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The Intervals Aren’t Alright!

Core EM

Hyperkalemia, Sodium-channel blockade (ex: tricyclic acid overdose), Pre-excitation syndromes (ex: Wolff-- Parkinson-White syndrome), Aberrant conduction (ex: bundle branch blocks), Ventricular-Paced beats, Hypothermia, Ventricular ectopy What immediate interventions should be considered based off of this initial ECG?

Plasma 130
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The Intervals Aren’t Alright!

Core EM

Hyperkalemia, Sodium-channel blockade (ex: tricyclic acid overdose), Pre-excitation syndromes (ex: Wolff-- Parkinson-White syndrome), Aberrant conduction (ex: bundle branch blocks), Ventricular-Paced beats, Hypothermia, Ventricular ectopy What immediate interventions should be considered based off of this initial ECG?

Plasma 130
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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

Authors: Alex Rogers, MD (EM Resident Physician, Christus Spohn/Texas A&M University School of Medicine, Corpus Christi, TX); J.D. Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] Poisoning & Drug Overdose. J Med Toxicol.

E-9-1-1 111
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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

REBEL EM

Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh Frozen Plasma (RETIC): A Single-Centre Parallel-Group, Open-Label Randomised Trial. appeared first on REBEL EM - Emergency Medicine Blog. PMID: 36942533 Innerhofer P et al. Lancet Haematol 2017. PMID: 28457980 Jehan F et al.

FFP 145
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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. Metabolism of DEG adapted from Bessenhofer, et al.

E-9-1-1 92
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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. A dexmedetomidine (Precedex) 400 mcg in 0.9 2022;23(1):4-9. J Med Chem.

NARCAN 89
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ToxCard: Iron

EMDocs

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. 2 L/hr in adults. 1 Deferoxamine is safe in children. mg of elemental iron.

E-9-1-1 98