Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002 Oct 3;347(14):1057-67. What we already know about the topic: Carbon monoxide poisoning is responsible for about 40,000 v…
“You must grow like a tree, not like a mushroom.” -Janet Erskine Stuart Amanita genus mushrooms cause a deadly toxidrome. Mortality is cited as 10-30%. The mushrooms can be identified by dots or scales on the cap. Cooking…
Overdose and EKGs they start to all look the same…widened QRS, that thing in aVR…vfib (hopefully not). Here’s a highlight of key EKG findings associated with a few toxidromes: (1) Bupropion overdose (2) TCA overdose (3) Di…
Here’s an EKG you may never have seen before. Only slightly frightening, right? The rate is tachycardic and the width of the QRS tells you that it is coming from below the AV node. The defining feature here is that the QRS complex…
Salicylate toxicity has a long history of causing morbidity and mortality in ED patients. Historically there has been a decline in the number of cases of salicylate poisoning due to concern regarding Reye’s syndrome. However, in recen…
A Trichobezoar A 45 year-old female with hx of anemia presents to your ER complaining of 2 days of abdominal pain with nausea and several episodes of dark emesis but otherwise conversant and non-toxic in appearance. She has not passed stoo…
This pearl was created in light of our impending in-service exam this Wednesday. Hopefully reading this will give you at least 1 point on the exam. A 19 yo F ingested 150 pills of Tylenol four hours ago and is presenting now because she do…
A 42 yr old male is BIBEMS by his friend after reportedly ingesting an unknown amount of metoprolol 5 hours prior to arrival. In the ED he is hypotensive to 80s, bradycardic to 40s, with decreased mental status. The patient is intubated, a…
The nurse comes running over from triage to the cardiac room because there’s a patient in triage who claims she took a whole bottle of her imipramine before she went to bed last night (12 hours ago). On exam, patient appears indiffere…
Your dad wanted to make this holiday season extra special, so he decided to paint the house in candy-cane pattern. The intermittent red and white stripes were so disorienting, that he mistook his paint thinner for his nalgene, and took a bi…
In my last day as TR, I will end with a final “Name that Poisonous Beast!”. Farewell, to poisonous beasts everywhere! In this case, back in the garden. Name this poisonous beast! A) And it’s amphibian colleague: B)
And back by popular demand, it’s another installment of “Name that Poisonous Beast!” Name this poisonous beast! A) And it’s stony neighbor: B)
A 24yo M with hx schizophrenia presents to the ED agitated, threatening staff and making gestures of self-harm. You are unable to verbally deescalate him and go to order some sedative medication. However, on his chart you see “Allergy: ha…
It’s the final part of “Name that Poisonous Beast!”. Today, we’re going to take a walk in the garden. Name this poisonous beast! A) And it’s seedy neighbor: B)
Part 3 of “Name that Poisonous Beast” is ocean-themed. Name this poisonous beast! A) And it’s floaty colleague: B)