The Approach to the Poisoned Patient
A focused update on poisonings, toxicologic emergencies, and toxidromes with pearls, pitfalls, and myths. What can the emergency physician miss?
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Toxicology
Physostigmine for Management of Anticholinergic Toxidrome
From the understanding of physostigmine’s mechanism of action and the above data, we would like to summarize key points and recommendations regarding the use of physostigmine.
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Intern Report Collection
Our ongoing intern report series is the product of first-year EM residents at UT Southwestern exploring clinical questions they have found to be particularly intriguing. For med students & junior residents – if you haven’t encountered these issues yet, you will!
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Lipid Emulsion Therapy
“The lack of high-quality controlled human studies precludes ILE as a first-line agent for indications other than local anesthetic systemic toxicity”
Thanks to James Cao, MD for this excellent review of the literature on the use of ILE therapy in various toxicologic emergencies.
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Electronic Cigarettes and Liquid Nicotine Poisoning
“The delayed phase consists of cns and respiratory depression, dyspnea, bradycardia, hypotension, shock, mydriasis, weakness, muscle paralysis, and coma”
We are very pleased to present you with this overview on the potential dangers of electronic cigarettes and liquid nicotine from the toxicologists at UT Southwestern.
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Synthetic Cannabinoids
“There have been a growing number of cases associated with life-threatening neurotoxic effects and cardiotoxic effects”
Cynthia Santos, MD gives a nice overview of the increasingly popular synthetic cannabinoids, including the range of clinical presentations, management, and the bottom line for your practice in the ED.
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Alternative "Legal" Highs: Kratom, Salvia Divinorum, Methoxetamine
“Think about these substances in a patient with either an opioid, sympathomimetic, or hallucinogenic toxidrome”
Alex Koyfman, MD summarizes the assorted clinical presentations of these three “legal” highs.
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Bath Salts
“Psychosis that can last for days to weeks”
Unless your patient on bath salts is very forthcoming, you may be on your own when making this clinical diagnosis. Be prepared with this primer on cathinones by Kyle Brown, MD.