Cardiology , Toxicology

Alcohol-Induced Narrow Complex Tachycardia

5/15/2025 Pham To Uyen, MD , Huynh Minh Tri, MD , Vo Thanh Tan, MD

Narrow complex tachycardia can be a life-threatening condition that requires prompt evaluation and treatment. Synchronized cardioversion is critical in hemodynamically unstable patients.

Toxicology

Toxic Twist: Valacyclovir and the Mystery of Altered Mental Status

5/15/2025 Alexander Kalicki, MD , Megan Stark Claypool, MD , Duncan Grossman, DO, MSEd

Errors in medication prescription can lead to serious consequences and even toxicity, as demonstrated in this case of a patient who was taking valacyclovir. A thorough medication reconciliation is req

Toxicology , Psychiatry

Rethinking B52

5/13/2025 Adrianne Buckles, DO , Jonathan Dobrinsky, MD

Acute agitation is a common presentation in the emergency department. Are your practice protocols keeping up with the latest evidence on appropriate medications? It could be time to rethink the fall-b

Toxicology , Addiction Medicine , Neurology , Social EM

Subacute Combined Degeneration Secondary to Nitrous Oxide Use: A Case Report

5/12/2025 Brianna McMonagle , Colleen Arnold, MD , Marlena Wosiski-Kuhn, MD, PhD , Anita Goel, MD

Nitrous oxide toxicity can be difficult to recognize, but when left untreated, it can lead to irreversible neurologic damage. Get some pointers in dealing with this vague presentation.

Toxicology , Psychiatry

A Case of Lithium Toxicity Masked by Behavioral Symptoms in a Psychiatric Patient

5/6/2025 Rebecca Notini Kirby, MD , James O'Neill, MD , Jennifer Hannum, MD

Distinguishing between medical and psychiatric causes of altered mental status (AMS) can be challenging, as the two may present with similar clinical manifestations.1 As a result, patients with underl

Toxicology

A Case of Severe Lactic Acidosis Due to Metformin Toxicity

3/23/2025 Natalie Rech, MD , Sarah E. Fabiano, MD, FACEP, FAAEM

Metformin toxicity causes a profound lactic acidosis and can be concerning in patients with existing kidney impairment.

Cardiology , Toxicology

Nitroglycerin's Hidden Trigger: The Bezold-Jarisch Reflex Revealed

3/19/2025 Jacob Goodbar , Amanda Murphy, MD

Quick recognition of the Bezold-Jarisch reflex triad of hypotension, bradycardia, and apnea is important for any physician who administers nitroglycerin. This knowledge can ensure positive patient out

International EM , Toxicology , Medical Education

Toxicology in Australia: Extreme Education

3/19/2025 Brittany (Ladson) Garza, DO, MPH

If you’re looking for an eye-opening elective, consider a toxicology rotation in Australia. EMRA Toxicology Committee Vice Chair Brittany Garza, DO, MPH, shares a firsthand account.

Toxicology , Pharmacology

Case Report: A Review of Metformin-Associated Lactic Acidosis

12/10/2024 Madeleine Silverstein, MD , Avirale Sharma, MD , Vivek Medepalli, MD , Andrea Nillas, MD , Jedidiah Leaf, MD , Dazhe Cao, MD

In the emergency department, it can be difficult to get a complete medication history, especially in patients who have altered mental status or are too acutely ill to provide a meaningful history. Yet

Orthopedics , Neurology , Toxicology

Delayed Presentation of Gluteal Compartment Syndrome Complicated by Sciatic Neuropathy Following Prolonged Immobilization Due to Opioid Overdose: A Case Report

12/10/2024 Georgina Koutouzis, DO , Vanna Albert, MD

Compartment syndrome is an orthopedic emergency that can be difficult to identify but can lead to significant morbidity and mortality if unidentified or left untreated. A major risk factor for develop

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