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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] 6] Action of local anesthetics is dependent upon the molecule crossing the plasma membrane in a unionized form. [2] If epinephrine is used, small initial doses ( <1 ug/kg) are preferred.

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Transfusion Reactions

Core EM

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

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Transfusion Reactions

Core EM

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

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Spicy Bites - Snake Envenomation

FOAMfrat

Along with inducing coagulopathy, venom toxins may contribute to local and/or systemic hemorrhage and plasma extravasation by means of basement membrane degradation within the vasculature. These side effects do not contraindicate antivenom administration and can be treated with antihistamines and epinephrine. Accessed 10 July 2024.

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Sepsis Updates Relevant to the Emergency Physician

EMDocs

Multiple studies published in 2022 have indicated that, despite disagreement surrounding prognostic accuracy, no such screening tool so far exists. The first was the suggestion to use balanced crystalloid fluids, such as lactated ringers or plasma-lyte, instead of normal saline. 32,33 Once the dose of norepinephrine is between 0.25-0.5

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