ACEP Now

JANUARY 9, 2024

On physical examination, the child was non-toxic, well-nourished, alert, awake, and not in acute distress. 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. Discussion Lead poisoning is a serious health concern.

Poisoning 52

Poisoning Pediatrics Emergency Department Wellness 52

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.

Poisoning 98

Poisoning Burns Resuscitation Pediatrics 98

Emergency Medicine Cases

JANUARY 3, 2017

If we can recognize these overdoses early and manage them appropriately, well - we’ll save some lives. The post Episode 90 – Low and Slow Poisoning appeared first on Emergency Medicine Cases. And inevitably we’re gonna be faced with both intentional and unintentional overdoses from these drugs in the ED.

Poisoning 40

Poisoning Wellness EMS 40

The Trauma Pro

NOVEMBER 3, 2023

Might you poison your relationship with them in the process? Since you have already looked at the available data, you will be able to ask appropriate questions and deflect answers like, “well that’s how we did it where I trained.” What would you do? You are now in an interesting place. Do you discontinue the order?

Poisoning 113

Poisoning Wellness 113

ACEP Now

SEPTEMBER 5, 2024

It is important to evaluate for both the position of the SMA in relationship to the SMV as well as for the “whirlpool” sign. Dr. Cantor is the emeritus medical director for the Central New York Poison Control Center and professor of emergency medicine and pediatrics in Syracuse, New York. References Zhou L, Li S, Wang W, et al.

Ultrasounds 40

Ultrasounds Wellness Pediatrics Poisoning 40

Mind The Bleep

OCTOBER 29, 2024

Alkali burns result in liquefaction necrosis, allowing for deeper tissue injury as well as vascular injury that can lead to both local and systemic toxicity [1]. National Poisons Information Service (0344 892 0111) and TOXBASE have useful information on special chemicals and are accessible 24/7.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Northwestern EM Blog

MAY 2, 2022

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.

Burns 52

Burns Poisoning EKG/ECG Operations 52

Dr. Smith's ECG Blog

FEBRUARY 18, 2022

Intravascular Neutrophil Activation Due to Carbon Monoxide Poisoning What do you think of this ECG? The assessment of QT intervals in acute carbon monoxide poisoning I was not worried about this ECG. Read more about CO poisoning and cardiac ischemia here (ECG is pasted below): What is the treatment for this subendocardial ischemia?

Poisoning 52

Poisoning EKG/ECG Wellness 52

EMDocs

AUGUST 31, 2023

On follow-up 1 week later, the patient was doing well, ambulating and playing without significant discomfort. Poison Control: The F(ab2)ulous Expanded Indication of Anavip | FCEP. link] Blue Ridge Poison Center, University of Virginia Health. References: Ubani C, DeGelorm A, Sollee D. Accessed May 7, 2022. 2016;8(1):113-119.

Allergic Reactions 96

Allergic Reactions Anaphylaxis Poisoning EMS 96

Taming the SRU

JULY 19, 2023

Fundamentals of ECMO - leadership curriculum - ultrasound GR - macgyver techniques fundamentals of ecmo WITH dr. bonomo ECPR from the ED: The ideal patients: Young patients with refractory VF/VT arrest ≤ 30 min since arrest onset Poisonings with cardiogenic shock Severe hypothermia with arrest Massive PE with arrest Key points: Good CPR/advanced ACLS (..)

Ultrasounds 85

Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 85

EM Curious

MAY 14, 2015

How do you manage carbon monoxide poisoning? HOT, RED, AND TENDER SEPTIC JOINT [BLOG]: EM Docs brings us a well versed update on the septic joint, including key history and background, diagnostic work up strategy, and management. Do you know the causes of methemoglobinemia? Watch this lecture here @ Maryland CC Project.

Ultrasounds 52

Ultrasounds Poisoning EMS Burns 52

RCEM Learning

APRIL 9, 2024

Maintain a Positive Mindset and Well-being: Exam preparation can be demanding, so it’s important to take care of your mental and physical well-being. A positive mindset and well-being contribute to better focus and performance during the exam.

Infectious Diseases 52

Infectious Diseases Airway Management Resuscitation Poisoning 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

This study expands upon that investigation to patients with other conditions as well. While supplemental oxygen is undoubtedly beneficial for patients acutely desaturating, in respiratory distress, or suffering from carbon monoxide poisoning just to name a few, there is widespread “indication creep” for this therapy.

Poisoning 52

Poisoning Administration Hospitals Sepsis 52

RCEM Learning

APRIL 9, 2024

Take care of your physical and mental well-being, and ensure you get adequate rest and relaxation. Stay Calm and Confident: Prior to the exam, maintain a calm and positive mindset. Build your confidence by regularly practicing SBA questions and reinforcing your knowledge.

Infectious Diseases 52

Infectious Diseases Airway Management Dislocations Poisoning 52

Pediatric Emergency Playbook

JULY 1, 2016

Lab work can be helpful, as well as US of the hip to look for an effusion, but sometimes, regardless of the results, the joint just has to be tapped to know for sure. If you have any suspicion of the general wellness of the child, get a screening CBC, and perhaps a peripheral blood smear. These children don’t look to well.

Fractures 52

Fractures Poisoning Wellness Sepsis 52

ACEP Now

MAY 10, 2024

A retrospective study of 34 patients including both children and adults aged 2–78 years, evaluated the duration of EAC FB and its relationship to successful removal as well as complications. During this time, outpatient ENT appointments were difficult to obtain. References Karimnegad K, Nelson, EJ, Rohde RL et al.

Pediatrics 52

Pediatrics Emergency Department Poisoning Outcomes 52

Mind The Bleep

JULY 8, 2023

Therefore, I’m sharing the things that worked well and were time-effective, and those that didn’t. Other resources Flashcards worked very well for me, but aren’t everyone’s cup of tea. It’s really nicely laid out, and goes through condition by condition, as well as where conditions overlap multiple specialties.

EKG/ECG 52

EKG/ECG Wellness Hyperthermia / Hypothermia Poisoning 52

Taming the SRU

APRIL 13, 2023

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

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

ACEP Now

APRIL 2, 2024

3 Case 1: Posterior Stroke Presenting as Food Poisoning A 42-year-old man presents to the emergency department (ED) with sudden onset of severe vertigo, headache, nausea, and vomiting after eating Italian food. The patient is anti-coagulated and does well. His blood pressure is 190 over 115. MRI/MRA reveals a right VAD.

Stroke 40

Stroke Documentation/Coding Poisoning Emergency Department 40

Mind The Bleep

SEPTEMBER 12, 2023

Trisomy 21 (T21) / Prader Willi Congenital infections, TORCH (or SCORTCH ) Acquired infections (sepsis) Peroxisomal disorders, e.g. neonatal adrenoleukodystrophy, Zellwegers syndrome Iatrogenic / poisoning, e.g. benzodiazepines / atracurium Congenital Hypothyroidism Hypoglycaemia Inborn errors of metabolism, e.g. mucopolysaccharidoses, amino acidurias, (..)

Sepsis 52

Sepsis Seizures Poisoning Wellness 52

ACEP Now

FEBRUARY 11, 2024

4 It is believed that substantial gastrointestinal loss causes chloride and potassium depletion, as well as hypovolemia, acute kidney injury, and renal potassium loss. Poison centers see nearly 1,500% increase in calls related to injected weight-loss drugs as people accidentally overdose. Diabetes Care. 2018;41:258–66. CNN website.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

Pediatric Education

MARCH 24, 2024

Some people recommend boiling these utensils for 5 minutes as well. Wash with hot soapy water, rinse and dry all bottles, cups, nipples, rings or other equipment (including breast pumping equipment). For glass bottles, a dishwasher with heated water and hot drying cycle can be used. which can also touch the formula.

Pediatrics 40

Pediatrics Poisoning Research Wellness 40

Pediatric Education

NOVEMBER 12, 2023

weeks was seen for well-care. Bull MJ, Engle WA, The Committee on Injury and Poison Prevention and the Committee on Fetus and Newborn. Patient Presentation A former 35 week, appropriate for gestational age male, now 37.5 To view current news articles on this topic check Google News. Pediatrics. 2009;123(5):1424-1429. doi:10.1542/peds.2009-0559

Pediatrics 40

Pediatrics Poisoning Hospitals Documentation/Coding 40

Pediatric Education

MAY 7, 2023

The fever was responsive to antipyretics, and he was taking some dextromethorphan as well. What are services that a poison center can offer? Maximum temperature was 102.4F 5 days ago. The last recorded temperature was the evening before at 100.1F. Questions for Further Discussion 1. What are some common toxidromes?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Infectious Diseases Pediatrics Poisoning 40

Taming the SRU

APRIL 10, 2023

5] There are reports of OAHL occurring after oral, intranasal, intravenous, and transdermal administration, as well as one case of intra-arterial administration. Opioid-Associated Hearing Loss: A 20-Year Review from the New Jersey Poison Center. Journal of Medical Toxicology. 2013;9(2):179-183. Journal of Medical Toxicology.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Administration Emergency Department 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

2) Hypoxia, including poisons of oxidative phosphorylation such as HS, CO, CN. 3) Anemia, or poisons of hemoglobin such as methemoglobin or CO 4) Fixed coronary stenosis that limits flow. Hypotension may of course be a result of a brady- or tachydysrhythmia. I would immediately intubate a patient who is this ill.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

RebelEM

FEBRUARY 15, 2024

Additionally, intubation can risk hemodynamic instability as well as hypoxemia from the procedure itself. 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. Paper: Freund Y et al.

Poisoning 141

Poisoning Airway Management Seizures Shock 141

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. 1 The choice of GI decontamination should be made with toxicologist / poison control review and recommendation, and possibly including endoscopist input. 2 L/hr in adults. McGraw Hill; 2019.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

Northwestern EM Blog

FEBRUARY 4, 2025

Poison control was consulted for additional workup due to concern for Kratom toxicity. Although no confirmatory testing is available, poison control believed there was a reasonable likelihood Kratom toxicity contributed to the patients likely seizure. Just over half of these cases required medical intervention.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

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?

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

SEPTEMBER 7, 2023

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.

Poisoning 91

Poisoning CDC Administration Emergency Department 91

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. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S. in wetlands, rivers, and lake areas Coral snakes inhabit the southern U.S. Basics are best!

CDC 130

CDC Poisoning Pediatrics Shock 130

EMDocs

AUGUST 15, 2023

Treatment of snakebite poisoning. Clinical Pearls: Most snake envenomations in the US are caused by pit vipers (crotalidae) and are characterized by local tissue injury and coagulopathic effects Copperhead and cottonmouth ( Agkistrodon sp. Am J Hosp Pharm. 1991;48(10):2190-2196. Venomous Snakes | NIOSH | CDC. Published April 15, 2022.

Poisoning 98

Poisoning CDC Administration EMS 98

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. From Mullens et al., Forrester, M.B.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Sensible Medicine

SEPTEMBER 3, 2024

It is well-recognized that our commercial drug development process, a process that has led to so many nearly miraculous advancements, serves people with rare diseases poorly. Sensible Medicine readers appreciate a well-designed clinical trial. Your supervisor says, “Look, the plant has some similarities to poison ivy.

Pediatrics 81

Pediatrics Poisoning Research Military 81

EMDocs

JUNE 25, 2024

Consider escharotomy if there is any issue with perfusion or neurologic deficit, as well as difficult ventilation in the intubated patient. 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.

Burns 96

Burns Fluid Resuscitation Resuscitation Poisoning 96

ALiEM

MARCH 5, 2024

How can people become poisoned with willow bark? Cases of toxicity have been reported following ingestion of supplements as well as ingestion of willow bark tea [4,5]. 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].

Hyperthermia / Hypothermia 114

Hyperthermia / Hypothermia Anaphylaxis Poisoning Administration 114