E-9-1-1 and Overdose - Paramedicine Now

The Broselow-Luten System

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%. Initially tested in Johannesburg, South Africa: 1 month old to 12 years old Broselow predicted within 10% of weight in 63.6% 2007-2902 Wells M, Coovadia A, Kramer E, Goldstein L. 2020;13(1):9.

E-9-1-1

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

20-something with huge verapamil overdose and cardiogenic shock

Dr. Smith's ECG Blog

MAY 26, 2023

A 20-something presented after a huge verapamil overdose in cardiogenic shock. And she does not know that this is an overdose; she thinks it is a patient with chest pain!! Comment on High Dose Insulin and Calcium Channel Blocker Overdose I do not have any explanation for the ST-T abnormalities here. Learning Points: 1.

Overdose

Overdose E-9-1-1 Coronary ICU

ToxCard: Benzonatate

EMDocs

JANUARY 17, 2024

What are the treatment options for a benzonatate overdose? 1) There are a limited number of antitussives on the US market which include benzonatate, codeine, dextromethorphan, diphenhydramine, and hydrocodone. 9) The safety announcement highlighted the mortality risk of exploratory ingestions in children under 10 years.

E-9-1-1

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

ToxCard: Anticholinergic Plant Toxicity

EMDocs

FEBRUARY 15, 2024

1 These plants contain tropane alkaloids such as atropine (mixture of d-hyoscyamine and l-hyoscyamine) and scopolamine which are muscarinic receptor antagonists. 2 Jimson weed ( Datura stramonium, Figure 1) is one of several anticholinergic plants that if ingested can cause anticholinergic toxicity. 3 Figure 1. 3 Figure 1.

E-9-1-1

E-9-1-1 Overdose ED OR

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

REBEL EM

SEPTEMBER 27, 2023

Dosing: 1-2 mEq/kg bolus If there is a response, initiate an infusion: 150 mEq in 1L of D5W at maintenance Severely poisoned patients, may require multiple boluses of sodium-bicarbonate until the QRS narrows. 1985 Aug 22;313(8):474-9. Mohan S, Backus T, Furlano E, Howland MA, Smith SW, Su MK. N Engl J Med. PMID: 4022081.

E-9-1-1

E-9-1-1 Overdose EMS

ToxCard: N-Acetylcysteine for Acetaminophen Toxicity

EMDocs

AUGUST 3, 2023

PMID: 25133498 Ghannoum M, Kazim S, Grunbaum AM, Villeneuve E, Gosselin S. Massive acetaminophen overdose: effect of hemodialysis on acetaminophen and acetylcysteine kinetics. Adverse reactions to acetylcysteine and effects of overdose. Clin Toxicol (Phila). 2014 Sep-Oct;52(8):856-67. doi: 10.3109/15563650.2014.946994.

Overdose

Overdose E-9-1-1 OR ED

ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

APRIL 10, 2024

1-5] Since then, many more medications have been developed and deployed. 1-5] This post focuses on the identification and management of Local Anesthetic Systemic Toxicity (LAST). 3-5,7] Symptom onset is usually within 1 minute of intravascular injection but can be delayed if multiple injections or continuous infusion. [5]

E-9-1-1

E-9-1-1 Plasma Epinephrine Life Support

ToxCard: Diethylene Glycol

EMDocs

SEPTEMBER 7, 2023

1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity? Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. Toxicity typically evolves through three phases: 2,3,7,8,9 Phase 1: Gastrointestinal symptoms (e.g., 1, 2010, pp.

E-9-1-1

E-9-1-1 ALS Emergency Department Plasma

A Relatively Narrow Complex Tachycardia at a Rate of 180.

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

Common culprits in this situation are tricyclic overdose and cocaine toxicity (remember cocaine not only increases dopamine in central synapses, but is also a local anesthetic (-caine!) Vittinghoff, E. Metoprolol and atenolol are overwhelmingly beta-1 cardioselective. due to Na channel blockade. is intuitive, and not surprising.

E-9-1-1

E-9-1-1 Coronary Epinephrine Overdose

An Unusual Bradycardia

Dr. Smith's ECG Blog

MAY 5, 2023

. = Dr. Smith was reading ECGs — and he sent myself and Dr. Meyers the tracing shown in Figure-1. Figure-1: The initial ECG in today's case. Our Initial Thoughts on the ECG in Figure-1: Dr. Meyers said the following: "I see 2 different atrial foci — one sinus and one ectopic. At the time we did not yet know the history.

E-9-1-1

E-9-1-1 NARCAN Naloxone Overdose

Calcium in Out-of-Hospital Cardiac Arrest

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. Calcium acts as a vasopressor and inotropic agent (Lindqwister, et al.,

E-9-1-1

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

2024 Emergency Medicine Research Highlights: Forced Air, Sepsis, and More

ACEP Now

JANUARY 5, 2025

1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent. As it turns out, common sense likely rules the day when presented with patients whose low GCS is the result of a self-limited overdose toxidrome. Theodorou A, Melanis K, Bakola E, et al. 2024;332(19):1623-1633.

ALS

ALS E-9-1-1 ED Emergency Department

ToxCard: Bupropion

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). 3 This is slow!

Overdose

Overdose E-9-1-1 ALS Emergency Department

ToxCard: Naloxone – Pearls and Pitfalls

EMDocs

JANUARY 22, 2025

Background: Fentanyl has contributed to a significant increase in drug overdose deaths in recent years. 1 Most heroin in the United States actually contains fentanyl and fentanyl analogs. Naloxone reverses the analgesic, respiratory, sedative , and miotic e ffects of opioids. 6 Image 1: Structure of naloxone.

Naloxone

Naloxone E-9-1-1 Overdose NARCAN

ToxCard: Iron

EMDocs

DECEMBER 6, 2024

Historically, iron toxicity and exposure affected children in unintentional overdose disproportionately. 1 The incidence of iron overdose and iron ingestion related deaths has significantly decreased over time, likely attributable to federal regulation. 1 Table 1: Iron content of various preparations.

E-9-1-1

E-9-1-1 Frozen Plasma Plasma Overdose

Paramedicine Now

The Broselow-Luten System

20-something with huge verapamil overdose and cardiogenic shock

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ToxCard: Benzonatate

ToxCard: Anticholinergic Plant Toxicity

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

ToxCard: N-Acetylcysteine for Acetaminophen Toxicity

ToxCard: Local Anesthetic Systemic Toxicity

ToxCard: Diethylene Glycol

A Relatively Narrow Complex Tachycardia at a Rate of 180.

An Unusual Bradycardia

Calcium in Out-of-Hospital Cardiac Arrest

2024 Emergency Medicine Research Highlights: Forced Air, Sepsis, and More

ToxCard: Bupropion

ToxCard: Naloxone – Pearls and Pitfalls

ToxCard: Iron

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