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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.

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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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. 2 L/hr in adults. Tenenbein M.

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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

For large burns, consider albumin to lower total volume administration and improve urine output. 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. For isolated burn injury, use balanced crystalloids like LR.

Burns 86
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Grand Rounds Recap 8.16.23

Taming the SRU

Shewakramani Sepsis is associated with 20-40% mortality Screening tools for detecting patient at risk for sepsis in the ED SIRS Criteria (more sensitive tool) Temp <36C (96.8F) or >38C (100.4F) HR >90 RR >20 WBC <4k or >12k (or >10% bands) qSOFA Score GCS <15 RR >22 SBP <100mmHg Overall, SIRS Criteria remains (..)

Sepsis 95
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Episode 20 - Emergency Department Management of North American Snake Envenomations

EB Medicine

Nachi: And don’t forget our peer reviewers this month, Dr. Daniel Sessions, a medical toxicologist working at the South Texas Poison Center, and our very own editor-in-chief, Dr. Andy Jagoda, who is also Chair of the Department of Emergency Medicine at Mount Sinai in New York City. Jeff: What a team! But, let’s get back to the snakes.