Emergency Medicine Cases

JANUARY 3, 2017

If we can recognize these overdoses early and manage them appropriately, well - we’ll save some lives. The post Episode 90 – Low and Slow Poisoning appeared first on Emergency Medicine Cases. And inevitably we’re gonna be faced with both intentional and unintentional overdoses from these drugs in the ED.

Poisoning 40

Poisoning Wellness EMS 40

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.

Poisoning 81

Poisoning Burns Resuscitation Pediatrics 81

ACEP Now

APRIL 2, 2024

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. Ackee fruit poisoning in eight siblings: implications for public health awareness. References Katibi OS, Olaosebikan R, et al.

Poisoning 40

Poisoning Administration Documentation/Coding Urgent Care 40

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

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. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S. in wetlands, rivers, and lake areas Coral snakes inhabit the southern U.S. Basics are best!

CDC 130

CDC Poisoning Pediatrics Shock 130

ALiEM

MARCH 5, 2024

How can people become poisoned with willow bark? Cases of toxicity have been reported following ingestion of supplements as well as ingestion of willow bark tea [4,5]. 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

EMDocs

JUNE 14, 2023

Organophosphate poisoning in agriculturally centered communities has developed into a public health concern in developing countries, poisons millions and kills hundreds of thousands each year worldwide and is a reason why understanding organophosphate toxicity has become a critical addition to our knowledge of toxicology. 2013;6:524.

PPE 68

PPE Poisoning Seizures Emergency Department 68

Northwestern EM Blog

MAY 2, 2022

The post goes into detail on the pathophysiology, signs, symptoms, and diagnosis of both carbon monoxide and cyanide poisonings, so this commentary will focus on the clinical approach. An elevated lactic acid is a surrogate for cyanide poisoning, specifically a level of 8-10 mmol/L or greater is sensitive and should prompt intervention.

Burns 52

Burns Poisoning EKG/ECG Operations 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

Taming the SRU

FEBRUARY 7, 2024

Vaughan SJS/TEN and DRESS are life-threatening drug reactions that require immediate discontinuation of the drug and specialist involvement In SJS/TEN, if >10% skin involvement or worsening symptoms, transfer the patient to a Burn Center DRESS has characteristic multi organ involvement, so a high level of suspicion for complications should be maintained (..)

Administration 87

Administration PPE Ultrasounds Poisoning 87

RebelEM

FEBRUARY 15, 2024

Additionally, intubation can risk hemodynamic instability as well as hypoxemia from the procedure itself. 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. Paper: Freund Y et al.

Poisoning 129

Poisoning Airway Management Seizures Shock 129

EMDocs

AUGUST 15, 2023

Treatment of snakebite poisoning. Clinical Pearls: Most snake envenomations in the US are caused by pit vipers (crotalidae) and are characterized by local tissue injury and coagulopathic effects Copperhead and cottonmouth ( Agkistrodon sp. Am J Hosp Pharm. 1991;48(10):2190-2196. Venomous Snakes | NIOSH | CDC. Published April 15, 2022.

Poisoning 79

Poisoning Administration CDC EMS 79

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. From Mullens et al., Forrester, M.B.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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

ACEP Now

APRIL 2, 2024

They are found in large numbers in the mouth, throat, and stomach, as well as throughout the body. 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

RCEM Learning

APRIL 9, 2024

Take care of your physical and mental well-being, and ensure you get adequate rest and relaxation. Stay Calm and Confident: Prior to the exam, maintain a calm and positive mindset. Build your confidence by regularly practicing SBA questions and reinforcing your knowledge.

Infectious Diseases 52

Infectious Diseases Airway Management Dislocations Resuscitation 52

ALiEM

NOVEMBER 29, 2023

In patients with skin changes, consider topical wound care as well as further evaluation of deep tissue infections, osteomyelitis, and ischemia. Xylazine Poisoning: A Systematic Review. In patients with minimal response to naloxone, xylazine toxicity may be suspected [10]. Clin Toxicol (Phila). 2023 Mar;61(3):173-180.

Forensics 67

Forensics Administration Poisoning Emergency Department 67

PulmCCM

DECEMBER 3, 2023

Well, that would be ground-breaking and practice-changing, to say the least. This review in poisoned patients suggested early intubation was associated with lower rates of aspiration pneumonia, but most others did not. But there was a whopping 6% absolute reduction in all-cause mortality (11.6% vs 17.6%) in the sigh-ventilation group!

Poisoning 64

Poisoning Outcomes Hospitals Academics 64

Pediatric Education

JUNE 18, 2023

He and his mother had cleaned it well with soap and water and then used some iodine solution on his leg scrapes. The past medical history showed a history of poison ivy reaction the year before. They may contain additional active ingredients as well including alcohol. I think the iodine is possibly irritating it though.

Allergic Reactions 40

Allergic Reactions Poisoning Pediatrics Infectious Diseases 40

Taming the SRU

JULY 19, 2023

Fundamentals of ECMO - leadership curriculum - ultrasound GR - macgyver techniques fundamentals of ecmo WITH dr. bonomo ECPR from the ED: The ideal patients: Young patients with refractory VF/VT arrest ≤ 30 min since arrest onset Poisonings with cardiogenic shock Severe hypothermia with arrest Massive PE with arrest Key points: Good CPR/advanced ACLS (..)

Ultrasounds 73

Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 73

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

PEMBlog

OCTOBER 19, 2023

Cannabinoid poisoning D. Tyrosinemia The patient’s CT scan revealed liver replaced and distorted by innumerable, variably-enhancing nodules, as well as nephromegaly. Based on his x-ray and abnormal labs, a CT of his abdomen and pelvis was also obtained with one relevant image shown here: A. Hepatic cancer B. Hepatic hemangioma C.

Urgent Care 52

Urgent Care Pediatrics Poisoning Wellness 52

The Skeptics' Guide to EM

JANUARY 23, 2021

The difference in training between and emergency medicine physician and APPs is well recognized. They also excluded those with a triage level ESI 1 or 5, as these are less common, as well as those with a final diagnosis of injury or poisoning – as in those cases the diagnosis would generally be apparent.

Research 52

Research Poisoning Documentation/Coding Outcomes 52

ACEP Now

MARCH 6, 2024

Many clinicians staffing emergency departments intubate infrequently, as well, and these results are likely applicable to a wide scope of practice. 10 The trial was stopped due to superiority due to both its overall mortality benefit, as well as a reduction in the need for mechanical ventilation. N Engl J Med. 2023;389(5):418-429.

Research 52

Research Airway Management Stroke Outcomes 52

PEMBlog

APRIL 26, 2023

Kit Carney and Dr. Kristen Humphrey discuss gun violence, its impact on our patients and their families, as well as practical tips on advocating for safe storage of firearms, and how we can support victims of violence. Denise Dowd, Robert D. Garry Gardner, Kyran P. Quinlan, Michele Burns Ewald, Beth E. Ebel, Richard Lichenstein, Marlene D.

Pediatrics 52

Pediatrics Wellness Poisoning Research 52

Mind The Bleep

JULY 8, 2023

Therefore, I’m sharing the things that worked well and were time-effective, and those that didn’t. Other resources Flashcards worked very well for me, but aren’t everyone’s cup of tea. It’s really nicely laid out, and goes through condition by condition, as well as where conditions overlap multiple specialties.

EKG/ECG 52

EKG/ECG Wellness Hyperthermia / Hypothermia Poisoning 52

ACEP Now

FEBRUARY 11, 2024

4 It is believed that substantial gastrointestinal loss causes chloride and potassium depletion, as well as hypovolemia, acute kidney injury, and renal potassium loss. 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. CNN website.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

Pediatric Education

MARCH 24, 2024

Some people recommend boiling these utensils for 5 minutes as well. Wash with hot soapy water, rinse and dry all bottles, cups, nipples, rings or other equipment (including breast pumping equipment). For glass bottles, a dishwasher with heated water and hot drying cycle can be used. which can also touch the formula.

Pediatrics 40

Pediatrics Poisoning Research Wellness 40

The Skeptics' Guide to EM

FEBRUARY 2, 2019

This study expands upon that investigation to patients with other conditions as well. While supplemental oxygen is undoubtedly beneficial for patients acutely desaturating, in respiratory distress, or suffering from carbon monoxide poisoning just to name a few, there is widespread “indication creep” for this therapy.

Administration 52

Administration Poisoning Hospitals Outcomes 52

EM Curious

MAY 14, 2015

How do you manage carbon monoxide poisoning? HOT, RED, AND TENDER SEPTIC JOINT [BLOG]: EM Docs brings us a well versed update on the septic joint, including key history and background, diagnostic work up strategy, and management. Do you know the causes of methemoglobinemia? Watch this lecture here @ Maryland CC Project.

Ultrasounds 52

Ultrasounds Poisoning EMS Burns 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

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Pediatric Education

NOVEMBER 12, 2023

weeks was seen for well-care. Bull MJ, Engle WA, The Committee on Injury and Poison Prevention and the Committee on Fetus and Newborn. Patient Presentation A former 35 week, appropriate for gestational age male, now 37.5 To view current news articles on this topic check Google News. Pediatrics. 2009;123(5):1424-1429. doi:10.1542/peds.2009-0559

Pediatrics 40

Pediatrics Hospitals Poisoning Documentation/Coding 40

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

Pediatric Education

MAY 7, 2023

The fever was responsive to antipyretics, and he was taking some dextromethorphan as well. What are services that a poison center can offer? Maximum temperature was 102.4F 5 days ago. The last recorded temperature was the evening before at 100.1F. Questions for Further Discussion 1. What are some common toxidromes?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Infectious Diseases Pediatrics Poisoning 40

Medagadget

JUNE 12, 2023

But despite the long history of research, therapeutic electricity has also had its fair share of quackery and shams, which Adee asserts has negatively impacted the pace of research in this field, as well as its acceptance in education.

Research 79

Research Academics Documentation/Coding Poisoning 79

Pediatric Emergency Playbook

JULY 1, 2016

Lab work can be helpful, as well as US of the hip to look for an effusion, but sometimes, regardless of the results, the joint just has to be tapped to know for sure. If you have any suspicion of the general wellness of the child, get a screening CBC, and perhaps a peripheral blood smear. These children don’t look to well.

Fractures 52

Fractures Poisoning Wellness Sepsis 52