Remove 2017 Remove EKG/ECG Remove Poisoning
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ACMT Toxicology Visual Pearl: The Heart Won’t Go On and On

ALiEM

Lily of the valley poisoning is important to recognize because it presents as digitalis toxicity [3]. ouabain, poison rope) Asclepias spp. 2, 5] Poisoning from plant cardiac glycosides causes reversible inhibition of sodium-potassium ATPase, which increases cardiac inotropy and automaticity. [2, Elsevier; 2017.

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ACMT Toxicology Visual Pearl: Salt, not Shock

ALiEM

What agent would most likely be responsible for these ECG findings? This EKG shows a wide complex (QRS 240 msec), irregular rhythm with left bundle branch block morphology at a rate slower than expected (90 bpm) for a ventricular arrhythmia such as ventricular tachycardia. Poisoning by sodium channel blocking agents.

Shock 73
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ToxCard: Bupropion

EMDocs

3 Always get an EKG to assess for cardiotoxicity, including widened QRS and prolonged QTc, although this may not be evident right away. 3 Cardiotoxicity 3 All patients need an EKG and cardiac monitoring. 6,15 Discuss cases of overdose, including pediatric exploratory ingestions, with a medical toxicologist or your local poison center.

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Seizure in a 30 something

Dr. Smith's ECG Blog

The ECG below was recorded by EMS. ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. At first glance, the ECG does not look too abnormal. In my experience, the pathologic finding in the above ECG is the easiest one to overlook — especially if you are in a rush and do not do a systematic review.

Seizures 113
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Case Report: A Patient With a Fishy Story

ACEP Now

An EKG was performed on arrival, showing no abnormalities. Ciguatera fish poisoning, a foodborne illness caused by consuming reef fish contaminated with ciguatoxins, is characterized by a combination of gastrointestinal, neurological, and cardiovascular symptoms. 4 Treatment of ciguatera poisoning is supportive and symptomatic.

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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

1-3,5,7,9] All patients developing symptoms of LAST should be placed on a continuous cardiac monitor and have an ECG performed. [2] Poisoning & Drug Overdose. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017. doi:10.1097/AAP.0000000000000320

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The Toxic Shelf

Cook County EM Blog

If a wide complex rhythm is present on ECG, sodium bicarbonate boluses (to overcome sodium channel blockade) should be administered. Early consultation with the poison center is prudent. Treatment: The mainstay of treatment is supportive care. Seizures should be treated with benzodiazepines. Bishop-Freeman, Erin M. Shonsey, Laura W.