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ToxCard: Diphenhydramine Toxicity

The ToxCard series returns with diphenhydramine toxicity.

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    Articles

    TXA Use in Trauma: An Update

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    As Emergency Physicians, we are always looking for ways to improve the care we provide to our patients. Based on clinical data which have come to light over the past several years, tranexamic acid (TXA) displays considerable promise toward reducing mortality in hemorrhagic trauma. It’s widely available, cost-effective, and an
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    • practice updates

    The Evaluation of Occult Subarachnoid Hemorrhage: Why Are We Still Doing LPs? Is CTA A Better Alternative?

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    It’s 4pm on a Wednesday. As per usual, the chart rack is full, and you’re trying to stay positive and keep up morale of the entire team. You pick up your next chart, and as you read the chief complaint, your heart sinks into your belly. The complaint is, “severe
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    • practice updates

    EM Mindset: Bob Stuntz – Developing the EM Mindset

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    Whether we are working with a medical student, an off-service resident, or even one of our own, most of us involved in the education of emergency medicine have described the mindset of emergency medicine as different from most other specialties. But are we really unique in our approach to patient
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    Transesophageal Echocardiography in Cardiac Arrest

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    What if there was a way to better visualize the heart during cardiac arrest? What if you could see something on the ultrasound screen that triggered a specific, critical, and time-sensitive intervention? According to the 2008 ACEP Ultrasound Guidelines, as well as Matt and Mike from the Ultrasound podcast, that
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    Pediatric Cardiogenic Shock

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    Pediatric cardiogenic shock is an often insidious phenomenon with presentations requiring a broad differential diagnosis. Even after narrowing the diagnosis to cardiogenic shock, the list of possible etiologies is vast and the cause important to determine because the source of the shock will respond differently to different treatments.
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    Roc Rocks and Sux Sucks! Why Rocuronium is the Agent of Choice for RSI

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    I recently had the pleasure of engaging in a point-counterpoint discussion on the optimal agent for Rapid Sequence Intubation with Billy Mallon at Essentials of Emergency Medicine 2014. I took the pro-rocuronium side. For decades, succinylcholine (suxamethonium) was the paralytic agent of choice (and the only available option) for RSI.
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    Acute heart failure exacerbation disposition

    Not all patients require admission

     

    Consider patient hemodynamics, respiratory status, ECG, labs (Cr, troponin, sodium/electrolytes), ability to ambulate, follow up

     

    Elevated troponin and serum Cr associated with worse outcomes

     

    Don’t use risk tools alone for DC, but Ottawa Heart Failure Risk Scale may assist in admission (ACEP Level B)

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