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The NICO Trial: NIV in Comatose Patients with Acute Poisoning

RebelEM

There has been no high level evidence to help guide practice until now…the Non-Invasive Airway Management of Comatose Poisoned Emergency Patients (NICO) trial. Effect of Noninvasive Airway management of Comatose Patients with Acute Poisoning: A Randomized Clinical Trial. Paper: Freund Y et al.

Poisoning 141
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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. Authors evaluated the relationship between QRS duration and negative clinical events in patients with confirmed tricyclic anti-depressant (TCA) poisoning. Treatment is guided by administration of sodium-bicarbonate. Boehnert 1985 ).

Poisoning 105
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Seizure in a 30 something

Dr. Smith's ECG Blog

Her husband called EMS when the patient experienced new onset seizures accompanied by micturition. The ECG below was recorded by EMS. However, cardiac syncope is always a differential diagnosis when someone presents with first time seizures. Discussion : The patient in today’s case presented with "seizures".

Seizures 107
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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.

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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

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. 1 Seizures may occur due to lowered seizure threshold. 6 Seizures have been observed and are dose-dependent.

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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. Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Can progress to hepatic failure.

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ToxCard: Benzonatate

EMDocs

When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. 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)