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

Toxicology , Dermatology

Case Report: Severe Chronic Argyria Secondary to Silver Supplement Use

12/10/2024 Brian Evans, MD , Jonathan Bartolomei, MD , Cory Howard, MD

Colloidal silver is a popular, yet unregulated, supplement used for a spectrum of perceived health benefits. However, the FDA issued a final rule deeming it “not generally recognized as safe and effec

Trauma , Urology , Psychiatry , Toxicology

Auto-Orchiectomy: Examining Cases, Causes, and Motives

12/3/2024 Samantha K. Kos, MS , Hannah G. Davis-Adams, BS, BA , Brooke M. Beers, MS , Bryan R. Troop, MD, FACS

Auto-orchiectomy has been linked to psychosis, substance use, and psychiatric disorders. Treating the result of the behavior is critical - but it’s also important to address the underlying impetus.

Toxicology , EMS , Prehospital Care

Buprenorphine on Wheels: Management of Opioid Use Disorder in Pre-Hospital Setting

12/2/2024 Carlos Rodriguez, DO , Sergio Camba, MD , Kimberly Baldino, MD

When paramedics initiate buprenorphine treatment for opioid use disorder (OUD) and suspected overdose in the prehospital setting, they reach patients who face the highest risk of opioid-related mortal

Toxicology , Dermatology , Psychiatry

Osteomyelitis and Auditory Hallucinations Associated with Long-Term Inhalant Use

12/2/2024 Laura Szczesniak, MD, PhD , Michael J. Uihlein, MD, CAQ Sports Medicine

The use of inhalants can lead to classic findings in the emergency department, but don’t forget to perform a thorough skin exam in any patient experiencing the effects of huffing.

Toxicology

Now That’s What I Call Tox!

12/2/2024 Brittany (Ladson) Garza, DO, MPH , E. Mason Jackson, MD , Katherine M. Markin, MD , John Michael Sherman, MD , Laura Szczesniak, MD, PhD

EMRA’s Toxicology Committee summarizes noteworthy toxicology papers. These were some of our favorites from 2024!

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