The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Naloxone is a well-established medication used primarily for reversing opioid overdoses. Traditionally, naloxone has been used in cases of suspected opioid overdose where patients exhibit signs of severe respiratory depression or loss of consciousness (LOC). Today’s study looks at the role of naloxone in OHCA.

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Naloxone NARCAN Overdose CPR 239

Dr. Smith's ECG Blog

MAY 26, 2023

A 20-something presented after a huge verapamil overdose in cardiogenic shock. And she does not know that this is an overdose; she thinks it is a patient with chest pain!! Comment on High Dose Insulin and Calcium Channel Blocker Overdose I do not have any explanation for the ST-T abnormalities here. The initial K was 3.0

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Overdose E-9-1-1 Coronary OR 91

Peter Canning

JANUARY 20, 2024

I have called the time on a number of her neighbors in this building, some of them victims of overdose. While the news often focuses on the dangers of fentanyl to youth, what I see on the street and what the data shows is that the group that is seeing the biggest increase in overdoses is the elderly. of all overdoses to 11.1%.

Overdose 59

Overdose Naloxone Firefighter First Responder 59

The Skeptics' Guide to EM

JUNE 24, 2023

EDs are an important touch point for individuals with opioid use disorder (OUD), given the number of encounters for overdose and complications associated with drug use. Fentanyl test strips (FTS) have been suggested as one harm reduction strategy to reduce opioid overdose deaths.

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Overdose Emergency Department ALS ED 187

Peter Canning

NOVEMBER 27, 2024

decrease in overdoses in Connecticut since November 2021 based on rolling 12-month averages with the latest 12-month period ending June 2024. After the presentation I saw in the chat a comment about white overdoses being down, but minority overdoses still rising. Black opioid overdose deaths declined 9.1%

Overdose 52

Overdose EMS 52

University of Maryland Department of Emergency Med

JULY 18, 2023

Standard treatment for APAP overdose is with N-acetylcysteine (N. Acetaminophen (APAP) is the leading cause of acute liver failure worldwide. Click to view the rest

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Overdose 61

ALiEM

NOVEMBER 29, 2023

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.

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Naloxone Overdose Epinephrine ALS 169

Peter Canning

MAY 22, 2024

Drug overdose deaths are down 3.1% 107,543 people died of drug overdoses in 2023 down from 111,029 in 2022. Here in Connecticut, drug overdose deaths have been decreasing for the last two years (down 14% in 2023 from the 2021 high). Ten years ago when I responded to an overdose, I was the only one carrying naloxone.

Overdose 52

Overdose Naloxone First Responder OR 52

Emergency Medicine Cases

MARCH 14, 2023

Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning.

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Overdose EMS 130

Peter Canning

OCTOBER 1, 2024

Is the decline in drug overdose deaths more related to the increased availability of naloxone, improved treatment for people who use drugs, or changes in the street drug supply, which while still quite toxic may be less so due to adulteration with other chemicals? A recent article in NPR, The pipeline of deadly fentanyl into the U.S.

Overdose 52

Overdose Naloxone OR 52

The Skeptics' Guide to EM

JANUARY 19, 2019

The EMS crew observes drug paraphernalia and suspect an intravenous (IV) opioid overdose. Background: There have been close to 400,000 deaths from an overdose involving any opioid (prescription and illicit opioids) between 1999 and 2017. [1] Wave 2: Rapid increase in overdose deaths involving heroin starting in 2010.

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Naloxone Overdose Emergency Medical Services Emergency Department 130

The Skeptics' Guide to EM

MAY 21, 2017

Do heroin overdose patients require observation after receiving naloxone? Do heroin overdose patients require observation after receiving naloxone? Opioids depress the heart rate and breathing and overdoses can result in death. The second new recommendation was about opioid overdose treatment. Clinical Toxicology 2017.

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Naloxone Overdose First Responder BLS 130

EMergucate

APRIL 3, 2019

The ECG below is taken from a collapsed 70kg 56 yo man with a known mental health history, thought to have taken a multi-drug overdose.

Overdose 130

Overdose 130

EMergucate

AUGUST 10, 2022

You are reviewing a 16 year old girl who has taken an estimated 66-222mg/Kg overdose of her grandmothers SR Theophylline … Continue reading →

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Overdose 130

EMergucate

JANUARY 9, 2024

20 year old epileptic woman presented to the emergency department after polypharmacy overdose. Her VBG showed the following: PH = … Continue reading →

Overdose 130

Overdose Emergency Department 130

ALiEM

FEBRUARY 5, 2024

Cambron DO Jun 1, 2023 AIR EM Docs N-acetylcysteine for Acetaminophen Toxicity Eric Sabatini Regueira, MD and Ann-Jeannette Geib, MD Aug 3, 2023 HM EM Docs Methylene blue Quinton Nannet, MD and Christine Murphy, MD Dec 27, 2022 HM EM Docs Acute organophosphate toxicity Daniel Escobar, MD and Ann-Jeannette Geib, MD Jun 7, 2023 HM Core EM Updates in (..)

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Overdose Critical Care EMS Emergency Department 215

REBEL EM

OCTOBER 16, 2024

Take Home Points Orogastric lavage may still play an important role in treatment of the overdose patient. Strongly consider orogastric lavage in a patient who has taken an overdose of drugs that are particularly toxic, suspected extreme doses associated with high morbidity/mortality and do not have easily available and effective antidotes.

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Overdose EMS OR 105

Peter Canning

MARCH 5, 2024

Connecticut opioid-related deaths declined for the second year in a row, down 14% from their 2021 high of 1431 opioid deaths, according to the latest statistics from the Connecticut Office of the Medical Examiner (OCME). Opioid deaths represented 92% of all overdose deaths in Connecticut.

Overdose 52

Overdose Naloxone EMS OR 52

EMergucate

AUGUST 4, 2021

A 60 year old male presents with an overdose. Below is the patients ECG: Describe and interpret the ECG What … Continue reading →

Overdose 130

Overdose 130

EMergucate

JULY 3, 2016

A 44 year old man presents to your ED after taking an overdose of paracetamol about 12 hours ago. His paracetamol nomogram is as follows:

Overdose 130

Overdose ED EMS 130

EMergucate

JUNE 30, 2020

The following ECG is taken from a 27 year old female who has presented following an intentional overdose of an unknown quantity of escitalopram and alcohol.

Overdose 130

Overdose 130

EMergucate

JULY 1, 2020

The following ECG is taken from a 27 year old female who has presented following an intentional overdose of an unknown quantity of escitalopram and alcohol.

Overdose 130

Overdose 130

EMergucate

DECEMBER 20, 2022

This ECG was obtained from a 22 year old man who had taken a polypharmacy overdose 24 hours ago. He had suffered a bradycardic / asystolic arrest and is currently in the intensive care unit.

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Overdose EMS 130

Emergency Medicine Cases

MARCH 23, 2021

In this month's EM Quick Hits podcast: Justin Morgenstern on colchicine for COVID pneumonia, Victoria Myers on sodium bicarbonate in cardiac arrest, Brit Long on troponin in chronic kidney disease, Michelle Klaiman on GHB overdose, Ian Walker on iloprost for frostbite, Sarah Reid on tips on avoiding patient and parent complaints.

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Overdose EMS 130

Emergency Medicine Cases

JANUARY 3, 2017

One of the things we need to think about whenever we see a patient who’s going low and slow with hypotension and bradycardia is an overdose. And inevitably we’re gonna be faced with both intentional and unintentional overdoses from these drugs in the ED.

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Overdose ED EMS 100

The Skeptics' Guide to EM

APRIL 20, 2024

With the 2014 CDC declaration that prescription drug overdose is one of the five top health threats, there has been a movement away from opioids as the mainstay of pain management for rib fractures [6].

Emergency Department 207

Emergency Department Overdose ALS ED 207

EMergucate

APRIL 5, 2017

A 37 year old man presents after a multidrug overdose, 20 hours post ingestion. His Paracetamol level at 20 hours … Continue reading →

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Overdose EMS 100

EMergucate

JULY 6, 2016

A 44 year old man presents 12 hours following a Paracetamol overdose The Paracetamol Nomogram on its own is not validated for … Continue reading →

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Overdose EMS 100

EMergucate

APRIL 4, 2017

A 37 year old man presents 20 hours after an overdose of 20 paracetamol tablets, 20 Ibuprofen tablets and 2.5 grams of Quetiapine. His Paractemol nomogram is attached

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Overdose EMS 100

Emergency Medicine Cases

APRIL 20, 2021

AV nodal blocker overdose? What are the latest recommendations about dosing of atropine and when is atropine likely to be detrimental? How is the treatment of bradycardia different in the patient with hypothermia? Cardiac ischemia? Myxedema coma? What are the most common pitfalls in utilizing transcutaneous and transvenous pacing?

Overdose 130

Overdose EMS Epinephrine 130

EMergucate

APRIL 11, 2015

A 27 year old man is brought to your ED by ambulance after taking an overdose of a commonly used medication. He is tachypnoeic with a normal mental state and blood pressure. His ABG (RA) shows:

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Overdose Ambulance ED EMS 100

Emergency Medicine Cases

OCTOBER 9, 2018

In anticipation of EM Cases Episode 116 on Opioid Misuse, Overdose and Withdrawal, Dr. Michelle Klaiman, Addictions and Emergency Medicine specialist, tells her Best Case Ever exemplifying how we can positively impact the lives of ED patients for years to come - even when they present with simple, run-of-the-mill diagnoses - by thinking outside the (..)

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Overdose ED EMS Naloxone 130

ALiEM

FEBRUARY 20, 2024

Managing cardiovascular collapse in severe flecainide overdose without recourse to extracorporeal therapy. Am J Emerg Med. 2022 Jun;56:394.e1-394.e4. doi: 10.1016/j.ajem.2022.03.006. 2022.03.006. Epub 2022 Mar 9. PMID: 35287973. Devin R, Devin R, Garrett P, Anstey C. Emerg Med Australas. 2007 Apr;19(2):155-9. doi: 10.1111/j.1742-6723.2006.00909.x.

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Life Support Overdose ED 183

EMergucate

MARCH 26, 2013

A 40 year old man presents following a large overdose of an antispasmodic agent. Check out his ECG

Overdose 100

Overdose EMS 100

EMergucate

JUNE 21, 2022

17 year old girl presented to ED with aspirin overdose. Her VBG showed the following: PH = 7.45 pCO2 = … Continue reading →

Overdose 100

Overdose ED 100

EMergucate

NOVEMBER 13, 2012

Cinchonism = toxidrome caused by quinine or cinchona bark overdose Signs and symptoms: tinnitus, impaired hearing blurred vision headache vertigo … Continue reading →

Overdose 100

Overdose OR EMS 100

EMergucate

APRIL 11, 2022

20 year old epileptic woman presented to the emergency department after polypharmacy overdose. Her VBG showed the following: PH = … Continue reading →

Overdose 100

Overdose Emergency Department 100