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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] Poisoning & Drug Overdose. lidocaine) or an ester (e.g.,

E-9-1-1 93
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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. Poison centers see nearly 1,500% increase in calls related to injected weight-loss drugs as people accidentally overdose. Semaglutide has a half-life of approximately one week; as such, it is long-acting and requires supportive measures. CNN website.

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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 65
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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. She was in shock with thready pulses. A prehospital ECG was recorded: Limb leads: Precordial Leads What is the therapy?

Plasma 52
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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. PMID: 36942533 Innerhofer P et al. Lancet Haematol 2017. PMID: 28457980 Jehan F et al.

FFP 132