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Organophosphate Poisoning

EM SIM Cases

Organophosphate poisoning is a well-known (but rare in developed nations) toxidrome with specific antidotes available for patient treatment and survival. He looks so unwell that he is placed into the resuscitation bay. Organophosphate poisoning Download Case courtesy of Frank Gaillard, Radiopaedia.org.

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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. Opioid overdose remains the leading cause of cardiac arrest due to poisoning in North America.

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REBEL Core Cast 103.0 – Caustic Ingestions

RebelEM

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. N Engl J Med.

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ToxCard: Diethylene Glycol

EMDocs

In mass poisoning cases, DEG has been substituted as a solvent in oral medications and in topical medicinal products. DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur.

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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

Consider escharotomy if there is any issue with perfusion or neurologic deficit, as well as difficult ventilation in the intubated patient. Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion.

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Grand Rounds Recap 1.31.24

Taming the SRU

Vaughan SJS/TEN and DRESS are life-threatening drug reactions that require immediate discontinuation of the drug and specialist involvement In SJS/TEN, if >10% skin involvement or worsening symptoms, transfer the patient to a Burn Center DRESS has characteristic multi organ involvement, so a high level of suspicion for complications should be maintained (..)

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Beyond the Burns: Toxic House Fire Gases

Northwestern EM Blog

The post goes into detail on the pathophysiology, signs, symptoms, and diagnosis of both carbon monoxide and cyanide poisonings, so this commentary will focus on the clinical approach. An elevated lactic acid is a surrogate for cyanide poisoning, specifically a level of 8-10 mmol/L or greater is sensitive and should prompt intervention.

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