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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] 6] Action of local anesthetics is dependent upon the molecule crossing the plasma membrane in a unionized form. [2] If epinephrine is used, small initial doses ( <1 ug/kg) are preferred.

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A middle aged man with unwitnessed cardiac arrest

Dr. Smith's ECG Blog

Chest compressions were continued, and the patient was given 1 round of epinephrine, calcium, bicarb, glucose. Terbutaline and Albuterol for Lowering of Plasma Postassium Initial labs returned and confirmed critical hyperkalemia and new renal failure. We should also have given 0.25mg intramuscular terbutaline, but we did not.

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Sepsis Updates Relevant to the Emergency Physician

EMDocs

The first was the suggestion to use balanced crystalloid fluids, such as lactated ringers or plasma-lyte, instead of normal saline. 34 If a MAP of 65 mmHg is still not achieved, epinephrine should be added as a third agent (Figure 1). Restriction of Intravenous Fluid in ICU Patients with Septic Shock. units/minute. N Engl J Med.

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