ALiEM

FEBRUARY 5, 2024

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to toxicology in the Emergency Department. Reference Lin M, Phipps M, Chan TM, et al.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

Pediatric EM Morsels

OCTOBER 27, 2023

Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. 2010) ‘140: Does physician estimates of pediatric patient weights lead to inaccurate medication dosages’, Annals of Emergency Medicine , 56(3), p. Academic Emergency Medicine, 14: 500-501. Ann Emerg Med.

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

ACEP Now

JULY 7, 2023

CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. Xylazine is a veterinary sedative that has been increasingly implicated in overdose deaths throughout the United States. percent of all overdose deaths in 2020. References Friedman J, et al. Alexander RS, et al.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

ACEP Now

JULY 7, 2023

Emergency departments (EDs) focus on rapid initiation of medical treatment. Patients with opiate overdose get naloxone. References American College of Emergency Physicians Clinical Policies Subcommittee on the Adult Psychiatric P, Nazarian DJ, Broder JS, et al. Ann Emerg Med. West J Emerg Med.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

REBEL EM

JUNE 5, 2023

Background Information: Opioid overdose deaths have been increasing in the past twenty years. The national number of overdose deaths from any opioid has increased 62.5% In addition, buprenorphine has a lower risk of death from overdose when compared to methadone (2). PMID 33392580. Characteristics: Mean age 35.5 Homeless: 32.6%

Naloxone 88

Naloxone ED Overdose Emergency Department 88

EMDocs

JANUARY 17, 2024

She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). What are the treatment options for a benzonatate overdose? Management: The mainstay of treatment of benzonatate overdose is supportive and symptomatic care.

E-9-1-1 84

E-9-1-1 Overdose Emergency Medical Services Life Support 84

ACEP Now

JANUARY 5, 2025

The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergency departments (EDs) and intensive care units. He is the Annals of Emergency Medicine podcast co-host and Journal Club editor. References Gibbs KW, Semler MW, Driver BE, et al.

ALS 40

ALS E-9-1-1 ED Emergency Department 40

EMDocs

SEPTEMBER 7, 2023

Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. Metabolism of DEG adapted from Bessenhofer, et al. 2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department.

E-9-1-1 87

E-9-1-1 ALS Plasma Emergency Department 87

REBEL EM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. Click here for Direct Download of the Podcast Paper: Knack SKS et al. References: Knack SKS et al. Range 5 to 9) Etomidate: 7.0 95% CI -1.4

ED 93

ED ICU Emergency Department Overdose 93

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Carsten L, et al. Monika BM, Martin D, Balthasar E, et al.

Defibrillator 106

Defibrillator CPR Epinephrine Life Support 106

ACEP Now

MAY 8, 2023

1,2 With such enormous popularity it is no surprise that each year there are 56,000 emergency department (ED) visits, 2,600 hospitalizations, and 500 deaths in the U.S. 1,2 With such enormous popularity it is no surprise that each year there are 56,000 emergency department (ED) visits, 2,600 hospitalizations, and 500 deaths in the U.S.

Overdose 52

Overdose ALS OR EMS 52

EMDocs

JUNE 5, 2024

doi:10.1016/0002-9343(89)90302-1 Guglielminotti J, Pascal Pernet, Maury É, et al. Negative anion gap and elevated osmolar gap due to lithium overdose. 061057 Wu AHB, McKay C, Broussard LA, et al. doi:10.1373/49.3.357 The post ToxCard: Osmol Gap – Part 2 appeared first on emDOCs.net - Emergency Medicine Education.

Overdose 97

Overdose ALS OR Emergency Department 97

NAEMSP

APRIL 19, 2023

Current AHA guidelines do not recommend routine use of calcium in cardiac arrest (Panchal, et al., Calcium acts as a vasopressor and inotropic agent (Lindqwister, et al., risk ratio >1) was 4% for ROSC, 6% for 30 day survival, and 4% for survival with a favorable neurologic outcome at 30 days (Vallentin, et al.,

E-9-1-1 52

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

EMDocs

JULY 30, 2024

3 When administered early after overdose, nicotinamide may decrease the severity of toxicity. doi: 10.1056/NEJM198001103020202 Buonvicino D, Mazzola F, Zamporlini F, et al. The father reported the patient was in his usual state of health approximately two hours ago. Empiric treatment is recommended given low toxicity of nicotinamide.

Overdose 72

Overdose ED Emergency Department OR 72

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 87

Overdose E-9-1-1 ALS Emergency Department 87

Don't Forget the Bubbles

SEPTEMBER 6, 2023

14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. A 2023 Quality Improvement (QI) project involved the introduction of a medical clearance algorithm for children presenting with psychiatric emergencies. Acad Emerg Med. Ann Emerg Med. Ann Gen Psychiatry.

Emergency Department 119

Emergency Department ED ALS Overdose 119

The Skeptics' Guide to EM

AUGUST 18, 2018

[display_podcast] Date: August 16th, 2018 Reference: Hohl C et al. Prospective Validation of Clinical Criteria to Identify Emergency Department Patients at High Risk for Adverse Drug Events. Guest Skeptic: Dr. Chris Bond is an emergency physician and clinical lecturer at the University of Calgary. Reference: Hohl C et al.

Emergency Department 130

Emergency Department Overdose ED ALS 130

Pediatric EM Morsels

SEPTEMBER 1, 2023

One such vital aspect of pediatric emergency medicine is the appreciation of how psychosocial history impacts a patient’s life and care. As previously mentioned by Dr. Richardson , adolescents use the Emergency Department as their Primary Care resource often. Cappelli M, Gray C, Zemek R, et al. Pediatrics.

ED 164

ED Emergency Department Overdose ALS 164

REBEL EM

DECEMBER 19, 2022

REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. The fragility index of these findings found to be 1 for VC and 9 for DED Obtaining a second defibrillator in the emergency department or intensive care unit can be very easy to do.

Defibrillator 52

Defibrillator Paramedic CPR EMS 52

The Skeptics' Guide to EM

DECEMBER 28, 2024

Date: December 26, 2024 Reference: Steinhauser S et al. Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder. She is anAssistant Professor and Director of Research in theDepartment of Emergency Medicine at the NYU Grossman Long Island Hospital Campus.

Emergency Department 222

Emergency Department Overdose ED ALS 222

ALiEM

JANUARY 6, 2025

The pain worsened today, prompting him to come to the emergency department for evaluation. Necrotizing fasciitis Case Question: Will naloxone reverse a xylazine overdose? Thus, Narcan is reasonable to administer in the setting of a suspected overdose since the patients presentation can be due to combined use.

NARCAN 141

NARCAN Overdose Naloxone Emergency Department 141

EMDocs

JANUARY 22, 2025

Is there an ideal observation period in the emergency department after reversal with naloxone? Background: Fentanyl has contributed to a significant increase in drug overdose deaths in recent years. Data suggest that the first month and in particular the first 48 hours after overdose carry a significant risk of death.

Naloxone 93

Naloxone E-9-1-1 Overdose NARCAN 93

ACEP Now

FEBRUARY 11, 2025

A 33-year-old male with a history of drug use presented to the emergency department (ED) for extreme agitation after receiving two doses of 2 mg naloxone by EMS for respiratory depression. He was admitted for a suspected kratom overdose and acute kratom withdrawal. Gummin DD, Mowry JB, Beuhler MC, et al. 2022;23(1):4-9.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89