Author: Alec Feuerbach Peer Reviewers: Trevor Cerbini, Nicole Anthony Faculty Reviewer: Scott Kendall Two years ago, Dr. Trevor Cerbini wrote an excellent post for this blog highlighting the basics – and beauty – of buprenorphine (bupe). He highlighted the staggering mortality of Opioid Use Disorder (OUD), explaining that 5.5% Read more…
Our toxicology mini-fellowship meeting last week was all about bupe (buprenorphine)! Here is a brief review of the key points of discussion. Why does this matter? As emergency physicians, we are on the frontline in caring for patients with opioid use disorder (OUD). These patients come to the ED Read more…
This is a special post based on recent FDA and CDC advisories Reviewed by Dr. Sage Wiener A 42-year-old man presents to the ED with a history of alcohol use disorder, brought in by EMS for intoxication and acute vision loss. Triage vitals are BP 108/90 mm Hg, HR Read more…
Faculty Reviewer: Sage Wiener, MD The Case It’s Saturday at 11:30 pm. You are just beginning your shift, when EMS rolls in accompanied by the NYPD. Their 24-year-old patient looks extremely sick and is moaning to you that he wants to die. He is asking about “little people” and Read more…
It’s intern year and you’re on nights in the MICU. You’re always a little bit out of your element when not in the ED. Tonight you get sign out on an older lady with afib and CHF presenting for AMS, being followed by neuro and on BiPAP and critically ill Read more…
“He took all his medication,” you chuckle to yourself as you read the chief complaint on the board. “Man, isn’t that what we try to get all our patients to do?” As you open up the patient’s chart, however, your smugness quickly turns to unease when you read through the triage Read more…
The Case 50-year-old woman is brought in by EMS after intentional ingestion of her 500 mg extended release valproate in a suicide attempt approximately 40 minutes prior to arrival. She had recently filled her valproate prescription with 80 tablets and took nearly all of them. She admits to feeling depressed Read more…
It’s four o’ clock on a gentle Sunday afternoon. You stir the dregs of your Turkish coffee, secretly hoping for an exciting patient to fill the last three hours of you Critical Care & Trauma shift. As you set your mug on top of the “No eating or drinking!” sign, Read more…
It’s a busy night shift when a nurse alerts you to an elderly patient sent from a nursing home who is hypotensive, tachycardic, tachypneic, febrile, altered, and appears dehydrated. You assume sepsis, send labs, begin treating empirically with broad spectrum antibiotics, and start fluid resuscitating the patient. Despite receiving 30cc/kg of normal Read more…
Welcome to the Kings County/SUNY Downstate toxicology blog series. In our first case, we will discuss the differential diagnosis and management of the poisoned patient who presents with hypotension and bradycardia. Case A 23 year old female is brought in by EMS after an intentional overdose. She reports taking a Read more…