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. Drug Alcohol Depend.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

EM Ottawa

FEBRUARY 26, 2024

2023 Dec 19;330(23):2267-2274. Methodology: 3.5/5 5 Usefulness: 3/5 Freund Y, et al.

Airway Management 68

Airway Management Poisoning Hospitals 68

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. Accessed March 13, 2023. Accessed March 17, 2023. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S. Basics are best!

CDC 130

CDC Poisoning Pediatrics Shock 130

ACEP Now

FEBRUARY 6, 2024

Dr. Filip is the medical director of the Arkansas Poison Center and faculty member in the emergency medicine residency at UAMS. Artifactual elevation of lactate in ethylene glycol poisoning. Ethylene glycol poisoning presenting with a falsely elevated lactate level. 2023 Oct;19(4):362-367. Epub 2023 Sep 11.

Poisoning 52

Poisoning Pediatrics Shock Research 52

ALiEM

JUNE 15, 2023

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, Retrieved Jun 5, 2023.

Poisoning 98

Poisoning EKG/ECG Hospitals 98

ACEP Now

JANUARY 9, 2024

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. In the emergency department, consultations were made with the regional poison-control center and the regional lead center. Discussion Lead poisoning is a serious health concern.

Poisoning 52

Poisoning Pediatrics Emergency Department Wellness 52

RebelEM

DECEMBER 13, 2023

Carbon monoxide poisoning may lead to delayed neurologic sequalae – a constellation of dementia, psychosis, parkinsonism, amnestic syndromes, among other neurologic impairments. Weaver 2002 ) As always, call your local toxicologist or regional poison control center to help determine the need for hyperbaric therapy. N Engl J Med.

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Poisoning EMS 105

Sensible Medicine

NOVEMBER 10, 2023

There were no data suitable to support initial emergency use authorization— and there is certainly no data to support administering the shot to a child born in 2023. Meanwhile, the virus has mutated, most kids already had covid, and there is no reliable data that little kids benefit from a COVID19 shot in 2023 and beyond.

CDC 145

CDC Pediatrics Poisoning Hospitals 145

EMDocs

MARCH 4, 2025

Toxicity: Carbon monoxide poisoning Time Course: Typically, a rapidly progressing disease process. 2023 Mar;65:76-83. Bacterial Meningitis Mimics: Other flu-like illnesses: COVID, influenza, toxic shock syndrome, myocarditis, endocarditis, spinal epidural abscess, pneumonia. Consider cryptococcus meningitis in these patients.

Infectious Diseases 85

Infectious Diseases Seizures Poisoning Sepsis 85

EMDocs

SEPTEMBER 7, 2023

In mass poisoning cases, DEG has been substituted as a solvent in oral medications and in topical medicinal products. 4 Despite the policy changes in the United States, epidemic poisonings involving DEG continue to impact adults and children on a global scale with 14 mass poisonings occurring since the Sulfanilamide Disaster.

Poisoning 94

Poisoning CDC Administration Emergency Department 94

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. Accessed April 15, 2023.

Hyperthermia / Hypothermia 111

Hyperthermia / Hypothermia Poisoning Seizures COPD 111

EB Medicine

DECEMBER 1, 2023

In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the December 2023 Pediatric Emergency Medicine Practice article, Management of Pediatric Toxic Ingestions in the Emergenc y Department. Need help now?

Pediatrics 69

Pediatrics Poisoning EKG/ECG 69

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. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. PMID: 57446.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

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. 2023 Mar;97(3):651-661. Organophosphorus nerve agent poisoning: managing the poisoned patient.

Poisoning 78

Poisoning Seizures Hospitals 78

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. Accessed August 20, 2023.

Poisoning 67

Poisoning Pediatrics Seizures Administration 67

Broome Docs

MAY 31, 2024

Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial. 2023 Dec 19;330(23):2267-2274. 2023 Mar;64(3):400-404. 2023 Nov 28;27(1):465. 2023 Sep 8;9(1):73. doi: 10.1001/jama.2023.24391. 2023.24391. Marking the midline… is it a thing? J Emerg Med.

Airway Management 82

Airway Management Poisoning Pediatrics 82

EMDocs

JUNE 8, 2024

2023, www.uptodate.com/contents/overview-of-eye-injuries-in-the-emergency-department?search=traumatic+iritis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2. 2023, eyewiki.aao.org/Traumatic_Iritis#cite_note-trei-4. Posttraumatic Iridocyclitis – Injuries; Poisoning.” Grigorian, A.

EMS 98

EMS Allergic Reactions Poisoning Emergency Department 98

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. Updated 2023 Jul 17]. Updated 2023 Jul 17]. This should be done continuously for at least 20-30 minutes. Chemical Burns. In: StatPearls [Internet]. Chemical burns: effect of prompt first aid.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

PEMBlog

OCTOBER 19, 2023

Cannabinoid poisoning D. Seattle (WA): University of Washington, Seattle; 1993-2023. 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. Entamoeba histolytica infection E. Tyrosinemia Type I. GeneReviews® [Internet].

Urgent Care 52

Urgent Care Pediatrics Poisoning Wellness 52

ACEP Now

MARCH 6, 2024

The Sisyphean task remains to try to keep up—and, in that vein—here is a light round of the emergency medicine literature from 2023. Effect of noninvasive airway management of comatose patients with acute poisoning: a randomized clinical trial. The post Fourteen Emergency Medicine Research Gems from 2023 appeared first on ACEP Now.

Research 52

Research Airway Management Stroke Outcomes 52

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

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. Pediatric Emergency Care , 31 (6), pp.416-418.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

ALiEM

NOVEMBER 1, 2023

2023 May 22. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. 2023 Jun 26. Treasure Island (FL): StatPearls Publishing; 2023 Jan–.  PMID 24072332 Baranwal AK, Singhi SC: Acute iron poisoning: management guidelines. Curr Opin Pediatr 2006;18(2):174-9.  PMID 16601499 Velasquez J, Wray AA. Deferoxamine.

Shock 64

Shock Poisoning Pediatrics 64

ALiEM

NOVEMBER 29, 2023

Published May 2023. Published 2023 Mar 29. 2023 Jun 15;388(24):2209-2212. Epub 2023 Apr 26. Published 2023 June 30. 2023 Mar;61(3):173-180. Xylazine Poisoning: A Systematic Review. Bryan Judge, Louise Kao, and Matthew Salzman. Read More in the Series References Drug Enforcement Administration.

Forensics 67

Forensics Administration Poisoning Emergency Department 67

EMDocs

AUGUST 31, 2023

Poison Control: The F(ab2)ulous Expanded Indication of Anavip | FCEP. Accessed August 17, 2023. link] Blue Ridge Poison Center, University of Virginia Health. Research suggests that F(Ab’) 2 antivenom, compared against F(ab) antivenom, may be associated with lower rates of late and recurrent coagulopathy. Accessed May 7, 2022.

Allergic Reactions 97

Allergic Reactions Anaphylaxis Poisoning EMS 97

Emergency Medicine Education

MARCH 7, 2024

In November 2023, JAMA published an article on noninvasive airway management among patients with depressed consciousness. The watch-and-wait approach, involving close monitoring for individuals with traditional GCS scores <9 and suspected acute poisoning, demonstrated positive outcomes. Link to article

Airway Management 40

Airway Management Poisoning Outcomes 40

ACEP Now

MAY 8, 2023

8 A retrospective study of acetaminophen-poisoned patients found that when using a threshold of 3.5 Updated February 12, 2023. Accessed April 2, 2023. Population-based incidence and outcome of acetaminophen poisoning by type of ingestion. Normal serum AST and ALT levels alone are not predictors of outcome. for death.

Poisoning 52

Poisoning Outcomes Administration EMS 52

Taming the SRU

DECEMBER 11, 2023

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. Accessed March 6, 2023. link] Accessed April 16, 2023.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

There are many ways to estimate the QTc ( ie, I illustrate a user-friendly method I developed and have used for decades in the October 25, 2023 post). For clarity in Figure-1 — I've reproduced the initial ECG in today's case. To determine the QTc — We need to correct this 450 msec. value for the patient's heart rate of ~75/minute.

Seizures 113

Seizures EKG/ECG EMS Stroke 113

PulmCCM

DECEMBER 3, 2023

A European critical care society advised in 2023 against “sighs” resulting in pressure >35 cm H2O. This review in poisoned patients suggested early intubation was associated with lower rates of aspiration pneumonia, but most others did not. But not everyone gave up on sighs.

Poisoning 64

Poisoning Hospitals Outcomes Academics 64

ACEP Now

AUGUST 9, 2024

A five-year poison center experience. Poisoning, envenomation, and trauma from marine creatures. Hack is chief of the division of medical toxicology and vice chair for research at East Carolina University in Greenville, N.C. References Mouchbahani-Constance S, Choinière M, Sharif-Naeini R. 2023;8(5):e1090. Johnston MW, Purkis SJ.

Poisoning 52

Poisoning Burns Seizures Fractures 52

Mind The Bleep

JANUARY 29, 2024

2023 Jul 25. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. 2023 Jul 4. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. Abnormalities can be grouped into: Small pupil Large pupil Abnormal reflexes Small Pupil (miosis) Bilateral (causes): Opioids – always check the drug chart. Pupillary Light Reflex.

Poisoning 52

Poisoning Radiology Radiology 52

Dr. Smith's ECG Blog

DECEMBER 7, 2023

My Comment by K EN G RAUER, MD ( 12/7 /2023 ): = The art of serial ECG comparison is masterfully demonstrated by Dr. Frick in today's post, which marks his 1st contribution to Dr. Smith's ECG Blog. Serial EKG is very high yield diagnostic test in patients with stuttering angina.

EKG/ECG 124

EKG/ECG Poisoning Hospitals 124

Emergency Medicine Ireland

MAY 27, 2024

The ventilator is a bit of a poisoned chalice. 208 , 528–548 (2023). The ventilator is a bit of a poisoned chalice. Dobutamine has the benefit of at least having substantial clinical experience in PH patients even if the tachycardia and even worse the a fib is less than desirable. 31 , 369–385 (2015). Johnson, S. Barnett, C.

Poisoning 52

Poisoning Shock Wellness 52

ACEP Now

FEBRUARY 11, 2024

Poison centers see nearly 1,500% increase in calls related to injected weight-loss drugs as people accidentally overdose. Published December 18, 2023. Published January 2023.Updated Updated May 16, 2023. Published January 2023. Diabetes Care. 2018;41:258–66. CNN website. Accessed January 11, 2024.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

Mind The Bleep

SEPTEMBER 12, 2023

Trisomy 21 (T21) / Prader Willi Congenital infections, TORCH (or SCORTCH ) Acquired infections (sepsis) Peroxisomal disorders, e.g. neonatal adrenoleukodystrophy, Zellwegers syndrome Iatrogenic / poisoning, e.g. benzodiazepines / atracurium Congenital Hypothyroidism Hypoglycaemia Inborn errors of metabolism, e.g. mucopolysaccharidoses, amino acidurias, (..)

Sepsis 52

Sepsis Seizures Poisoning Wellness 52

Pediatric Education

MARCH 24, 2024

Related Cases Disease: Infant and Toddler Nutrition | Food Safety | Food Contamination and Poisoning Symptom/Presentation: Health Maintenance and Disease Prevention Specialty: Nutrition / Dietetics Age: Newborn To Learn More To view pediatric review articles on this topic from the past year check PubMed. Published online October 19, 2023.

Pediatrics 40

Pediatrics Poisoning Research Wellness 40