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.

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Seizures Poisoning Forensics Emergency Department 72

Emergency Medicine Cases

OCTOBER 11, 2022

The post EM Quick Hits 43 Pediatric Cannabis Poisoning, Esophageal Perforation, Brugada, Career Transitions in EM appeared first on Emergency Medicine Cases.

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Poisoning EMS Pediatrics Wellness 52

Emergency Medicine Cases

AUGUST 27, 2019

In this Rapid Reviews Video Nick Clarridge covers an approach to the bradycardic and hypotensive patient as well as the recognition, management and controversies of digoxin overdose. The post Rapid Reviews Video – Low and Slow Poisoning Part 2: Digoxin Overdose appeared first on Emergency Medicine Cases.

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Poisoning Wellness EMS 52

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.

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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.

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Poisoning Burns Resuscitation Pediatrics 94

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!

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CDC Poisoning Pediatrics Shock 130

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.

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Poisoning CDC Administration Emergency Department 84

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.

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Poisoning Wellness EMS 40

Sensible Medicine

MAY 25, 2024

Imagine if your cancer doctor took money from Karyopharm and then prescribed the toxic poison selenexor (studied in the unethical trial Boston) over safer and cheaper alternatives. Approximately ~100% of academic oncologists eat well every night, don’t lose their homes, send their kids to college, and die with millions in the bank.

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Academics Poisoning Research Wellness 145

ALiEM

OCTOBER 11, 2023

Pufferfish, also known as fugu, is served as a delicacy and perioral numbness is a well-known effect [4]. What is the clinical presentation of tetrodotoxin poisoning following pufferfish ingestion? [4, A cluster of tetrodotoxin poisoning in Oman. Case Report of Tetrodotoxin Poisoning from Lagocephalus sceleratus in Lebanon.

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Poisoning Burns Wellness Outcomes 81

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?

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Poisoning Wellness 113

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?

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Head Injuries Pediatrics Outcomes Shock 246

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.

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Pediatrics Poisoning Research Military 79

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.

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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.

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Burns Fluid Resuscitation PPE Hyperthermia / Hypothermia 52

Taming the SRU

FEBRUARY 7, 2024

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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PPE Administration Ultrasounds Poisoning 98

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.

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Burns Fluid Resuscitation Resuscitation Poisoning 92

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

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.,

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Pediatrics Poisoning Ultrasounds Dehydration 111

EMDocs

JUNE 8, 2024

Post septal (retrobulbar) is higher risk to vision and requires CT imaging to diagnose as well as thorough exam to check for proptosis, afferent pupillary defect, increased intraocular pressure [7]. Posttraumatic Iridocyclitis – Injuries; Poisoning.” Orbital hemorrhage: preseptal is less dangerous and more obvious on exam.

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EMS Allergic Reactions Poisoning Emergency Department 96

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.

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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?

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Poisoning EKG/ECG Wellness 52

ACEP Now

APRIL 2, 2024

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. Ackee fruit poisoning in eight siblings: implications for public health awareness. References Katibi OS, Olaosebikan R, et al.

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Poisoning Administration Documentation/Coding Urgent Care 40

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 (..)

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Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 84

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

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

ALiEM

NOVEMBER 29, 2023

In patients with skin changes, consider topical wound care as well as further evaluation of deep tissue infections, osteomyelitis, and ischemia. Xylazine Poisoning: A Systematic Review. In patients with minimal response to naloxone, xylazine toxicity may be suspected [10]. Clin Toxicol (Phila). 2023 Mar;61(3):173-180.

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Forensics Administration Poisoning Emergency Department 67

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.

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Ultrasounds Poisoning EMS Burns 52

Sensible Medicine

OCTOBER 8, 2024

We received this essay from Dr. Bernhard Ortel, a dermatologist who has spent a career studying the physics and medical effects of solar radiation as well as treating its consequences. This is most well appreciated with depression (e.g., Adam Cifu Sensible Medicine is a reader-supported publication.

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Poisoning Wellness Research Outcomes 73

PulmCCM

DECEMBER 3, 2023

Well, that would be ground-breaking and practice-changing, to say the least. This review in poisoned patients suggested early intubation was associated with lower rates of aspiration pneumonia, but most others did not. But there was a whopping 6% absolute reduction in all-cause mortality (11.6% vs 17.6%) in the sigh-ventilation group!

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Poisoning Hospitals Outcomes Academics 64

The Skeptics' Guide to EM

JANUARY 23, 2021

The difference in training between and emergency medicine physician and APPs is well recognized. They also excluded those with a triage level ESI 1 or 5, as these are less common, as well as those with a final diagnosis of injury or poisoning – as in those cases the diagnosis would generally be apparent.

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Poisoning Research Documentation/Coding Operations 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.

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Infectious Diseases Airway Management Resuscitation Poisoning 52

Emergency Medicine Ireland

MAY 27, 2024

This is a somewhat philosophical approach that reminds us that the PA pressures themselves don’t prognosticate especially well but a failure of flow from right to left will result in cardiogenic shock and death. The ventilator is a bit of a poisoned chalice. Well, take a step back to start with. We probably need the CVP more.

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Poisoning Shock Wellness 52

Taming the SRU

DECEMBER 11, 2023

In conjunction with the Drug and Poison Information Center (DPIC), intravenous methylene blue was initiated for suspected methemoglobinemia with moderate improvement of her symptoms over the next hour, including return of baseline mental status and resolution of hypoxia. Despite supplemental oxygen, she remained hypoxic.

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EMS Psychiatric Emergency Department Poisoning 97

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.

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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.

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Infectious Diseases Airway Management Dislocations Poisoning 52

EB Medicine

SEPTEMBER 1, 2018

Nachi: And don’t forget our peer reviewers this month, Dr. Daniel Sessions, a medical toxicologist working at the South Texas Poison Center, and our very own editor-in-chief, Dr. Andy Jagoda, who is also Chair of the Department of Emergency Medicine at Mount Sinai in New York City. Jeff: What a team! But, let’s get back to the snakes.

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Emergency Department Poisoning Anaphylaxis Allergic Reactions 40