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Questions: What are the symptoms of second-generation antipsychotic overdose? How is second-generation antipsychotic overdose diagnosed? What is the treatment for patients who have overdosed on second-generation antipsychotics? 4 The specific incidence of second-generation antipsychotic drug overdose is unknown, however, 4.7%
Pilot Testing Fentanyl Test Strip Distribution in an EmergencyDepartment Setting: Experiences, Lessons Learned, and Suggestions from Staff. AEM June 2023 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate.
He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. […] The post SGEM#374: Bad Habits – Medications for Opioid Use Disorder in the EmergencyDepartment first appeared on The Skeptics Guide to Emergency Medicine. Date: August 23rd, 2022 Reference: Schoenfeld et al.
Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergencydepartment: A randomized controlled trial. Reference: Ramesh S, Ayyan SM, Rath DP, Sadanandan DM. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta.
Do heroin overdose patients require observation after receiving naloxone? Guest Skeptic: Dr. Richard Hamilton (@RJHamiltonMD) is Chair of the Department of Emergency Medicine at Drexel University College of Medicine. Do heroin overdose patients require observation after receiving naloxone? Clinical Toxicology 2017.
The EMS crew observes drug paraphernalia and suspect an intravenous (IV) opioid overdose. He is alert and oriented times three with normal vital signs by the time he arrives in the emergencydepartment. 1] Two-thirds of the all the drug overdoses in the US in 2016 (63,632) involved an opioid (42,249). [2]
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 EmergencyDepartment. More specifically, we identified 3 AIR and 5 Honorable Mentions.
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 May 2023.
Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. The PAWPER tape as a tool for rapid weight assessment in a Paediatric EmergencyDepartment: Validation study and comparison with parents’ estimation and Broselow tape. Int J Emerg Med.
Emergencydepartments (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. Ann Emerg Med.
CASE A 30-year-old woman presents to the emergencydepartment 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. She reports fevers up to 103 degrees Fahrenheit.
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%
The Case An elderly male with a past medical history of hypertension and diabetes presents to the emergencydepartment with a chief complaint of diarrhea and shortness of breath. His vital signs are: HR 60, BP 105/65, RR 30, O2 100% on room air, oral T 98.6 F, and FSG 120. His only medications were lisinopril and metformin.
IF YOU OR A LOVED ONE NEEDS HELP, CALL 988 OR SEEK CARE AT A LOCAL EMERGENCYDEPARTMENT. Unlike other methods, such as firearms, hangings, intentional overdoses, and cutting, chemical suicides tend to linger in the area where the act was committed. TRIGGER WARNING: TOPICS OF SUICIDE MAY BE HARD FOR SOME PEOPLE TO READ ABOUT.
The Case An elderly male with a past medical history of hypertension and diabetes presents to the emergencydepartment with a chief complaint of diarrhea and shortness of breath. His vital signs are: HR 60, BP 105/65, RR 30, O2 100% on room air, oral T 98.6 F, and FSG 120. His only medications were lisinopril and metformin.
She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergencydepartment (ED). What are the treatment options for a benzonatate overdose? Management: The mainstay of treatment of benzonatate overdose is supportive and symptomatic care.
Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the EmergencyDepartment: Consensus Statement of the American Association for Emergency Psychiatry. Erratum in: West J Emerg Med. Pediatric Agitation in the EmergencyDepartment: A Survey of Pediatric Emergency Care Coordinators.
8 However, it is not considered first line in treatment of anticholinergic toxicity and is not available in all emergencydepartments. Use of a physostigmine continuous infusion for the treatment of severe and recurrent antimuscarinic toxicity in a mixed drug overdose. Goldfrank’s Toxicologic Emergencies, 11e.
1,2 With such enormous popularity it is no surprise that each year there are 56,000 emergencydepartment (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 emergencydepartment (ED) visits, 2,600 hospitalizations, and 500 deaths in the U.S.
First, and not least, the Annals of Emergency Medicine Podcast , the Ryan and Rory Show, recapping the articles from each month’s issue, available for free on your choice of streaming platforms: Apple Podcasts Google Podcasts Soundcloud Then, there’s always something to learn from ACEP Now!
Background: Standard rapid sequence intubation (RSI) in the emergencydepartment involves administration of an induction agent and a neuroblocking agent in quick succession. appeared first on REBEL EM - Emergency Medicine Blog. Range 5 to 9) Etomidate: 7.0 Range 5 to 9) Diff -0.2; 95% CI -1.4
Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. 2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergencydepartment. Metabolism of DEG adapted from Bessenhofer, et al.
The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergencydepartments (EDs) and intensive care units. Effectiveness of direct admission compared to admission through the emergencydepartment: a stepped-wedge cluster-randomized trial.
Negative anion gap and elevated osmolar gap due to lithium overdose. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the EmergencyDepartment. Can Med Assoc J. 2007;176(7):921-923. doi:10.1503/cmaj.061057
Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergencydepartment (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Am J Emerg Med. 1996;40(3):483-485. Accidental hypothermia.
Background: Ketamine, developed in 1962, has been widely used for pediatric sedation in emergencydepartments before painful procedures. Overdoses do occur when using the IV form. It is effective in treating chronic pain conditions like sickle cell disease. What are our takeaways? Frawley, J., Sandoval, S.,
A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergencydepartment after an episode of syncope while standing in line at a grocery store. Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc. He did not have chest pain. Is it STEMI?
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. Turkish Journal of Emergency Medicine, 22 , 67-74. References: 1. Ramazan, K., S., & Basar, C.
This was not a Code 3 respiratory distress, fentanyl overdose with minimal response to Narcan or even an unconscious stroke patient with the blood pressure of a giraffe. In hindsight, I was not 100% certain, but relaying on my years of training, the voice inside my head and the gnawing feeling in my cut, it felt like the right thing to do.
3 When administered early after overdose, nicotinamide may decrease the severity of toxicity. The father reported the patient was in his usual state of health approximately two hours ago. Activated charcoal can be used to prevent absorption in acute ingestions, presenting within an hour of exposure.
Basic anatomy and physiology, what causes common diseases like diabetes and asthma, and how to treat emergencies associated with them. Depending on the state, EMTs are authorized to administer 10 to 20 different medications, including epinephrine for an anaphylactic reaction, narcan for an overdose, or albuterol for an asthma attack.
On the other hand, you could be called in to attend to the victim of a car accident or a shooting or a heart attack, drowning, mountaineering accident, or drug overdose. You may even have to deliver a baby! You can never predict what will happen over the course of any given shift. Do You Have What It Takes to Become an EMT?
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.
14-year-old Katy presents to the paediatric EmergencyDepartment (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.
Prospective Validation of Clinical Criteria to Identify EmergencyDepartment 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. [display_podcast] Date: August 16th, 2018 Reference: Hohl C et al. AEM Aug 2018. AEM Aug 2018.
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 EmergencyDepartment as their Primary Care resource often. This is particularly true for vulnerable adolescents.
Background: Frequent callers of emergency medical services comprise a disproportionate percentage of emergencydepartment visits. This study aims to describe reasons for calling 911 and healthcare services among frequent callers in Ontario. Methods: Cross-sectional research design.
An 18-month-old boy presents to the emergencydepartment with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergencydepartment , as it can be performed with ongoing resuscitation efforts. Temps greater than 41.5C
The fragility index of these findings found to be 1 for VC and 9 for DED Obtaining a second defibrillator in the emergencydepartment or intensive care unit can be very easy to do. It’s difficult to definitively say which of the two is statistically better, however there is a trend pointing toward DED.
Emergencydepartment 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. Date: December 26, 2024 Reference: Steinhauser S et al.
The pain worsened today, prompting him to come to the emergencydepartment 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.
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