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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.

Poisoning 106
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REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

RebelEM

Take Home Points: In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. Treatment is guided by administration of sodium-bicarbonate. Authors evaluated the relationship between QRS duration and negative clinical events in patients with confirmed tricyclic anti-depressant (TCA) poisoning.

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ToxCard: Organic Mercury Poisoning

EMDocs

Further, organic mercury readily crosses the placenta where it acts as a teratogen leading to a wide range of birth defects including developmental delay, blindness, seizures, and limb malformation. 6 The neurotoxicity caused by organic mercury poisoning is permanent, thus, you must act fast. Food and Drug Administration.

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ACMT Toxicology Visual Pearl: The Bark with Some Bite

ALiEM

How can people become poisoned with willow bark? With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. Pharmacokinetics of salicin after oral administration of a standardised willow bark extract. Tinnitus, nausea, vomiting, and abdominal pain are common. 2017;177(5):674-683.

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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: Benzonatate

EMDocs

The US Food and Drug Administration (FDA) approved benzonatate in 1958 for cough relief in patients ≥ 10 years. 8) Over the next 24 years, numerous peer reviewed publications on benzonatate poisoning appeared in the medical literature. (3, It is rapidly absorbed with an onset of 15-20 minutes and duration of up to 8 hours. (7)

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ToxCard: Anticholinergic Plant Toxicity

EMDocs

Diagnosis: Clinical exam findings, in combination with a thorough history help to make the diagnosis of anticholinergic plant poisoning. Physostigmine does not reverse seizures or dysrhythmias. Physostigmine does not reverse seizures or dysrhythmias. Jimson weed poisoning – a case report. 9 Physostigmine dosing: 0.5-2