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Snake Bites and Children

Pediatric EM Morsels

If you are managing a snake bite from a snake that does not typically reside in the U.S., please utilize other resources and local Toxicology experts for help with management protocols. 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.

CDC 130
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Case Report: A Child with a Rash and Lead Poisoning History

ACEP Now

On physical examination, the child was non-toxic, well-nourished, alert, awake, and not in acute distress. Incidentally, the day after ED visit number one, the mother was called by the child’s pediatrician advising her to bring him for evaluation of lead poisoning. Discussion Lead poisoning is a serious health concern.

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ToxCard: Diethylene Glycol

EMDocs

In mass poisoning cases, DEG has been substituted as a solvent in oral medications and in topical medicinal products. DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

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. 2008 Apr;39(4):1347-8. Epub 2008 Feb 28. doi: 10.1161/STROKEAHA.107.498345.

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Annals of B Pod: Social EM Corner- Suicide Related Behaviors

Taming the SRU

In conjunction with the Drug and Poison Information Center (DPIC), intravenous methylene blue was initiated for suspected methemoglobinemia with moderate improvement of her symptoms over the next hour, including return of baseline mental status and resolution of hypoxia. Despite supplemental oxygen, she remained hypoxic. 2022;48(1):57-73.

EMS 96
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ToxCard: Bupropion

EMDocs

3 Bupropion blocks the reuptake of dopamine and norepinephrine, as well as antagonizes acetylcholine at nicotinic receptors. 6,15 Discuss cases of overdose, including pediatric exploratory ingestions, with a medical toxicologist or your local poison center. 2008 Apr;51(4):412-5, 415.e1. Accessed 12/18/2022. Clin Toxicol (Phila).

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Episode 28 - Depressed and Suicidal Patients in the Emergency Department: An Evidence-Based Approach

EB Medicine

Jeff: If those figures seem a bit high, another CDC study found that in a general population survey of a quarter million people between 2006-2008, 9% met the criteria for major depression. The PSS-3 assesses for depression/hopelessness and suicidal ideations in the past 2 weeks as well as lifetime history of suicide attempt.