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Chemical Burns

Mind The Bleep

National Poisons Information Service (0344 892 0111) and TOXBASE have useful information on special chemicals and are accessible 24/7. These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11].

Burns 52
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Grand Rounds Recap 4.5.23

Taming the SRU

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

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Methanol poisoning

Don't Forget the Bubbles

You smell the faint odour of alcohol on the child’s breath A quick mental note: methanol poisoning? Methanol poisoning is rare, but when it strikes, its delayed onset and devastating effects make it a condition we must be ready to recognise and manage. Paracelsus was right, “The dose makes the poison.” What is Methanol?

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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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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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ToxCard: Bupropion

EMDocs

Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 Severe toxicity: Seizures: It is unclear if seizures are caused by bupropion or the active metabolite, hydroxybupropion. 3 Seizures are dose-dependent. 3 Seizures are dose-dependent.

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Grand Rounds Recap 4.19.23

Taming the SRU

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.