Remove Epinephrine Remove OR Remove Overdose
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Updates in High dose Insulin and Euglycemia Therapy (HIET) for the treatment of Beta-adrenergic Receptor and Calcium Channel Antagonists Overdose

Core EM

Background: An update to our 2015 post on HIET for beta-adrenergic receptor and calcium channel antagonists overdose. Beta-adrenergic receptor antagonists (Beta blockers, BB) and calcium channel antagonists (calcium channel blockers) are common drugs that can produce profound cardiac depression and shock when taken in overdose.

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SGEM#453: I Can’t Go For That – No, No Narcan for Out-of-Hospital Cardiac Arrests

The Skeptics' Guide to EM

You and your partner initiate high-quality CPR, place a supraglottic airway, establish intra-osseous (IO) access and administer epinephrine. Naloxone is a well-established medication used primarily for reversing opioid overdoses. Your partner asks if you want to administer naloxone as well.

Naloxone 260
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"Call HazMat Before Opening"

FOAMfrat

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. THIS ARTICLE IS COVERING THE MEDICAL ASPECTS OF CHEMICAL SUICIDES.

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ACMT Toxicology Visual Pearl: Needle to Necrosis

ALiEM

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.

Naloxone 169
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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. sodium bicarbonate. Then assume there is ACS.

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The Broselow-Luten System

Pediatric EM Morsels

Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Krug 2007] What If the Child is Obese or Emaciated? There are other systems that account for body habitus. Validation study done in Italy.

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emDOCs Podcast – Episode 93: BRASH Syndrome

EMDocs

An inciting event will typically push them over the edge into BRASH syndrome: Dehydration Hypotension from sepsis or another condition GI illness Dosage increase of a chronic medication (e.g., beta blocker) New medication (e.g., NSAID or potassium sparing diuretic) Ask the following: Is there mild hyperkalemia? Is there some renal injury?