Remove Outcomes Remove Poisoning Remove Shock
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Chemical Burns

Mind The Bleep

Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. National Poisons Information Service (0344 892 0111) and TOXBASE have useful information on special chemicals and are accessible 24/7. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes.

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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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. Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. This stage does not always occur. Antiemetics as needed.

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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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Glasgow Coma Scale in Children

Pediatric EM Morsels

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? Fun fact for animal lovers!-

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ToxCard: Bupropion

EMDocs

Cardiogenic shock and hypotension can occur (systolic heart failure with reduced ejection fraction.) 10,12 Refractory shock or malignant arrhythmias occur in < 5% of patients. Whole bowel irrigation: 3 Not routinely performed and limited evidence to support improved outcome in general. Accessed 12/18/2022. 2014;52(9):969-72.

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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.