Another busy day in the pediatric ED and Tim ‘The Tool-man’ Taylor brings in his 6yo boy who was complaining of abdominal and flank pain after drinking something in dad’s car garage. The boy said he “drank some of dad’s green garage gatorade” and Tim the Toolman says he’s acting a bit Read more…
Here’s Dr. Kincade with today’s Morning Report! ETOH Withdrawal Case: A 45yo M presents to the ED for EtOH detoxification. Drinks 1L of vodka daily. Last drink 18 hours prior. VS: HR:150 beats/min, BP: 172/84 mm Hg, diaphoretic and has a severe tremor. The patient denies illicit drug use Read more…
Thanks to Dr. Kopping for presenting today’s Morning Report! Digoxin Toxicity Digoxin falls under cardioactive steroids Fox glove, oleander, dried toad secretions Na/K ATPase inhibition Resting potential more positive, more likely to depolarize Increases inotropy by preventing Ca leaving cell via Na/Ca channel Increases automaticity Narrow therapeutic window Poisoning Read more…
A 32 year old woman rolls into the ER on a quiet springtime afternoon – you are told that she had just had a tonic clonic seizure. She took a sabbatical after finishing her EM/IM residency and opened a moonshine distillery on Nostrand and Church. She typically “tastes” one pint of Read more…
Today’s Morning Report is presented by Dr. Adal! Organophosphate and Carbamate Poisoning Epidemiology: 200K fatalities worldwide every year DDx: Cholinesterase inhibitors, Cholinomimetics, Nicotine alkaloids Kinetics: Absorption via ingestion, inhalation or topical contact. Minutes to hours depending on lipophilicity, metabolism and toxicity of compound Pathophysiology: Inhibition Read more…
Thanks to Dr. Rolston-Cregler for today’s Morning Report! Ethylene Glycol Toxicity The Basics Toxic Alcohol with the chemical structure C2H6O2 Main ingredient in antifreeze Sweet taste often attracts children and animals Clinical Presentation Altered mental status Dyspnea may be a manifestation of underlying metabolic acidosis Laboratory Read more…
Dr. Waldman presents today’s Morning Report! AMMONIA TOXICITY Where can we find ammonia: glass cleaners, toilet bowel cleaners, metal polishes, floor strippers, wax removers, smelling salts, some refrigerants, explosives, pharmaceuticals, pesticides, textiles, leather, flame-retardants, plastics, pulp and paper, rubber, petroleum products, and cyanide INHALATION INJURY: Most common 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…
This is a tough one and congratulations to the thorough responders. This month’s winner – Dr. Nico Grundmann! To start, TCA ingestion is the most common cause of Na-channel toxicity that we see in ECGs – but this patient was not taking TCA’s. She ingested more than 4 grams of Read more…