Remove Poisoning Remove Seizures Remove Shock
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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. References: Freund Y et al.

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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. COR 2a, LOE B-NR.

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REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

RebelEM

Take Home Points: In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. Authors evaluated the relationship between QRS duration and negative clinical events in patients with confirmed tricyclic anti-depressant (TCA) poisoning. Treatment is guided by administration of sodium-bicarbonate. Boehnert 1985 ).

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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

of exposures reported to poison control centers in 2021 were related to antipsychotics or sedative-hypnotics with the majority of those exposures occurring in patients 20 years of age or older. 1 Seizures may occur due to lowered seizure threshold. 6 Seizures have been observed and are dose-dependent. Front Psychiatry.

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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 is not truly quiescent as cellular toxicity progresses.

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emDOCs Podcast – Episode 115: Adult Meningitis

EMDocs

Neurologic deficits, seizures, cognitive issues, hearing loss. Bacterial Meningitis Mimics: Other flu-like illnesses: COVID, influenza, toxic shock syndrome, myocarditis, endocarditis, spinal epidural abscess, pneumonia. Toxicity: Carbon monoxide poisoning Time Course: Typically, a rapidly progressing disease process.

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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.