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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. Opioid overdose remains the leading cause of cardiac arrest due to poisoning in North America. COR 2a, LOE B-NR.

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ToxCard: Organic Mercury Poisoning

EMDocs

Diagnosis and Management: Whole blood mercury concentrations are the most useful for diagnosis of organic mercury poisoning, as organic mercury undergoes little urinary excretion. 6 The neurotoxicity caused by organic mercury poisoning is permanent, thus, you must act fast. Food and Drug Administration. Resources: S. Winship KA.

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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion. Calculating fluid resuscitation: Parkland formula: 4 mL X % TBSA X weight in kilograms. IOs and central lines are also options. Avoid normal saline.

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Grand Rounds Recap 1.31.24

Taming the SRU

For blood product administration, PROPPR showed that 1:1:1 platelet, plasma, and pRBC administration led to earlier hemostasis along with less death due to blood loss and whole blood compared to separate blood product administration led to decreased death at 24 hours.

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ToxCard: Iron

EMDocs

In the late 1990s, iron was the leading cause of poisoning deaths reported to poison control centers for children less than 6 years of age. In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. Antiemetics as needed.

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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. 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.

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ToxCard: Benzonatate

EMDocs

She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). Upon ED arrival, she had a heart rate (HR) of 160 and blood pressure (BP) of 80s/40s.