Emergency Medicine Cases

FEBRUARY 12, 2019

On this EM Quick Hits podcast we have Emily Austin on organophosphate poisoning, Arun Sayal on malrotation of metacarpal fractures, Andrew Petrosoniak on pitfalls in abdominal stab wound management, Anand Swaminathan on tranexamic acid for non-massive hemoptysis, and Natalie May on pediatric IV cannulation tips and tricks.

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Sensible Medicine

NOVEMBER 10, 2023

Specifically, the COVID19 shot was added to pediatric schedule, as if it is a necessary vaccine, but it is not. The White House and FDA poisoned public perception of kids vaccines with this regulatory fiasco. Enter the CDC, the agency took the COVID19 shot and added it to the pediatric schedule, placing it alongside vaccines like MMR.

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CDC Pediatrics Poisoning Hospitals 145

ACEP Now

FEBRUARY 6, 2024

found 100 percent of pediatric urine specimens fluoresced even in the absence of ethylene glycol. corroborated that most pediatric urine samples fluoresce under UV light and found considerable interrater variability. Pediatrics. Artifactual elevation of lactate in ethylene glycol poisoning. 2 Parsa, et al. J Emerg Med.

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Poisoning Pediatrics Shock Research 52

ACEP Now

JANUARY 9, 2024

Incidentally, the day after ED visit number one, the mother was called by the child’s pediatrician advising her to bring him for evaluation of lead poisoning. In the emergency department, consultations were made with the regional poison-control center and the regional lead center. Discussion Lead poisoning is a serious health concern.

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Emergency Medicine Cases

NOVEMBER 30, 2021

Sarah Reid on differentiating septic arthritis from transient synovitis in pediatric limp, Anand Swaminathan on managing tracheostomy complications in the ED, Nour Khatib on rural medicine and ethylene glycol poisoning, Justin Morgenstern on RCTs for ketamine in patients with severe agitation.

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RebelEM

JUNE 7, 2023

Clinicians are encouraged to call their local regional toxicologist and poison control center whenever a caustic ingestion poisoning is suspected. Management Always consider calling your local toxicologist or regional poison control center, as even substances with a neutral pH may have caustic potential. Pediatr Emerg Care.

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Emergency Medicine Cases

DECEMBER 8, 2020

In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an approach to hyperthermia, Brit Long on diagnosis and management of malignant otitis externa, Jesse McLaren on ECG diagnosis of occlusion MI in patients with BBB and Peter Brindley on prone CPR.

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EMDocs

AUGUST 3, 2023

These local protocols vary from the labeled dosing; contacting and using your local poison center’s protocol is recommended. Extracorporeal treatment for acetaminophen poisoning: recommendations from the EXTRIP workgroup. Pediatr Emerg Care. Clin Toxicol (Phila). 2015;53(10):941-949. Clin Toxicol (Phila). Epub 2014 Aug 18.

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Broome Docs

MAY 31, 2024

Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial. JAMA Pediatr. 2023 Dec 19;330(23):2267-2274. doi: 10.1001/jama.2023.24391. 2023.24391. PMID: 38019968 write something here Justin’s longer / Full write up here. 2024 Apr 1:e240167. doi: 10.1001/jamapediatrics.2024.0167.

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Airway Management Poisoning Pediatrics 82

Northwestern EM Blog

MARCH 28, 2022

Clinical Findings of Methanol Poisoning CNS sedation Seizures Rapid, Deep Breathing Hypotension Ocular findings: Blindness Afferent pupillary defect Optic disk hyperemia Mydriasis Ethylene Glycol Toxicity Similarly, the toxic metabolites of ethylene glycol cause end-organ damage at levels greater than 20mg/dl.

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Pediatric Emergency Playbook

JULY 1, 2020

Traditional Approach: Secretory -- poisoned mucosal villi -- "the sieve" Cytotoxic -- destroyed mucosal villi -- "the shred" Osmotic -- malabsorption -- "the pull" Inflammatory -- edema, motility -- "the push" Lots of overlap, difficult to apply to clinical signs and symptoms. Pediatrics. Pediatrics 1980; 65:1125.

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Poisoning Pediatrics Outcomes 52

ACEP Now

JULY 8, 2023

1 The authors evaluated four parameters for their ability to predict severe illness in the pediatric ED setting: altered mental status, abnormal capillary refill, abnormal peripheral pulses, and cold or mottled extremities. Dr. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington.

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Pediatrics Poisoning Emergency Department Sepsis 52

ALiEM

NOVEMBER 1, 2023

Curr Opin Pediatr 2006;18(2):174-9.  PMID 24072332 Baranwal AK, Singhi SC: Acute iron poisoning: management guidelines. Indian Pediatr 2003;40(6):534-40.  In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. McGraw-Hill Education; 2019 Madiwale T, Liebelt E. Iron: not a benign therapeutic drug.

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ACEP Now

MAY 10, 2024

A recent 5-year retrospective study of 1,197 pediatric patients at a single institution studied 759 kids (63.4 A recent 5-year retrospective study of 1,197 pediatric patients at a single institution studied 759 kids (63.4 percent of ED pediatric patients compared to 92.9 So how successful are we at extracting the EAC FB?

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Pediatrics Emergency Department Poisoning Outcomes 52

ACEP Now

SEPTEMBER 5, 2024

Jones is associate professor at the department of emergency medicine & pediatrics and the program director of pediatric emergency medicine fellowship at the University of Kentucky in Lexington, Kentucky. References Zhou L, Li S, Wang W, et al.

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Emergency Medicine Cases

MAY 21, 2019

In this EM Cases main episode podcast we have the director of the Burn Unit at Hospital for Sick Children, Dr. Joel Fish and EM educator Dr. Maria Ivankovic discuss dozens of pearls and pitfalls in the management of both pediatric and adult burn and inhalation injuries management with a special appearance by airway master George Kovacs to talk about (..)

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Pediatric Education

NOVEMBER 12, 2023

Bull MJ, Engle WA, The Committee on Injury and Poison Prevention and the Committee on Fetus and Newborn. Pediatrics. Pediatrics. Pediatrics. D’Alessandro, MD Professor of Pediatrics, University of Iowa Safe Transportation of Preterm and Low Birth Weight Infants at Hospital Discharge. 2009;123(5):1424-1429.

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ALiEM

AUGUST 16, 2023

Pediatr Rev. Chemically induced methemoglobinemia from aniline poisoning. Methemoglobinemia: a review and recommendations for management. J Cardiothorac Vasc Anesth. 2014;28(4):1043-1047. doi:10.1053/j.jvca.2013.02.005. 2013.02.005. PMID 23953868 Mack E. Focus on diagnosis: co-oximetry. 2007;28(2):73-74. doi:10.1542/pir.28-2-73.

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Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C cuffed ETT) preloaded and intubate through the stoma if PPV needed Infection (i.e.

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Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Pediatric Emergency Playbook

JUNE 1, 2016

Hypovolemic Shock The most common presentation of pediatric shock; look for decreased activity, decreased urine output, absence of tears, dry mucous membranes, sunken fontanelle. Cold shock is the most common presentation in pediatric septic shock, and is treated with epinephrine. Is this in an infarction, an infection, a poisoning?

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Pediatric Education

MARCH 24, 2024

Entrance for young children can occur through the mother when in-utero or through breastfeeding, or through the environment including dermal, inhalation and ingestis to be inadequate studies of these potential contaminants in the pediatric age group. D’Alessandro, MD Professor of Pediatrics, University of Iowa

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Pediatric Education

MAY 7, 2023

What are services that a poison center can offer? Pediatr Neurol. D’Alessandro, MD Professor of Pediatrics, University of Iowa Insidious Onset of Serotonin Syndrome in a 6-Year-Old Boy. J Am Acad Child Adolesc Psychiatry. 2021;60(2):201-202. doi:10.1016/j.jaac.2020.08.439 2020.08.439 French S, Wray C. 2019;90:66-67.

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Hyperthermia / Hypothermia Infectious Diseases Pediatrics Poisoning 40

Pediatric Emergency Playbook

JULY 1, 2016

Children with limb-length discrepancy only need a non-urgent referral to pediatric orthopedics to look for congenital dysplasia of the hip, or other growth abnormalities. They look like stacks of paper within normal bone – you can see them also in anemia, lead poisoning, and other causes. Some are treated with orthotics.

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Fractures Poisoning Wellness Sepsis 52

EMDocs

DECEMBER 6, 2024

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. Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). 2 L/hr in adults.

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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? Fun fact for animal lovers!-

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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.

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Pediatrics Poisoning Research Military 78

Don't Forget the Bubbles

JANUARY 17, 2024

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. Closer to home, the New South Wales Poisons Information Centre (NSWPIC) reported 129 incidents involving water-absorbing beads since 2004. BMC Pediatrics , 20 , pp.1-5. Arch Pediatr.

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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. Clinical Pediatrics.

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ALiEM

NOVEMBER 15, 2023

Although poisoning by ingestion of cyanogenic foods is much more common in tropical countries, there have been reported cases in the US [1, 3]. What are the symptoms of cyanide poisoning? How to you treat cyanide poisoning? [1, grams (50 mL) Pediatrics: 250-412 mg/kg (1-1.65 mL/kg) not to exceed 50 mL or 12.5

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Pediatric EM Morsels

MARCH 17, 2023

Call your friends … at the Poison Center! Your state poison center and local toxicologists are a wealth of knowledge and help for management and treatment. Management of pediatric snake bites: are we doing too much? J Pediatr Surg. Pediatr Nephrol. But that puts them at risk for snake bites in some areas.

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CDC Poisoning Pediatrics Shock 130

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)

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Taming the SRU

JUNE 7, 2023

CPC: Rheumatic Fever - Carbon Monoxide Poisoning - Pediatrics: Toxicology - Combined EM/IM: Competency CPC: Rheumatic Fever WITH Drs.

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Poisoning EKG/ECG Pediatrics Burns 76

EMDocs

AUGUST 15, 2023

He was admitted to the pediatrics service for further management. Treatment of snakebite poisoning. Vital signs are HR 142 bpm, BP 133/86 mmHg, RR 22 breaths/min, SpO 2 98% on room air, T 98.7°F. Laboratory testing demonstrated platelets 482 × 10 9 /L, fibrinogen 241 mg/dL, and INR 1.2. How do you manage crotalid envenomations?

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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.

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EMDocs

JUNE 25, 2024

Typically for adults with a TBSA of at least 20% or 10% in pediatric patients. 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. IOs and central lines are also options.

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ACEP Now

OCTOBER 10, 2023

The patient’s urine was obtained and compared with the urine of his emergency physician using a Wood’s lamp, and the patient’s was found to be brightly fluorescent, supporting the presumptive diagnosis of EG poisoning. After resolution of EG poisoning, he was transferred to psychiatry and ultimately discharged home without complication.

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Poisoning Pediatrics Research Wellness 52

EMDocs

JANUARY 4, 2024

If > 500 msec give 2 grams magnesium IV in adults, 50 mg/kg up to 2 grams in pediatric patients and observe closely for the development of dysrhythmias. 6,15 Discuss cases of overdose, including pediatric exploratory ingestions, with a medical toxicologist or your local poison center. Accessed 12/18/2022. 2014;52(9):969-72.

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