Core EM

JANUARY 25, 2024

Background: An update to our 2015 post on HIET for beta-adrenergic receptor and calcium channel antagonists overdose. Beta-adrenergic receptor antagonists (Beta blockers, BB) and calcium channel antagonists (calcium channel blockers) are common drugs that can produce profound cardiac depression and shock when taken in overdose.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

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]. MMWR Morb Mortal Wkly Rep.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

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%. link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. 2012.05.028 Silvagni D, Baggio L, Mazzi C, et al. doi:10.1111/1742-6723.12389 Zhu S, Zhu J, Zhou H, et al. Zaritsky, A.,

E-9-1-1 268

E-9-1-1 Emergency Medical Services Life Support ALS 268

REBEL EM

SEPTEMBER 1, 2022

Paper: Vallentin MF et al. 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.

Epinephrine 52

Epinephrine Overdose ALS 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. References Gummin DD, Mowry JB, Beuhler MC, et al. Insulin versus vasopressin and epinephrine to treat beta-blocker toxicity. Circulation.

Epinephrine 99

Epinephrine Overdose OR ALS 99

EMDocs

APRIL 10, 2024

1,2] Consider using a physiological marker to help identify inadvertent vascular injection, such as epinephrine. [3] If epinephrine is used, small initial doses ( <1 ug/kg) are preferred. Poisoning & Drug Overdose. doi:10.1136/bcr-2019-233119 Neal JM, Barrington MJ, Fettiplace MR, et al. J Med Toxicol.

E-9-1-1 93

E-9-1-1 Plasma Epinephrine EMS 93

EMDocs

JANUARY 16, 2024

The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU. Carsten L, et al.

Defibrillator 84

Defibrillator CPR Epinephrine Life Support 84