practice updates

Pearls and Pitfalls of Salicylate Toxicity in the Emergency Department

Emergency physicians commonly care for poisoned patients. These exposures may be either intentional or unintentional. Salicylates are commonly found in many topical and over the counter preparations, yet salicylate toxicity is often overlooked and underestimated as a potential cause for illness in our patients. Below is a condensed quick-guide of common mistakes that emergency physicians may be making with respect to salicylate overdoses and how to fix them. The goals of care to take away from this article are prevention of intestinal absorption and CNS entry of salicylates, as well as drug elimination.

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Teaching the Modern EM Resident

Current EM residents, as part of the Millennial Generation (born between 1981 and the present), now see this new technology as a way of life, and feel the need to be connected online at all times.5,6 As a result, many EM residents have abandoned the traditional lecture hall and textbooks, and have taken to their electronic devices and the World Wide Web for obtaining information.

In order to continue providing quality education that meets the needs of the modern EM resident, the type and quality of educational resources that we deliver must also change.

So the question becomes: How do we use these new resources to guide the education of our current EM residents both on and off shift?

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Hypertensive Crisis in Kids

I think that we’d all agree that 144/89 is not a normal blood pressure, but it is one that those of us who have the pleasure of caring for adults will look at with almost a sense of comfort – because it isn’t 70/30 or 210/120. Unfortunately, however, this sense of reassurance cannot be had when dealing with children. Depending on the patient’s sex, age, and height, 144/89 may not only represent hypertension but may be associated with hypertensive crisis in kids!

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