Northwestern EM Blog

FEBRUARY 4, 2025

Poison control was consulted for additional workup due to concern for Kratom toxicity. Although no confirmatory testing is available, poison control believed there was a reasonable likelihood Kratom toxicity contributed to the patients likely seizure. Just over half of these cases required medical intervention. References 1.

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Seizures Poisoning Forensics Emergency Department 72

EMDocs

FEBRUARY 15, 2024

Diagnosis: Clinical exam findings, in combination with a thorough history help to make the diagnosis of anticholinergic plant poisoning. 11 Consider consulting a toxicologist or regional poison control center (1-800-222-1222 in the United States) if there diagnostic or management uncertainty. McGraw Hill; 2019. 2002; 6(4):28-30.

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Hyperthermia / Hypothermia Poisoning Seizures COPD 102

ALiEM

NOVEMBER 15, 2023

Although poisoning by ingestion of cyanogenic foods is much more common in tropical countries, there have been reported cases in the US [1, 3]. What are the symptoms of cyanide poisoning? How to you treat cyanide poisoning? [1, Hydroxocobalamin is the preferred antidote for cyanide poisoning. McGraw Hill; 2019.

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Poisoning Pediatrics Seizures Administration 67

EMDocs

JANUARY 17, 2024

8) Over the next 24 years, numerous peer reviewed publications on benzonatate poisoning appeared in the medical literature. (3, 8) Over the next 24 years, numerous peer reviewed publications on benzonatate poisoning appeared in the medical literature. (3, 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9)

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Poisoning Seizures Pediatrics EMS 74

EMDocs

DECEMBER 19, 2023

McGraw Hill; 2019. Food Poisoning. McGraw Hill; 2019. Poisoning, Envenomation, and Trauma from Marine Creatures. [link] Blohm E, Brush D. Marine Envenomations. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Goldfrank’s Toxicologic Emergencies, 11e. Accessed August 25, 2022. doi:10.1136/emj.2005.028456

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Poisoning Seizures Anaphylaxis Burns 102

EMDocs

JUNE 25, 2024

Systemic poisoning from inhaled toxins, obstruction of the upper airway from heat injury and edema, and chemical injury to the lower respiratory system from smoke inhalation. If the patient is altered after smoke exposure in an enclosed spaced, consider carbon monoxide or cyanide poisoning. link] (2019).

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Burns Fluid Resuscitation Resuscitation Poisoning 86

EMDocs

JUNE 8, 2024

2019, wikem.org/wiki/Traumatic_iritis. Posttraumatic Iridocyclitis – Injuries; Poisoning.” 2023, www.merckmanuals.com/professional/injuries-poisoning/eye-trauma/posttraumatic-iridocyclitis?query=Traumatic+Iritis+and+Chemical+Iritis. Review of Optometry , 15 Jan. Lu, Kevin, et al. Traumatic Iritis.” WikEM , Oct.

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EMS Allergic Reactions Poisoning Emergency Department 92

ALiEM

NOVEMBER 1, 2023

McGraw-Hill Education; 2019 Madiwale T, Liebelt E.  PMID 24072332 Baranwal AK, Singhi SC: Acute iron poisoning: management guidelines. Blake Froberg, Bryan Judge, and Louise Kao. Read More in the Series References Perrone J. In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. Deferoxamine. 2023 May 22.

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Shock Poisoning Pediatrics 64

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Date: January 28th, 2019 Reference: Chu DK et al. Date: January 28th, 2019 Reference: Chu DK et al. 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.

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Poisoning Administration Hospitals Sepsis 52

EMDocs

JUNE 5, 2024

New York Mcgraw-Hill Education; 2019. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department. References: Nelson LS, Goldfrank LR. Goldfrank’s Toxicologic Emergencies. J Toxicol Clin Toxicol.

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Poisoning Emergency Department EMS 90

EMDocs

MAY 23, 2024

8 Case Follow-up: Due to the large osmol gap and the concerning clinical history, the resident contacts Poison Control due to the unknown ingestion. New York Mcgraw-Hill Education; 2019. Pharmacotherapy. 2003;23(9):1085-1086. doi:10.1592/phco.23.10.1085.32751 23.10.1085.32751 Koeppen BM, Stanton BA. Renal Physiology. Clin Biochem.

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Poisoning EMS 75

ALiEM

NOVEMBER 29, 2023

Notes from the Field: Xylazine Detection and Involvement in Drug Overdose Deaths – United States, 2019. Xylazine Poisoning: A Systematic Review. Available at: Xylazine (usdoj.gov) Kariisa M, Patel P, Smith H, Bitting J. MMWR Morb Mortal Wkly Rep. 2021;70(37):1300-1302. Published 2021 Sep 17. Clin Toxicol (Phila).

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Forensics Administration Poisoning Emergency Department 67

Cook County EM Blog

MAY 29, 2023

Early consultation with the poison center is prudent. 28 June 2019. Published 2019 May 3. Lipid emulsion therapy carries a theoretical benefit given similar structure and toxicity to local anesthetic agents, however, there have not yet been reports on the use of lipid emulsion therapy for benzonatate toxicity. Shonsey, Laura W.

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Seizures Administration Resuscitation Poisoning 52

Dr. Smith's ECG Blog

OCTOBER 17, 2022

This patient had CO poisoning but did not have myocardial injury or OMI. Finally — My intellectual curiosity would love to see a baseline ECG on this patient — and — I'd love to see a repeat ECG after the patient recovered from the CO poisoning that led to his hospitalization. This ECG is interesting because it mimics TQRSD.

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EKG/ECG Poisoning Hospitals 52

ALiEM

AUGUST 16, 2023

Chemically induced methemoglobinemia from aniline poisoning. 2019, McGraw-Hill Education: New York. 2019, McGraw-Hill Education: New York. West J Med. 1984;140(2):282-286. PMID 6730477 Howland M. Methylene Blue, in Goldfrank’s Toxicologic Emergencies , L. Nelson, et al., Nelson, et al., 1703-1712.

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Poisoning Seizures Administration Pediatrics 52

Mind The Bleep

OCTOBER 29, 2024

National Poisons Information Service (0344 892 0111) and TOXBASE have useful information on special chemicals and are accessible 24/7. 2019 Nov;34(4):276-281. Epub 2019 Nov 29. This should be done continuously for at least 20-30 minutes. J Med Toxicol. 2015 Jun;11(2):227-31. doi: 10.1007/s13181-014-0440-1. Murari A, Singh KN.

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Burns Fluid Resuscitation PPE Resuscitation 52

ACEP Now

MAY 10, 2024

Dr. Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Regional Poison Control Center at Upstate Medical University in Syracuse, New York. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington.

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Pediatrics Emergency Department Poisoning Outcomes 52

Northwestern EM Blog

JUNE 16, 2024

If high suspicion or known overdose, involve and consult your local Poison Center [8]. Sinus Node Dysfunction (Sick Sinus Syndrome) [9-10]: Sick sinus syndrome is most commonly due to aging of the sinus node and surrounding atrial myocytes. It is often associated with severe bradycardia (HR<50 bpm. Hamilton, R. Joglar, J. Marine, J.

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Hyperthermia / Hypothermia Infectious Diseases Stroke Poisoning 52

ACEP Now

SEPTEMBER 13, 2023

Dr. Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Regional Poison Control Center at Upstate Medical University in Syracuse, New York. Bloodstream infections in children with sickle cell disease: 2010-2019. J Pediatr Pharmacol Ther.

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Pediatrics Ultrasounds Emergency Department Poisoning 40

Pediatric Education

NOVEMBER 12, 2023

Bull MJ, Engle WA, The Committee on Injury and Poison Prevention and the Committee on Fetus and Newborn. 2019-1703 Author Donna M. To view current news articles on this topic check Google News. To view images related to this topic check Google Images. To view videos related to this topic check YouTube Videos. Pediatrics. J Perinatol.

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Pediatrics Poisoning Hospitals Documentation/Coding 40

PEMBlog

APRIL 26, 2023

From 2019 to 2020, the rate of firearm related deaths among children increased by 30%. Denise Dowd, Robert D. Garry Gardner, Kyran P. Quinlan, Michele Burns Ewald, Beth E. Ebel, Richard Lichenstein, Marlene D. Melzer-Lange, Joseph O’Neil, Wendy J. Each year, 3200 children die from firearm-related injuries.

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Pediatrics Wellness Poisoning Burns 52

EMDocs

NOVEMBER 19, 2024

of exposures reported to poison control centers in 2021 were related to antipsychotics or sedative-hypnotics with the majority of those exposures occurring in patients 20 years of age or older. Consult a medical toxicologist or regional poison control (at 1-800-222-1222 in the United States). New York, NY: McGraw-Hill Education; 2019.

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Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 102

Pediatric EM Morsels

JULY 21, 2023

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. 2019 Jul;20(7):660-666. 2019 Sep;241:112-118. Epub 2019 Apr 22.

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Head Injuries Pediatrics Outcomes Shock 246

EMDocs

JUNE 7, 2023

2,7 Organophosphate poisonings in agriculturally-centered communities are of public health concern in developing countries. Millions are poisoned, and hundreds of thousands die each year worldwide. Millions are poisoned, and hundreds of thousands die each year worldwide. 7 May lead to respiratory failure. C, Organophosphate; 2.

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Poisoning Airway Management Seizures PPE 94

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. Darracq, M.A., Rentmeester, L., Cantrell, F.L.

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Pediatrics Poisoning Ultrasounds Dehydration 111

ALiEM

OCTOBER 4, 2023

What are the symptoms of nerve agent poisoning? [1, Because of rapid progression, typical symptoms of industrial organophosphate poisoning may not be seen. Therapy for acute nerve agent poisoning: An update. 2019 Aug;9(4):337-342. Organophosphorus nerve agent poisoning: managing the poisoned patient.

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Poisoning Seizures Hospitals 78

EMDocs

APRIL 10, 2024

McGraw Hill Companies, Inc; 2019. Poisoning & Drug Overdose. doi:10.1136/bcr-2019-233119 Neal JM, Barrington MJ, Fettiplace MR, et al. The American Journal of Emergency Medicine. 2022;59:42-48. doi:10.1016/j.ajem.2022.06.017 2022.06.017 Nelson LS, Lewin NA, Howland MA, Hoffman RS, Goldfrank LR, Flomenbaum NE. J Med Toxicol.

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Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 105

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.

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Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

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.

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PPE Poisoning Seizures Emergency Department 82

ALiEM

FEBRUARY 20, 2024

Poisoning by sodium channel blocking agents. 2019 Oct;37(10):1989.e1-1989.e3. Epub 2019 Jul 21. Flecainide poisoning and prolongation of elimination due to alkalinization. The American College of Medical Toxicology hosts this Toxicology Visual Pearls series. The post was peer reviewed on behalf of ACMT by Drs.

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Shock EKG/ECG Poisoning Burns 73

Dr. Smith's ECG Blog

FEBRUARY 18, 2022

Intravascular Neutrophil Activation Due to Carbon Monoxide Poisoning What do you think of this ECG? The assessment of QT intervals in acute carbon monoxide poisoning I was not worried about this ECG. Read more about CO poisoning and cardiac ischemia here (ECG is pasted below): What is the treatment for this subendocardial ischemia?

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Poisoning EKG/ECG Wellness 52

Dr. Smith's ECG Blog

JANUARY 23, 2025

He has never been poisoned by the STEMI/NSTEMI paradigm because he has never been to medical school. We've reviewed illustrative cases on this subject often ( See My Comment in the September 17, 2020 post and the April 7, 2019 post , among others ). This was written by Hans Helseth. He just graduated from college. Lucky Hans.

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EKG/ECG Poisoning Wellness 119

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

PEARL #2: The principal abnormal finding on this ECG is QT prolongation , here with generalized nonspecific ST-T wave abnormalities. Over the years, I have found recall of a short LIST of Causes of QT Prolongation to be of invaluable assistance.

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Seizures EKG/ECG EMS Stroke 115

ACEP Now

SEPTEMBER 11, 2023

4 More recent data can be found in a 2019 retrospective review of data from the Kids Inpatient Database as part of the Healthcare Cost and Utilization Project. While there are reports of ARF deaths exceeding 1,000 children and adolescents in New York City in a single year in the late 1930s, there has been a significant decline.

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Pediatrics Poisoning Hospitals Emergency Department 40

EB Medicine

AUGUST 1, 2018

An RCT is underway in Canada on the use of ondansetron versus haloperidol with an estimated completion of July 2019. Jeff: And according to the national poison data system, states with marijuana use laws have seen a 30% increase in calls related to marijuana use by children.

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Seizures Hyperthermia / Hypothermia Administration Dehydration 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. Accessed January 10, 2019. This is especially important at this time of year when heating systems are working overtime here in the states.

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Emergency Department Stroke Outcomes Ultrasounds 40

EMDocs

JANUARY 22, 2025

Drug Overdose Deaths with Evidence of Counterfeit Pill Use – United States, July 2019-December 2021. Naloxone in opioid poisoning: walking the tightrope. 2019 Jan;26(1):7-15. Epub 2019 Jun 20. Hyattsville, MD: National Center for Health Statistics. DOI: [link] O’Donnell J, Tanz LJ, Miller KD, et al.

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Seizures Administration Emergency Department Poisoning 84