CNS symptoms include: Seizure, coma, altered mental status. [1] 2,9] Benzodiazepines are the first line treatment for seizures. Poisoning & Drug Overdose. mL/kg/min. [2]

Advances Cardiac Life Support (ACLS) 91

Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 91

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

DECEMBER 19, 2023

Food Poisoning. Poisoning, Envenomation, and Trauma from Marine Creatures. Possible early antibiotic treatment Minor Marine Trauma Mechanism: Bites, Stings, Nematocysts Envenomation Presentation: All can cause localized pain, erythema, and warmth Dermatologic: Urticaria, burning, pruritus, localized paresthesia. 2006;23(7):503-508.

Poisoning 89

Poisoning Seizures Anaphylaxis Burns 89

Taming the SRU

APRIL 17, 2023

Poison centers across the United States receive over 100,000 reports of exposures to toxic plants annually. More serious poisonings typically involve adults who ingest plants in larger quantities for recreational, self-harm, foraging or medicinal purposes (1). Spring has sprung. and so have many species of toxic plants! Decontaminate.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

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

Cook County EM Blog

MAY 29, 2023

Signs and symptoms of toxicity include alerted mental status, seizures, CNS depression, apnea, respiratory failure, hypotension, ventricular dysrhythmias, and cardiac arrest. If a therapeutic dose is chewed, it can lead to bronchospasm, laryngospasm, seizures, and cardiovascular collapse which further reinforces the danger to children.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

ACEP Now

FEBRUARY 11, 2024

Patient C, a 27-year-old female with a history of epilepsy, taking valproate and endorsing adherence, is then brought in by ambulance for a witnessed seizure. This is her first seizure in six years. This patient had her first seizure in years despite adherence to her valproate for management of her epilepsy. Diabetes Care.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

RebelEM

FEBRUARY 15, 2024

There has been no high level evidence to help guide practice until now…the Non-Invasive Airway Management of Comatose Poisoned Emergency Patients (NICO) trial. Effect of Noninvasive Airway management of Comatose Patients with Acute Poisoning: A Randomized Clinical Trial. Paper: Freund Y et al. References: Freund Y et al.

Poisoning 129

Poisoning Airway Management Seizures Shock 129

EMDocs

JULY 19, 2023

Further, organic mercury readily crosses the placenta where it acts as a teratogen leading to a wide range of birth defects including developmental delay, blindness, seizures, and limb malformation. 6 The neurotoxicity caused by organic mercury poisoning is permanent, thus, you must act fast. Adverse Drug React Acute Poisoning Rev.

Poisoning 65

Poisoning Fluid Resuscitation Administration Seizures 65

ACEP Now

APRIL 2, 2024

8 Seizures and thunderclap headache from reversible cerebral vasoconstriction syndrome have been reported. 2022 annual report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 40th annual report. Pepper spray injury severity: ten-year case experience of a poison control system. Eur J Pharmacol.

Burns 40

Burns Poisoning Seizures Stroke 40

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. In the ED, he was found to have a heart rate in the 40s, and a digoxin level of 1.0 ng/mL (cross reactivity of the assay) and a potassium of 4.2

Poisoning 52

Poisoning Seizures Documentation/Coding Emergency Department 52

ALiEM

AUGUST 16, 2023

Dyspnea Headache Syncope Coma Seizures How can you diagnose methemoglobinemia? Chemically induced methemoglobinemia from aniline poisoning. Signs and symptoms can include [3]: Cyanosis Chocolate brown color of arterial blood Low O 2 saturation (usually about 85%) on pulse oximetry that does not improve with supplemental oxygen.

Poisoning 52

Poisoning Seizures Administration Pediatrics 52

Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

ALiEM

OCTOBER 4, 2023

What are the symptoms of nerve agent poisoning? [1, 1, 5] Muscarinic symptoms (Common acronyms SLUDGE or DUMBBELLS) Salivation, emesis, diarrhea, and lacrimation Miosis Seizures Bradycardia, bronchospasm, and bronchorrhea are usually the cause of death. Use benzodiazepines such as diazepam or midazolam for seizures. McGraw Hill.

Poisoning 78

Poisoning Seizures Hospitals 78

Pediatric Education

MAY 7, 2023

What are services that a poison center can offer? Questions for Further Discussion 1. What are some common toxidromes? What are common treatments for anxiety and depression?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Infectious Diseases Pediatrics Poisoning 40

EMDocs

JANUARY 4, 2024

Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 Severe toxicity: Seizures: It is unclear if seizures are caused by bupropion or the active metabolite, hydroxybupropion. 3 Seizures are dose-dependent. 3 Seizures are dose-dependent.

Seizures 65

Seizures EKG/ECG Poisoning Shock 65

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

EB Medicine

AUGUST 1, 2018

Jeff: Medicinally, cannabinoids are currently used in the treatment of chronic pain syndromes, complications of multiple sclerosis and paraplegia, weight loss due to appetite suppression in HIV/aids, chemotherapy-induced nausea and vomiting, seizures, and many other neuropsychiatric disorders.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

AUGUST 3, 2023

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. Massive acetylcysteine overdose associated with cerebral edema and seizures. Clin Toxicol (Phila).

Poisoning 80

Poisoning Seizures Administration Pediatrics 80

Mind The Bleep

SEPTEMBER 12, 2023

Severe jaundice causing kernicterus may also cause central hypotonia and seizures. Everything Else Examine the abdomen for any organomegaly which can occur in metabolic or storage disorders or SCORTCH infections Look for signs of jaundice which can occur with hypothyroidism or inborn errors or metabolism.

Sepsis 52

Sepsis Seizures Poisoning Wellness 52

Emergency Medicine Journal

NOVEMBER 28, 2023

SEIZURE (FIT) 715 16 250 35 2.24[1.4 POISONING FROM ANY SOURCE 179 0 8 4.5 Abstract 2086 Table 1 Presentations Total first presentation over 2021 Total deaths (within 30 days ) Admission Admission (%) Percentage of deaths [CI ] INJURY OF SHOULDER/ARM/ELBOW/WRIST/HAND 8416 4 424 5 0.05[0.018 0.12 , 0.33] CHEST PAIN 5953 34 2077 34.9

Documentation/Coding 40

Documentation/Coding Sexual Assault Hyperthermia / Hypothermia Head Injuries 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. Seizures are very common as well. That’s quite a list. For a visual reference, see Table 3 in the print issue.

Emergency Department 40

Emergency Department Stroke Outcomes Wellness 40