Pediatric EM Morsels

JUNE 16, 2023

Sometimes this can be used to our advantage, like when we need to give subcutaneous fluids to a dehydrated patient without an IV, or when we need to give SQ medications for things like Sulfonylurea overdose , Hereditary Angioedema , or DVTs. 2022) Morel-lavallee lesions – diagnosis and practical management of these troublesome injuries!

Overdose 154

Overdose OR Critical Care ALS 154

Don't Forget the Bubbles

SEPTEMBER 6, 2023

A 2022 CDC report showed an overall trend of increasing mental health-related ED visits for children and young people aged 0-17 from 2019 to 2022. Published 2022 Jun 13. Published 2022 Feb 25. Mental health-related ED visits for children and young people are common and have been on the rise during the last decade.

Emergency Department 119

Emergency Department ED ALS Overdose 119

First Responders Foundation

DECEMBER 31, 2024

Initially an independent contract Attorney in 2022, Chief Dittman came to TXPSI with experience practicing law for over ten years in the areas of criminal defense, government liaison, administrative law, and family law. Dittman Division Chief, Internal Affairs Division, Texas Public Safety and Investigations (TXPSI LLC.)

Public Safety 52

Public Safety Emergency Medical Technician First Responder Emergency Medical Services 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

It is relieved with rest." == MY Comment, by K EN G RAUER, MD ( 11/1 /2022 ): == Like Dr. Smith — I interpreted the initial ECG in today’s case without the benefit of any history. Precordial Swirl in ECG #1: As discussed in the October 15, 2022 post in Dr. Smith's ECG Blog — Drs. Chest pain is squeezing or tight in nature.

Overdose 52

Overdose OR Coronary ACS 52

EM Literature of Note

MARCH 2, 2023

Here are a few of the highlights from around the remaining published literature we’ve looked at recently: Delayed QT Prolongation: Derivation of a Novel Risk Factor for Adverse Cardiovascular Events From Acute Drug Overdose Heads Up!

Overdose 52

Overdose Emergency Department EMS 52

NAEMSP

APRIL 19, 2023

Calcium is also frequently used in the treatment of hyperkalemia, calcium channel blocker overdose, hypermagnesemia, and hypocalcemia and may be more likely to be used when one of these diagnoses is the suspected cause of cardiac arrest. Vallentin, Povlsen, Granfeldt, Terkelsen, & Andersen, 2022).

E-9-1-1 52

E-9-1-1 Advanced Life Support Overdose CPR 52

EMDocs

JUNE 2, 2023

2022 May 11;12(5):e059876. mg/kg/dose (PO/IM/IV) Midazolam – 0.25-0.5 mg/kg/dose PO; 0.2-0.3 mg/kg IN; 0.1-0.15 Wong AH, Ray JM, Eixenberger C, Crispino LJ, Parker JB, Rosenberg A, Robinson L, McVaney C, Iennaco JD, Bernstein SL, Yonkers KA, Pavlo AJ. doi: 10.1136/bmjopen-2021-059876. PMID: 35545394; PMCID: PMC9096567.

Emergency Department 92

Emergency Department Emergency Medical Services Overdose ED 92

EMDocs

APRIL 10, 2024

Poisoning & Drug Overdose. McGraw Hill; 2022. Intravenous Lipid Emulsion for Local Anesthetic Toxicity: A Review of the Literature. J Med Toxicol. 2008;4(3):184-191. doi:10.1007/BF03161199 Olson K, Smollin C, eds. Walters E, Wurster Ovalle V, Yin S, Dribin T. BMJ Case Rep. 2020;13(1):e233119.

E-9-1-1 111

E-9-1-1 Plasma Epinephrine Life Support 111

REBEL EM

SEPTEMBER 1, 2022

Resus 2022. Although the results of both the short and long-term outcomes of the COCA trial do not support the use of calcium in all patients with OHCA, there are some populations that may still benefit from this treatment including patients with hyperkalemia, hypocalcemia, and calcium channel blocker overdose. Resus 2022.

Epinephrine 52

Epinephrine Overdose ALS OR 52

Handtevy

AUGUST 15, 2022

Sodium bicarbonate is indicated for select patients including preexisting metabolic acidosis, hyperkalemia, or tricyclic antidepressant overdose. However, many providers are still administering it for cardiac arrests even though we know it makes matters worse.

CPR 52

CPR ICU Overdose Critical Care 52

FOAMfrat

AUGUST 28, 2024

There are many underlying causes, such as stroke, central nervous system depression (opioid overdose, etc.), 2022, www.ncbi.nlm.nih.gov/books/NBK507807/. and muscular insufficiencies from conditions such as myasthenia gravis. o Respiratory alkalosis results from hyperventilation secondary to some other pathology.

Critical Care 98

Critical Care Overdose OR ALS 98

First Responders Foundation

DECEMBER 31, 2024

Initially an independent contract Attorney in 2022, Chief Dittman came to TXPSI with experience practicing law for over ten years in the areas of criminal defense, government liaison, administrative law, and family law. Dittman Division Chief, Internal Affairs Division, Texas Public Safety and Investigations (TXPSI LLC.)

Public Safety 52

Public Safety Emergency Medical Technician First Responder Emergency Medical Services 52

ACEP Now

FEBRUARY 11, 2024

There have been documented cases of overdose, and of note, there is no known antidote. Poison centers see nearly 1,500% increase in calls related to injected weight-loss drugs as people accidentally overdose. Updated December 11, 2022. Diabetes Care. 2018;41:258–66. CNN website. Published December 18, 2023. 2006;47(12):2207.

Overdose 52

Overdose ACS Plasma ALS 52

REBEL EM

DECEMBER 19, 2022

2022 Nov 6 PMID: 36342151 Clinical Question: How does double defibrillation and vector change defibrillation compare to standard therapy in OHCA patients with refractory ventricular fibrillation? 2022 Nov 6 PMID: 36342151 Cheskes S, et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. N Engl J Med.

Defibrillator 52

Defibrillator Paramedic CPR EMS 52

Peter Canning

NOVEMBER 27, 2024

decrease in overdoses in Connecticut since November 2021 based on rolling 12-month averages with the latest 12-month period ending June 2024. After the presentation I saw in the chat a comment about white overdoses being down, but minority overdoses still rising. Black opioid overdose deaths declined 9.1%

Overdose 52

Overdose EMS 52

ALiEM

NOVEMBER 29, 2023

Recently, xylazine has gained attention in the media with increasing reports of xylazine-related overdose deaths in patients. When combined with illicit opioids such as heroin and fentanyl, xylazine may increase the risk of fatal overdose given the augmented sedation and respiratory depression effects [2]. Published 2022 Aug 19.

Naloxone 169

Naloxone Overdose Epinephrine ALS 169

FOAMfrat

DECEMBER 26, 2024

Unlike other methods, such as firearms, hangings, intentional overdoses, and cutting, chemical suicides tend to linger in the area where the act was committed. As (Narayan & Petersen, 2022)explains, SulfHb is a stable, green-pigmented molecule, which constitutes less than 1% of normal hemoglobin invivo. 2018, 05 21).

Epinephrine 116

Epinephrine First Responder OR Emergency Management 116

The Skeptics' Guide to EM

AUGUST 27, 2022

Date: August 23rd, 2022 Reference: Schoenfeld et al. AEM August 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: August 23rd, 2022 Reference: Schoenfeld et al. He is successfully resuscitated using naloxone and is stable after an observation period.

Emergency Department 100

Emergency Department Naloxone Overdose ED 100

FOAMfrat

JUNE 3, 2024

Right as you’re making your bunk you get dispatched for a reported overdose with police enroute, no further information. We go into it with preconceptions of what to expect: “It’s a simple heroin overdose, we’ll wake them up and they’ll refuse, then we’ll go back to bed”. 21, 2022, p. 2022, July 6). Loiseau, M.,

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Overdose Ambulance First Responder ALS 98

EMDocs

JANUARY 4, 2024

Questions: What are the clinical manifestations of bupropion overdose? How is bupropion overdose treated? How long should a patient be observed after a bupropion overdose? 1 In addition to intentional overdoses, there are multiple case studies of abuse (ingestion, insufflation, injection). hours, SR 3 hours, XL 5 hours.

Overdose 91

Overdose E-9-1-1 ALS Emergency Department 91

Peter Canning

JANUARY 20, 2024

I have called the time on a number of her neighbors in this building, some of them victims of overdose. While the news often focuses on the dangers of fentanyl to youth, what I see on the street and what the data shows is that the group that is seeing the biggest increase in overdoses is the elderly. of all overdoses to 11.1%.

Overdose 59

Overdose Naloxone Firefighter First Responder 59

ACEP Now

JULY 7, 2023

Xylazine is a veterinary sedative that has been increasingly implicated in overdose deaths throughout the United States. percent of all overdose deaths in 2020. 1 Known by street names such as “tranq,” “tranq-dope,” or “zombie drug,” xylazine is increasingly found in patients with opioid overdose. Published online October, 2022.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

Peter Canning

OCTOBER 1, 2024

Is the decline in drug overdose deaths more related to the increased availability of naloxone, improved treatment for people who use drugs, or changes in the street drug supply, which while still quite toxic may be less so due to adulteration with other chemicals? A recent article in NPR, The pipeline of deadly fentanyl into the U.S.

Overdose 52

Overdose Naloxone OR 52

EMDocs

JANUARY 17, 2024

What are the treatment options for a benzonatate overdose? 7) Overdose literature review timeline: In 1986, the first two benzonatate fatalities were reported in the literature: a choking infant and an intentional overdose in a teenager. (8) There is no specific toxidrome or antidote for a benzonatate overdose.

E-9-1-1 89

E-9-1-1 Overdose Emergency Medical Services Life Support 89

Peter Canning

MAY 22, 2024

Drug overdose deaths are down 3.1% 107,543 people died of drug overdoses in 2023 down from 111,029 in 2022. Here in Connecticut, drug overdose deaths have been decreasing for the last two years (down 14% in 2023 from the 2021 high). Ten years ago when I responded to an overdose, I was the only one carrying naloxone.

Overdose 52

Overdose Naloxone First Responder OR 52

REBEL EM

JUNE 12, 2024

According to the 2022 Annual Report of the National Poison Data System from America’s Poison Center, CCBs and BBs account for the sixth and seventh largest number of fatalities from overdose. 2022 Annual Report of the National Poison Data System ® (NPDS) from America’s Poison Centers ® : 40th Annual Report.

Epinephrine 101

Epinephrine Overdose OR ALS 101

Peter Canning

MARCH 5, 2024

Connecticut opioid-related deaths declined for the second year in a row, down 14% from their 2021 high of 1431 opioid deaths, according to the latest statistics from the Connecticut Office of the Medical Examiner (OCME). Opioid deaths represented 92% of all overdose deaths in Connecticut.

Overdose 52

Overdose Naloxone EMS OR 52

ACEP Now

MAY 8, 2023

Unfortunately, most cases are not so simple, with half of them being unintentional overdoses, many with a delayed presentation; some with delayed-release formulations, combined formulations, or co-ingestions, and some in patients with co-morbidities—all factors that make recognition and management more challenging. for death. for death.

Overdose 52

Overdose ALS OR EMS 52

EMDocs

SEPTEMBER 7, 2023

Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. Accessed August 2022. FDA Consumer Magazine , June 1981, [link] Accessed August 2022. Accessed August 2022. DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity.

E-9-1-1 91

E-9-1-1 ALS Emergency Department Plasma 91

This Podcast Will Kill You

AUGUST 20, 2024

2022 Annual Report of the National Poison Data System®(NPDS) from America’s Poison Centers®: 40th Annual Report. CDC: May 14, 2024 Drug Overdose Death Rates. .” American Journal of Diseases of Children 137.9 1983): 870-873. Gummin, D.D., Mowry, J.B., Beuhler, M.C., Spyker, D.A., Rivers, L.J., Feldman, R., Bronstein, A.C.

Overdose 52

Overdose ALS 52

This Podcast Will Kill You

AUGUST 13, 2024

2022 Annual Report of the National Poison Data System®(NPDS) from America’s Poison Centers®: 40th Annual Report. CDC: May 14, 2024 Drug Overdose Death Rates. .” American Journal of Diseases of Children 137.9 1983): 870-873. Gummin, D.D., Mowry, J.B., Beuhler, M.C., Spyker, D.A., Rivers, L.J., Feldman, R., Bronstein, A.C.

Overdose 52

Overdose ALS 52

EMDocs

JANUARY 16, 2024

In our case, the patient had accidentally overdosed on drugs prior to being found. Accessed December 4, 2022 Swol, Justyna; Darocha, Tomasz; Paal, Peter; Brugger, Hermann; Podsiadło, Paweł; Kosiński, Sylweriusz; Puślecki, Mateusz; Ligowski, Marcin; Pasquier, Mathieu. Published 2022 Jan 3. doi: 10.1097/MAT.0000000000001518

Defibrillator 109

Defibrillator CPR Epinephrine Life Support 109

ACEP Now

OCTOBER 3, 2023

Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. Accessed 2022, [link]. The GCS must be obtained through interaction with the patient (i.e., Prehosp Emerg Care. J Safety Res.

Emergency Medical Services 98

Emergency Medical Services EMS OR Overdose 98

Handtevy

AUGUST 25, 2022

Overdoses do occur when using the IV form. This study confirms that in pediatrics Ketamine is mainly used for pain control and is highly effective. We’d advise agencies to consider non-IV routes (IM/IN/NEB) in kids to ensure safety and reduce errors. Read the study here: [link] Peter Antevy, MD Source: Goyal, A., Frawley, J.,

Overdose 52

Overdose EMS Emergency Department Ambulance 52

Dr. Smith's ECG Blog

JULY 21, 2024

These are also the most commonly reported findings in toxic overdoses with ventricular arrhythmias being reported as the leading cause of death. Meyers and Smith illustrate 20 example cases vs "look-alikes" of Swirl ( with my synthesis of "Swirl" ECG findings in My Comment on that post ) from October 15, 2022.

Defibrillator 131

Defibrillator Coronary ALS STEMI 131

EMDocs

DECEMBER 16, 2023

Updated 2022 Oct 24]. Temps greater than 41.5C per minute) 1,4 Body bag may be utilized if no immersion tank available 3 Evaporative cooling (DT 0.1C Neurogenic fever due to injury of the hypothalamus in a stroke patient: Case report. Medicine , 100 (13), e24053. link] Sánchez-Manso JC, Gujarathi R, Varacallo M. Autonomic Dysfunction.

EMS 94

EMS Heatstroke Emergency Department First Aid 94

Pediatric EM Morsels

SEPTEMBER 1, 2023

In a teen who presents with vomiting and abdominal pain, is this “just” viral gastroenteritis, or could this be a Tylenol overdose ? Pediatrics June 2022; 149 (6): e2021053458. Suicidality Suicide is the 3rd leading cause of death in the USA for people 10-24 years. Moral of the Morsel This is our lane. Ancker, Lisa Krams, Emily C.

ED 164

ED Emergency Department Overdose ALS 164