EMDocs

JANUARY 25, 2024

Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Warfarin is poison – and not just for rats Spinal epidural hematoma leaves patient paralyzed Facts : A 68-year-old male presents to the ED at the end of the night shift complaining of a 2 day history of 8/10 neck pain radiating to his upper back and increasing with movement.

Poisoning 90

Poisoning Documentation/Coding Patient Safety Hospitals 90

EM Ottawa

FEBRUARY 26, 2024

Question and Methods: Multicenter RCT involving comatose patients with suspected acute poisoning and GCS <9 compared a conservative airway strategy of withholding intubation versus routine practice for the primary hierarchical composite end point of in-hospital death, length of ICU stay, and length of […] The post Effect of Noninvasive Airway (..)

Airway Management 68

Airway Management Poisoning Hospitals 68

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, The entire plant is toxic.

Poisoning 98

Poisoning EKG/ECG Hospitals 98

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. References Hack J. 2023;43(10):20-21. J Emerg Med. 2009;27:132.e1-132.e2.

Poisoning 52

Poisoning Pediatrics Shock Research 52

EMDocs

MARCH 4, 2025

Toxicity: Carbon monoxide poisoning Time Course: Typically, a rapidly progressing disease process. HSV meningitis needs hospital admission. Bacterial Meningitis Mimics: Other flu-like illnesses: COVID, influenza, toxic shock syndrome, myocarditis, endocarditis, spinal epidural abscess, pneumonia. What about steroids?

Infectious Diseases 74

Infectious Diseases Seizures Poisoning Sepsis 74

Sensible Medicine

NOVEMBER 10, 2023

Finally, 3 doses were approved based on Ab titers, but randomized trials have never shown improvements in severe disease or hospitalization. The White House and FDA poisoned public perception of kids vaccines with this regulatory fiasco.

CDC 145

CDC Pediatrics Poisoning Hospitals 145

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 84

Poisoning CDC Administration Emergency Department 84

Ziqitza HealthCare Ltd

JULY 21, 2023

Emergency-type pregnancy, snake bite, food poisoning, cardiac arrest, etc. The paramedic is trained to provide pre-hospital care to patients during transport of the patient. How ambulance emergency number works Where the call is from to ascertain the location on the GPS. Name & contact details of the caller to track the caller.

Ambulance Services 98

Ambulance Services Poisoning Operations Hospitals 98

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. Give 600 mg IM every 5 min prehospital or 1-2 g loading dose IV in hospital with optional repeat bolus after 1 hour or continuous infusion. Provide supportive care.

Poisoning 78

Poisoning Seizures Hospitals 78

EMDocs

JANUARY 17, 2024

8) Over the next 24 years, numerous peer reviewed publications on benzonatate poisoning appeared in the medical literature. (3, 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)

Poisoning 81

Poisoning Seizures Pediatrics EMS 81

ACEP Now

AUGUST 11, 2024

Ciguatera fish poisoning, a foodborne illness caused by consuming reef fish contaminated with ciguatoxins, is characterized by a combination of gastrointestinal, neurological, and cardiovascular symptoms. 3 If water temperatures continue to rise, the distribution of ciguatera poisoning may change. Ciguatera poisoning.

Poisoning 52

Poisoning Infectious Diseases EKG/ECG Emergency Department 52

EMDocs

JULY 30, 2024

When should I suspect PNU poisoning? How do I treat PNU poisoning? Background: N-3-pyridylmethyl-N-p-nitrophenylurea (PNU, Pyrinuron, Pyriminil) was released in 1975 as a “safe” poison to use against mice resistant to anticoagulant rodenticides.¹ Fortunately, PNU poisoning is rare. Questions What is PNU? N Engl J Med.

Poisoning 71

Poisoning Seizures Fluid Resuscitation Pediatrics 71

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. When is it useful and what does it tell us?

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Sensible Medicine

SEPTEMBER 19, 2024

we’ve poisoned the food supply, engineered highly-addictive additives, and coated food with pesticides. Trust in hospitals and doctors decreased from 70% to 40%, according to a JAMA study published last month. The old guard has chalked up our chronic disease epidemic to “sedentary lifestyle and obesity.” In the U.S.,

Research 145

Research Military Poisoning Burns 145

Sensible Medicine

SEPTEMBER 3, 2024

Your supervisor says, “Look, the plant has some similarities to poison ivy. When we tested a treatment for this rash in mice, a specific prescription strength poison ivy cream cleared it right up. But this cream is not FDA approved for “freaky plant rash“, it is only approved for poison ivy.

Pediatrics 79

Pediatrics Poisoning Research Military 79

ACEP Now

JANUARY 5, 2025

Use of Bones Although the topic hardly rises to the level of serious controversy, the best protocol for vascular access in the context of out-of-hospital cardiac arrest is an ongoing unanswered question. In a setting where the ED is frequently described as the front door to the hospital, a very reasonable question to ask is: Why?

Sepsis 40

Sepsis Research Airway Management Stroke 40

EMDocs

OCTOBER 10, 2024

She is concerned about food poisoning and says the groin/thigh pain feels like a prior episode of sciatica. Hospital Inpatient : R thigh is indurated and blistered but abdomen is all but ignored. On the 2nd hospital day, she becomes obtunded and is intubated. She only gets worse, and by the 4th hospital day she is unresponsive.

Documentation/Coding 93

Documentation/Coding Hospitals Sepsis Infectious Diseases 93

Mind The Bleep

OCTOBER 29, 2024

First aid done pre-hospital. National Poisons Information Service (0344 892 0111) and TOXBASE have useful information on special chemicals and are accessible 24/7. The AMPLE framework offers a structured approach [2]. Type of chemical and strength. Was the patient wearing any protective equipment?

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

ACEP Now

APRIL 2, 2024

8 Diagnosis and Treatment Food poisoning may result in a similar clinical manifestation as Toxic Hypoglycemic Syndrome. Poison control was consulted, and they concurred with the diagnosis of THS. Under their recommendation, the patient was admitted to the hospital for observation on an intravenous dextrose infusion.

Poisoning 40

Poisoning Administration Documentation/Coding Urgent Care 40

PulmCCM

DECEMBER 3, 2023

Some ventilators have a “sigh” function built in, but more than ad hoc implementation would at most hospitals require changes to respiratory care protocols, training of respiratory therapists, agreement among attending physicians, etc. In the NICO randomized trial, the question was put to the test in intoxicated patients.

Poisoning 64

Poisoning Hospitals Outcomes Academics 64

Taming the SRU

MAY 1, 2023

Subsequent exposure results in a T-cell mediated response (Type IV hypersensitivity reaction) Plants: Toxicodendron species (poison ivy, poison oak, poison sumac) Also present in foods, including pistachio, cashew, and mango.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

ACEP Now

MAY 8, 2023

1,2 With such enormous popularity it is no surprise that each year there are 56,000 emergency department (ED) visits, 2,600 hospitalizations, and 500 deaths in the U.S. 8 A retrospective study of acetaminophen-poisoned patients found that when using a threshold of 3.5 take acetaminophen on a weekly basis. for death. 2002;359:558–563.

Poisoning 52

Poisoning Outcomes Administration EMS 52

Dr. Smith's ECG Blog

DECEMBER 7, 2023

On hospital day 3, the patient had recurrence of symptoms and the following EKG was obtained. Dr. Frick's Interpretation of ECG #5 : CP did not recur during the remainder of the hospital stay. The precordial T waves are now much more deeply inverted , and the T waves in II and aVF which were previously biphasic are now inverted.

EKG/ECG 126

EKG/ECG Poisoning Hospitals 126

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Background: The liberal use of supplemental oxygen therapy in acutely ill adults has a long history in the hospital, but high-quality therapy supporting its practice is unclear. The patient has an oxygen saturation of 98% on room air and your nurses ask if you want the patient to receive supplemental oxygen. The Lancet 2018.

Poisoning 52

Poisoning Administration Hospitals Sepsis 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. Despite supplemental oxygen, she remained hypoxic. 2018;44(1):4-11.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

The Skeptics' Guide to EM

JANUARY 23, 2021

He wants to know if being seen by an APP alters his chance of diagnostic testing or hospital admission. Clinical Question: Is ED evaluation by an APP associated with higher test utilization and hospitalization compared with evaluation by a physician? The patient is seen by an advanced practice provider (APP). Reference: Pines et al.

Poisoning 52

Poisoning Research Documentation/Coding Operations 52

ALiEM

NOVEMBER 29, 2023

Management of Xylazine Withdrawal in a Hospitalized Patient: A Case Report. Xylazine Poisoning: A Systematic Review. Xylazine Intoxication in Humans and Its Importance as an Emerging Adulterant in Abused Drugs: A Comprehensive Review of the Literature. Forensic Sci Int. 2014;240:1-8. Published 2014 Mar 26. PMID: 35020700 Knopf, A.

Forensics 67

Forensics Administration Poisoning Emergency Department 67

Dr. Smith's ECG Blog

OCTOBER 17, 2022

This patient had CO poisoning but did not have myocardial injury or OMI. Finally — My intellectual curiosity would love to see a baseline ECG on this patient — and — I'd love to see a repeat ECG after the patient recovered from the CO poisoning that led to his hospitalization. This ECG is interesting because it mimics TQRSD.

EKG/ECG 52

EKG/ECG Poisoning Hospitals 52

EB Medicine

MARCH 4, 2020

not ED specific) Food poisoning is responsible for 5% of AGE but results in 30% of deaths. Ciguatera Fish Poisoning Toxin produced by algae consumed by reef fish like grouper, red snapper, sea bass and Spanish mackerel. Consider them for immunocompromised patients and those with recent abx use or hospitalization.

Emergency Department 40

Emergency Department Dehydration Poisoning Allergic Reactions 40

ACEP Now

SEPTEMBER 11, 2023

5 Pediatric discharges were reported by 2,784 hospitals in 2000 and the number of reporting hospitals increased to 4,179 in 2012. This database systematically and randomly samples pediatric discharges from participating hospitals. Trends and presentation patterns of acute rheumatic fever hospitalizations in the United States.

Pediatrics 40

Pediatrics Poisoning Hospitals Emergency Department 40

ACEP Now

APRIL 2, 2024

Capsaicin pepper exposures send about 300-350 people to the hospital annually. 11 Pepper spray (oleoresin capsicum) is also used by law enforcement (and others) as non-lethal means of defense and results in about 600 hospital visits annually after exposure with eyes being most common site of injury. to recall the product. Weinberg RB.

Burns 40

Burns Poisoning Seizures Stroke 40

Ziqitza HealthCare Ltd

JUNE 13, 2024

Common reasons include infections, gastrointestinal issues, and food poisoning. Prioritizing life-threatening situations, emergency medical personnel try to stabilize patients before transferring them to a hospital for further treatment. However, if severe instances are not addressed, they can lead to shock or kidney failure.

Burns 52

Burns Stroke Ambulance Services Seizures 52

EB Medicine

SEPTEMBER 1, 2018

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.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

ACEP Now

MARCH 6, 2024

Finally, the “EXACT” trial examined whether, in patients with return of spontaneous circulation after an out of hospital cardiac arrest, a peripheral oxygenation target of 90–94 percent conferred a survival benefit, as compared with the typical 98–100 percent. Survival to hospital discharge favored the “standard care” group, 47.9

Research 52

Research Airway Management Stroke Outcomes 52

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

En route to the hospital the patient experienced multiple short-lasting episodes, with cramping and loss of consciousness. I find it is easier to measure the QTc when the paper speed is 50mm/s , as it is in the image above. I measure the RR interval at 795ms and the QT interval at 475ms. The QTc comes out at 533ms, dangerously prolonged.

Seizures 114

Seizures EKG/ECG EMS Stroke 114

Advanced Emergency Nursing from AENJ

MAY 27, 2014

Even after no longer having a role in resuscitation, CO2 was advocated for accelerating clearance of carbon monoxide poisoning into the 1950s and 1960s. New Treatment for Carbon Monoxide Poisoning. Carbonated Water Now Used In Gas Poisoning Treatment. Carbogen in experimental carbon-monoxide poisoning. In 1927, H.W.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

Northwestern EM Blog

JUNE 16, 2024

If high suspicion or known overdose, involve and consult your local Poison Center [8]. Seth Trueger, MD, MPH, FACEP Associate Professor of Emergency Medicine Northwestern Memorial Hospital How To Cite This Post: [Peer-Reviewed, Web Publication] Kilbane, K. It is often associated with severe bradycardia (HR<50 bpm. 2024, Jun 17).

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Infectious Diseases Stroke Poisoning 52