#FOAMtox

A 70-year-old male with presents with 5 days of fever and 3 days of anuria and malaise.  He also notes worsening abdominal distention and shortness of breath. He found and removed a tick 3 weeks ago and another one 1 week ago. Labs reveal WBC 2,200 cells/microL, HGB 11.2 g/dL, Plt 21 × 109/L, BUN 86 mg/dL, Creatinine 6.8 mg/dL, AST 350 U/L, ALT 119 U/L.

How can you use nitrous oxide in the ED?

What is tianeptine, and how will those with acute intoxication or withdrawal present in the ED?

Tox Cards returns with the osmol gap.

What is xylazine, and what do you need to know?

ToxCards returns with Local Anesthetic Systemic Toxicity (LAST).

Why is it important to repeat the ECG?

A 30-year-old male with history of IVDU presents with fever. He reports last drug use was one hour prior to arrival and admits to reusing the same cotton filter on multiple occasions. He denies recent cough, chest pain, shortness of breath, abdominal pain, nausea, vomiting, or diarrhea. VS include Temp 101.0°F, HR 110, BP 130/80, RR 18, SpO2 98% on room air. On exam, he is diaphoretic and has track marks on bilateral upper extremities. Lung sounds are clear, and there are no heart murmurs. Complete blood count and metabolic panel are unremarkable. What is the likely diagnosis?

Tox Cards is back and covers plants with anticholinergic toxicity.

The ToxCard series returns with benzonatate and what you need to know.