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ACMT Toxicology Visual Pearl: Salt, not Shock

ALiEM

Poisoning by sodium channel blocking agents. 2017 Jul;17(3):260-266. Flecainide poisoning and prolongation of elimination due to alkalinization. Read More in the Series References Kolecki PF, Curry SC. Crit Care Clin. 1997 Oct;13(4):829-48. PMID: 9330843. Valentino MA, Panakos A, Ragupathi L, Williams J, Pavri BB. 2019.158356.

Shock 73
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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. When is it useful and what does it tell us? Fun fact for animal lovers!-

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ToxCard: Bupropion

EMDocs

Cardiogenic shock and hypotension can occur (systolic heart failure with reduced ejection fraction.) 10,12 Refractory shock or malignant arrhythmias occur in < 5% of patients. 6,15 Discuss cases of overdose, including pediatric exploratory ingestions, with a medical toxicologist or your local poison center. Eds (2017).

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Episode 36 - Diagnosis and Management of Acute Gastroenteritis in the Emergency Department

EB Medicine

No 1996 AAP guidelines, 2016 ACG guidelines, and 2017 IDSA guidelines all note diarrhea illness but may be vomiting predominant. not ED specific) Food poisoning is responsible for 5% of AGE but results in 30% of deaths. IV hydration for patients with severe dehydration, hypovolemic shock, septic shock, or failed oral rehydration.

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Episode 20 - Emergency Department Management of North American Snake Envenomations

EB Medicine

Both are at the University of Florida Jacksonville, and they reviewed a total of 120 articles from 2006-2017, in addition to reviews from both Cochrane and Dare. Jeff: In one study of poison center data from the last decade, nearly half of all victims of snake bites were victims of unknown type snakes. 1-800-222-1222.

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

EB Medicine

Jeff: And while it seems crass to even mention the financial impact, the number is shocking - suicide has an estimated economic burden of $5.4 Jeff: a 2017 ACEP clinical policy also recommends against routine lab testing in those with acute psychiatric complaints. billion per year in the US. deaths per year per 100,000 individuals.