Remove OR Remove Overdose Remove Plasma
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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

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] 2] This linking group can be either an amide (e.g., lidocaine) or an ester (e.g.,

E-9-1-1 93
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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. 1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity?

E-9-1-1 66
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Popular Antiobesity Medications Bring New Challenges to Emergency Physicians

ACEP Now

There have been documented cases of overdose, and of note, there is no known antidote. Given the fact that he has not had these headaches before and has diffuse symptoms including weakness, lab work and head imaging are obtained. There were no acute findings on head CT.

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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). Internal potassium balance and the control of the plasma potassium concentration. A prehospital ECG was recorded: Limb leads: Precordial Leads What is the therapy? Medicine (Baltimore) 1981;60:339-54].

Plasma 52
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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

REBEL EM

Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 NOT STATISTICALLY SIGNIFICANT Also no difference in individual components given Thromboembolic Events: 4F-PCC: 35% Placebo: 24% Absolute Diff: 11%; 95% CI 1 to 21% Relative Risk 1.48; 95% CI 1.04 to 2.10; P = 0.03 Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72

FFP 144