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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

These medications are a vital tool in the care of ED patients, from simple local analgesia for a laceration repair to regional analgesia for painful procedures. Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] Poisoning & Drug Overdose.

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ToxCard: Diethylene Glycol

EMDocs

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. “Fomepizole” in Goldfrank’s Toxicologic Emergencies , 11e Eds.

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Severe shock, obtunded, and a diagnostic prehospital ECG. Also: How did this happen?

Dr. Smith's ECG Blog

This is pathognomonic of hyperkalemia (I suppose it could be due to a massive overdose of a sodium channel blocking drug, maybe). They transported to the ED. The history, obtained subsequently, is interesting: The patient had been seen at an outside ED 2 days prior and the K was 2.5 She was in shock with thready pulses.

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ToxCard: Naloxone – Pearls and Pitfalls

EMDocs

In the ED, he develops recurrent respiratory depression and hypoxia to 80%. Background: Fentanyl has contributed to a significant increase in drug overdose deaths in recent years. How long should they stay in the ED? Clinical Pearls: Naloxone is lifesaving in opioid overdoses. The answer is, its complicated.

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Case Report: Acute Kratom Withdrawal

ACEP Now

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. Todd DA, Kellogg JJ, Wallace ED, et al. Clin Toxicol (Phila).

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ToxCard: Iron

EMDocs

On arrival to the ED the patient’s initial vital signs are temperature 38.5C, BP 102/48, HR 106, RR 20. Historically, iron toxicity and exposure affected children in unintentional overdose disproportionately. Coagulopathy: Parenteral vitamin K and/or fresh frozen plasma (FFP) as clinically indicated. 2 L/hr in adults.

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