emergency medicine toxicology

EM Quick Hits 1 Massive PE, Gabapentin for Alcohol Withdrawal, Dental Avulsions, Pediatric Eye Exam, Best Resuscitation Fluid

EM Quick Hits is a brand new EM Cases podcast that contains 5 minute segments chosen from 10 specific topics by 10 different experts and educators. These topics are ones that either are not taught very well in training and/or that physicians tend to be not completely comfortable with. They include toxicology, trauma, ophthalmology, orthopaedics, resuscitation, human factors, addiction and pediatric emergencies. The EM Quick Hits Team is: Emily Austin, Peter Brindley, Chris Hicks, Michelle Klaiman, Anna MacDonald, Natalie May, Justin Morgenstern, Andrew Petrosoniak, Hans Rosenberg, Arun Sayal and Anand Swaminathan...

EMU 365 Toxicology Cases from the ED

In this EMU 65 video, Dr. Emily Austin discusses appropriate circumstances where you might consider gastric lavage, critical bupropion overdose and when to use intralipid emulsion therapy, types of inhalant exposures, and more...

Ep 116 Emergency Management of Opioid Misuse, Overdose and Withdrawal

In this episode Dr. Kathryn Dong, Dr. Michelle Klaiman and Dr. Aaron Orkin discuss the latest in naloxone in opioid overdose cardiac arrest and altered LOA, a 5-step approach to ED opioid withdrawal management and how we can improve mortality and morbidity in patients with opioid use disorder in the era of the opioid epidemic...

BCE 76 Opioid Withdrawal

In anticipation of EM Cases Episode 116 on Opioid Misuse, Overdose and Withdrawal, Dr. Michelle Klaiman, Addictions and Emergency Medicine specialist, tells her Best Case Ever exemplifying how we can positively impact the lives of ED patients for years to come - even when they present with simple, run-of-the-mill diagnoses - by thinking outside the box and doing brief screening and interventions for patients with opioid use disorder. She discusses alternative pain control options as well as the use of suboxone to treat opioid withdrawal and opioid addiction.Best Case Ever exemplifying how we can positively impact the lives of ED patients for years to come, even when they present with simple, run-of-the-mill diagnoses, by thinking outside the box and doing brief screening and interventions for patients with opioid use disorder.

Ep 115 Emergency Management of the Agitated Patient

Managing acutely agitated patients can cause anxiety in even the most seasoned emergency doctor. These are high risk patients and they are high risk to you and your ED staff. It’s important to understand that agitation or agitated delirium is a cardinal presentation – not a diagnosis. There is pathology lurking beneath - psychiatric, medical, traumatic and toxicological diagnoses driving these patients and we just won’t know which until we can safely calm them down...

BCE 75 Reuben Strayer’s Agitated Patient

In anticipation of Episode 115 Management of the Agitated Patient, Dr. Reuben Strayer tells the story of the case that got him interested in developing an expertise around management of the agitated patient that includes an important simple pitfall and pearl about physical restraint. It that could prevent a death in your ED...

Ep 106 Toxic Alcohols – Minding the Gaps

We see patients with toxic alcohol poisoning most commonly in three clinical scenarios. One, after an intentional suicide attempt where they tell you exactly what they took; two, when they come in agitated and won’t give you a history and the three, the inebriated patient found down. Alcohol is everywhere, and inevitably inebriated people show up at your ED with a myriad of medical and psychiatric problems. It’s our job as ED professionals, not only to identify traumatic, medical and psychiatric catastrophes in these patients but also to identify and manage the relatively rare but potentially life and sight threatening toxicologic diagnoses in the inebriated or agitated patient. And that isn’t so easy - especially when it comes to toxic alcohols. In this episode we help give you the knowledge of toxic alcohol poisoning recognition, clinical and lab clues, limitations of the osmolar gap, goals of management, time sensitive treatments and more...

BCE 64 Salicylate Poisoning

In this EM Cases Best Case Ever Hans Rosenberg and Rajiv Thavanathan discuss recognition and management pearls and pitfalls in salicylate poisoning. They answer question such as: What are the most important diagnostic clues of salicylate poisoning in the patient who presents with undifferentiated fever and altered level of awareness? What is the best timing and ventilation strategy for intubation? Which electrolyte abnormalities do you need to be on the lookout for? and many more...

Best Case Ever 56 Anion Gap Metabolic Acidosis

In this month's Best Case Ever on EM Cases Dr. Ross Claybo and Dr. Keerat Grewal tell the story of a patient with a complicated anion gap metabolic acidosis. We discuss how to sort through the differential diagnosis with a better mnemonic than MUDPILES, the controversy around administering sodium bicarbonate for metabolic acidosis, the indications for fomepizole and the value of taking time to to build a therapeutic relationship with your ED patients...

Episode 90 – Low and Slow Poisoning

One of the things we need to think about whenever we see a patient who’s going low and slow with hypotension and bradycardia is an overdose. B-blockers, calcium channel blockers (CCB) and digoxin are some of the most frequently prescribed cardiovascular drugs. And inevitably we’re gonna be faced with both intentional and unintentional overdoses from these drugs in the ED. If we can recognize these overdoses early and manage them appropriately, well - we’ll save some lives...