Patient Interactions , Medications

Introducing the ‘Fiver’: A Modernized Alternative to the ‘B-52’ for Acute Agitation Control

7/22/2024 LT Matthew J. Christensen, MD

Violence against health-care workers caused by acutely agitated patients is an unfortunate reality for many of us. When attempts at verbal redirection do not successfully de-escalate the situation, ex

Nephrology , Toxicology

Blue Dye, Gotta Try: A Case of Metformin-Associated Lactic Acidosis

7/15/2024 Marlee Thomas, DO , Howard Levitin, MD, FACEP , Ryan Stuart, MD , Maria Lucarelli, MD

MALA is a difficult diagnosis to make due to lack of specific lab testing revealing toxicity. However, this disorder should be considered in patients presenting with marked hemodynamic instability wit

Toxicology , Toxicology Committee

Xylazine, Illicit Drug Combo: Deadly Cocktail on the Rise

6/7/2024 Brittany (Ladson) Garza, DO , Laura Szczesniak, MD , Mason Jackson, MD

Emergency physicians must keep multiple things in mind when treating patients presenting with suspected xylazine exposure. First and foremost, it may be difficult to diagnose, as routine urine drug sc

Toxicology

A Case of Paralytic Shellfish Toxin Poisoning in the Aleutian Islands

4/15/2024 Sarah Spelsberg, MD, FAWM, FEWM , Megan Sarnecki, MD , Sara Filmalter, MD, CAQSM, FAWM, DIDMM , Abraham Boxx, BCP, BSN, RN, TCRN, CFRN, CCRN, CEN, NRP, FP-C, FAWM , Heather Edmison, FP-C , Holli Carter, RN, BSN, CCRN, CFRN

Paralytic shellfish poisoning (PSP) is caused by eating filter feeders contaminated by paralytic shellfish toxin from algae. Toxin levels contained in a single shellfish can be fatal to humans. In cas

Toxicology , Cardiology , Addiction Medicine

Dangerous Pill to Swallow: A Case Report

4/15/2024 Alaina Royalty, MD , Matthew Eisenstat, MD, FAAEM

Recent literature shows that illicit benzodiazepines have been associated with significant impairment, have higher potencies than standard benzodiazepines, and are harder to identify via screening met

Op-Ed , Addiction Medicine , Recreational Drugs

The Fentanyl-Tainted Drug Supply Requires EDs to do More

3/26/2024 Timothy Kelly, MD

The ever-growing frequency of patients presenting to the emergency department with fentanyl overdoses — and fentanyl’s surging presence in cocaine and other black-market drugs — demands that we, as em

Addiction Medicine , Toxicology , Medications

Case Report: A Review of Clonidine Overdose Management

3/19/2024 Rachel Martin, MD , Andrew Morgan, DO , Mark Gustafson, DO

Clonidine is a widely available drug and has been seen as the culprit in an increased number of intentional and accidental overdoses. Symptoms of toxicity include hypertension or hypotension, bradycar

Critical Care Alert , Critical Care , Airway , Toxicology

Critical Care Alert: Effect of Noninvasive Airway Management of Comatose Patients with Acute Poisoning: A Randomized Clinical Trial

2/22/2024 Alex Lucas, MD , Christian Kasianko, MD , Dustin Slagle, MD

How reliable is the old adage, "GCS less than 8, intubate"? A randomized trial examines the effect of intubation vs. noninvasive airway management for poisoned patients with GCS less than 8.

Toxicology , Cardiology

ECMO…The Ultimate Antidote?

1/15/2024 Mason Jackson, MD , Lindsay Davis, DO, MPH, NRP , Brittany (Ladson) Garza, DO

There is no shortage of literature supporting the role of ECMO in acute coronary syndrome, sepsis, acute respiratory distress syndrome, cardiac arrest, pulmonary embolism, traumatic pulmonary contusio

Neurology , Nephrology , Toxicology

Valacyclovir-Associated Neurotoxicity in End-Stage Renal Disease

1/15/2024 Chad Barnhart, MD, EMT-P , Matthew Ball, MD , Michael B. Holbrook, MD

Valacyclovir-associated neurotoxicity (VAN) is a relatively rare phenomenon. This case report details a unique presentation of VAN in a hemodialysis-dependent patient. It underscores the importance of

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