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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ACEP Now

AUGUST 9, 2024

More severe systemic reactions like delirium, seizures, limb paralysis, blood pressure changes, respiratory distress, dysrhythmia, myocardial ischemia, and syncope are rare. A five-year poison center experience. Poisoning, envenomation, and trauma from marine creatures. Clin Toxicol (Phila). 2016;54:313-318. J Emerg Med.

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ACEP Now

FEBRUARY 11, 2024

Patient C, a 27-year-old female with a history of epilepsy, taking valproate and endorsing adherence, is then brought in by ambulance for a witnessed seizure. This is her first seizure in six years. This patient had her first seizure in years despite adherence to her valproate for management of her epilepsy. Diabetes Care.

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Seizures Fluid Resuscitation Poisoning EKG/ECG 52

Don't Forget the Bubbles

NOVEMBER 29, 2024

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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ALiEM

AUGUST 16, 2023

Dyspnea Headache Syncope Coma Seizures How can you diagnose methemoglobinemia? Chemically induced methemoglobinemia from aniline poisoning. Signs and symptoms can include [3]: Cyanosis Chocolate brown color of arterial blood Low O 2 saturation (usually about 85%) on pulse oximetry that does not improve with supplemental oxygen.

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Poisoning Seizures Administration Pediatrics 52

Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

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Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Mind The Bleep

SEPTEMBER 12, 2023

Severe jaundice causing kernicterus may also cause central hypotonia and seizures. Everything Else Examine the abdomen for any organomegaly which can occur in metabolic or storage disorders or SCORTCH infections Look for signs of jaundice which can occur with hypothyroidism or inborn errors or metabolism.

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Sepsis Seizures Poisoning Wellness 52

Pediatric Education

MAY 7, 2023

What are services that a poison center can offer? Questions for Further Discussion 1. What are some common toxidromes? What are common treatments for anxiety and depression?

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Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

Her husband called EMS when the patient experienced new onset seizures accompanied by micturition. However, cardiac syncope is always a differential diagnosis when someone presents with first time seizures. There are a number of things to look for in an ECG that can hint at arrhythmia as the cause of an apparent seizure.

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Northwestern EM Blog

FEBRUARY 4, 2025

Written by: Dean Hayes (NUEM 27) Edited by: Andrew Long (NUEM 25 ) Expert Commentary by: Rafael Lima, MD A mid 20s male presents to the ED after seizure-like activity. Per the patient's partner at bedside, he had a 2-3 minute convulsive episode and the description is consistent with a likely seizure. and Can Kratom cause seizures?

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Seizures Poisoning Forensics Emergency Department 72

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. Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Can progress to hepatic failure.

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Poisoning Fluid Resuscitation Seizures Resuscitation 98

RebelEM

FEBRUARY 15, 2024

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. References: Freund Y et al.

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Poisoning Airway Management Seizures Shock 141

EMDocs

JULY 30, 2024

Shortly after this, he began vomiting, and developed a tonic clonic seizure. There was no prodromal illness, recent trauma, polyuria or polydipsia, family history of seizure disorder or diabetes. When should I suspect PNU poisoning? How do I treat PNU poisoning? Fortunately, PNU poisoning is rare. N Engl J Med.

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Poisoning Seizures Fluid Resuscitation Pediatrics 74

EMDocs

JANUARY 4, 2024

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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Seizures EKG/ECG Poisoning Shock 92

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, Benzodiazepines are first-line therapy for seizures.

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Poisoning Seizures Pediatrics EMS 89

ALiEM

OCTOBER 4, 2023

What are the symptoms of nerve agent poisoning? [1, 1, 5] Muscarinic symptoms (Common acronyms SLUDGE or DUMBBELLS) Salivation, emesis, diarrhea, and lacrimation Miosis Seizures Bradycardia, bronchospasm, and bronchorrhea are usually the cause of death. Use benzodiazepines such as diazepam or midazolam for seizures. McGraw Hill.

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Poisoning Seizures Hospitals 78

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, Hydroxocobalamin is the preferred antidote for cyanide poisoning. Journal of Acute Disease.

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Poisoning Pediatrics Seizures Administration 67

EMDocs

DECEMBER 19, 2023

Food Poisoning. Poisoning, Envenomation, and Trauma from Marine Creatures. Possible early antibiotic treatment Minor Marine Trauma Mechanism: Bites, Stings, Nematocysts Envenomation Presentation: All can cause localized pain, erythema, and warmth Dermatologic: Urticaria, burning, pruritus, localized paresthesia. 2006;23(7):503-508.

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Poisoning Seizures Anaphylaxis Burns 105

EMDocs

FEBRUARY 15, 2024

Diagnosis: Clinical exam findings, in combination with a thorough history help to make the diagnosis of anticholinergic plant poisoning. Physostigmine does not reverse seizures or dysrhythmias. Physostigmine does not reverse seizures or dysrhythmias. Jimson weed poisoning – a case report. 9 Physostigmine dosing: 0.5-2

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Hyperthermia / Hypothermia Poisoning Seizures COPD 111

Emergency Medicine Ireland

DECEMBER 27, 2021

This time round we’ll look at an oldie but a goodie: salicylate poisoning. This time round we’ll look at an oldie but a goodie: salicylate poisoning. I have not seen one of these in quite some time but it is a classic tox. Read More » Welcome back to the tasty morsels of critical care podcast.

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ALiEM

MARCH 5, 2024

How can people become poisoned with willow bark? With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. Willow tree bark extract has been used as an herbal supplement for chronic lower back pain, joint pain, osteoarthritis, sports performance, and weight loss [3].

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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.

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Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Cook County EM Blog

MAY 29, 2023

Signs and symptoms of toxicity include alerted mental status, seizures, CNS depression, apnea, respiratory failure, hypotension, ventricular dysrhythmias, and cardiac arrest. If a therapeutic dose is chewed, it can lead to bronchospasm, laryngospasm, seizures, and cardiovascular collapse which further reinforces the danger to children.

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Seizures Administration Resuscitation Poisoning 52

Ziqitza HealthCare Ltd

JUNE 13, 2024

Common reasons include infections, gastrointestinal issues, and food poisoning. Severe or persistent vomiting or diarrhea Prolonged episodes of severe vomiting or diarrhea can cause electrolyte imbalances and dehydration. However, if severe instances are not addressed, they can lead to shock or kidney failure.

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Burns Stroke Ambulance Services Seizures 52

Taming the SRU

APRIL 17, 2023

Poison centers across the United States receive over 100,000 reports of exposures to toxic plants annually. More serious poisonings typically involve adults who ingest plants in larger quantities for recreational, self-harm, foraging or medicinal purposes (1). Spring has sprung. and so have many species of toxic plants! Decontaminate.

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Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

ACEP Now

APRIL 2, 2024

1 In severe cases altered mental status, seizures, coma, or even death have been observed. 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. References Katibi OS, Olaosebikan R, et al.

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Poisoning Administration Urgent Care Documentation/Coding 40

ACEP Now

DECEMBER 10, 2023

5 Symptoms of milkweed poisoning may include abdominal discomfort, nausea, vomiting, diarrhea, weakness, lethargy, and confusion, progressing to seizures, heart rhythm changes, and bradycardia. In the ED, he was found to have a heart rate in the 40s, and a digoxin level of 1.0 ng/mL (cross reactivity of the assay) and a potassium of 4.2

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Poisoning Seizures Documentation/Coding Emergency Department 52

ACEP Now

APRIL 2, 2024

8 Seizures and thunderclap headache from reversible cerebral vasoconstriction syndrome have been reported. 2022 annual report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 40th annual report. Pepper spray injury severity: ten-year case experience of a poison control system. Eur J Pharmacol.

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Burns Poisoning Seizures Stroke 40

EB Medicine

AUGUST 1, 2018

Jeff: Medicinally, cannabinoids are currently used in the treatment of chronic pain syndromes, complications of multiple sclerosis and paraplegia, weight loss due to appetite suppression in HIV/aids, chemotherapy-induced nausea and vomiting, seizures, and many other neuropsychiatric disorders.

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Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Emergency Medicine Journal

NOVEMBER 28, 2023

SEIZURE (FIT) 715 16 250 35 2.24[1.4 POISONING FROM ANY SOURCE 179 0 8 4.5 Abstract 2086 Table 1 Presentations Total first presentation over 2021 Total deaths (within 30 days ) Admission Admission (%) Percentage of deaths [CI ] INJURY OF SHOULDER/ARM/ELBOW/WRIST/HAND 8416 4 424 5 0.05[0.018 0.12 , 0.33] CHEST PAIN 5953 34 2077 34.9

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Documentation/Coding Sexual Assault Hyperthermia / Hypothermia Head Injuries 40

EB Medicine

FEBRUARY 1, 2019

Jeff: Do consider adding on a venous or arterial carboxyhemoglobin in the right clinical scenario, as CO poisoning represents an important cause of headache you wouldn’t want to miss. Seizures are very common as well. That’s quite a list. For a visual reference, see Table 3 in the print issue.

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Emergency Department Stroke Outcomes Ultrasounds 40

EMDocs

JUNE 14, 2023

Organophosphate poisoning in agriculturally centered communities has developed into a public health concern in developing countries, poisons millions and kills hundreds of thousands each year worldwide and is a reason why understanding organophosphate toxicity has become a critical addition to our knowledge of toxicology. 2013;6:524.

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Taming the SRU

JANUARY 5, 2025

Potential complications include dysrhythmias, respiratory failure, DIC, seizures, and hepatic failure. An 11-year retrospective review of cyproheptadine use in serotonin syndrome cases reported to the California Poison Control System. Workup for complications should be initiated on a case by case basis. PMID: 32659853. Biermann, T.

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Hyperthermia / Hypothermia Dehydration Psychiatric Poisoning 97

EMDocs

JUNE 7, 2023

2,7 Organophosphate poisonings in agriculturally-centered communities are of public health concern in developing countries. Millions are poisoned, and hundreds of thousands die each year worldwide. Millions are poisoned, and hundreds of thousands die each year worldwide. 7 May lead to respiratory failure.

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Poisoning Airway Management Seizures PPE 98

Taming the SRU

SEPTEMBER 1, 2023

Shewakramani Sepsis is associated with 20-40% mortality Screening tools for detecting patient at risk for sepsis in the ED SIRS Criteria (more sensitive tool) Temp <36C (96.8F) or >38C (100.4F) HR >90 RR >20 WBC <4k or >12k (or >10% bands) qSOFA Score GCS <15 RR >22 SBP <100mmHg Overall, SIRS Criteria remains (..)

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Sepsis Fractures Documentation/Coding Administration 95

EMDocs

JANUARY 22, 2025

These included seizures, delirium, ARDS, hypotension, hypertension, and aspiration. drug seizure data, 2011-2016. Naloxone in opioid poisoning: walking the tightrope. A prospective study of 453 patients who were admitted after receiving naloxone reported life-threatening complications in over 1% of heroin-overdosed patients.

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Seizures Administration Emergency Department Poisoning 96

EMDocs

JULY 19, 2023

Further, organic mercury readily crosses the placenta where it acts as a teratogen leading to a wide range of birth defects including developmental delay, blindness, seizures, and limb malformation. 6 The neurotoxicity caused by organic mercury poisoning is permanent, thus, you must act fast. Adverse Drug React Acute Poisoning Rev.

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Poisoning Fluid Resuscitation Administration Seizures 92