Archive for June 2015

Recommendations for starting hemodialysis in salicylate toxicity

June 30, 2015, 9:03 pm

Screen Shot 2015-06-30 at 5.55.50 PM★★★½☆

Extracorporeal Treatment for Salicylate Poisoning: Systematic Review and Recommendations From the EXTRIP Workgroup. Juurlink D et al. Ann Emerg Med 2015 May 8 [Epub ahead of print]


Aspirin is an especially dangerous poison for a number reasons:

  • • It’s easy to purchase over-the-counter in large quantities
  • • Even after a life-threatening acute ingestion of salicylate, a patient can present

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Tox Tunes #97: Resurrection Mary (Ian Hunter)

June 21, 2015, 9:38 am

Combining Chicago lore, poisons, and a ghost, this is the perfect “Tox Tune” to post the weekend before smaccUS descends on the Windy City.

“Resurrection Mary,” which appeared on Ian Hunter’s 1996 album The Artful Dodger, recounts the famous Chicago ghost story involving about a vanishing hitchhiker who is periodically sited near the Resurrection Cemetery in southwest …

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Looking back: the first FOAMed meeting in the U.S.

June 20, 2015, 1:29 pm

FOAM mtg 2010

This photograph, from November 2010, documents what was to my knowledge the first #FOAMed get-together on U.S. soil. Gathered that evening at a tapas restaurant in San Francisco during the “Essentials of EM” conference were (from left to right):

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Illustrated case report of phenol exposure

June 18, 2015, 4:03 pm




Phenol Toxicity Following Cutaneous Exposure to Creolin®:A Case Report. Vearrier D et al. J Med Toxicol 2015 Jun;11:227-231.


This paper is worth looking at for the excellent color photographs of the partial thickness skin burns induced by exposure to Creolin®, which contains carbolic acid (phenol), sodium hydroxide, and isopropanol.

A 9-year-old girl was brought to the emergency department …

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Case series: 11 hospital workers symptomatic after ingesting “synthetic marijuana” brownies

June 16, 2015, 2:56 pm


Cluster of Acute Toxicity from Ingestion of Synthetic Cannabinoid-Laced Brownies. Obafemi AI et al. J Med Toxicol 2015 May 13 [Epub ahead of print]


This case series describes 11 patients brought to hospital after inadvertently ingesting brownies laced with the synthetic cannabinoid AM-2201.

All 11 patients were hospital workers who ingested brownies brought to work by a staff …

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Podcast: Managing the crashing tox patient with ECMO

June 16, 2015, 12:08 am

Screen Shot 2015-06-15 at 11.22.01 PM

As I wrote about in a recent column for Emergency Medicine News, extracorporeal membrane oxygenation (ECMO) may be the next big thing in managing the severely ill, crashing overdose patient in whom usual therapy is not working. On the new podcast posted today at the EDECMO website, Steve Aks and I got together over Skype with Joe Bellezzo, Zack …

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Dramatic recent increase in cases and deaths associated with use of synthetic cannabinoids

June 13, 2015, 5:22 pm


Increase in Reported Adverse Health Effects Related to Synthetic Cannabinoid Use —United States, January-May 2015. MMWR 2015 Jun 12;64:618-619.

Full Text

I have to say that this report shocked me some. Although I was aware of an increased number of news reports of incidents related to synthetic cannabinoids, I really had no idea the increased number of cases involving …

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How lipid rescue therapy works: it’s more than just a sink

June 9, 2015, 7:37 pm


Multi-modal contributions to detoxification of acute pharmacotoxicity by a triglyceride micro-emulsion. Fettiplace MR et al. J Control Release 2015 Jan 28;198:62-70


This study, from Guy Weinberg’s lab at the University of Illinois, used a rat model of bupivacaine toxicity, along with and computational analysis, to investigate the mechanisms by which lipid rescue therapy (LRT) might act in treating overdose …

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“Rick and Jerry”: a salute

June 8, 2015, 6:26 pm

At the Emergency Physicians Monthly website, Mel Herbert posted a lovely tribute to Rick Bukata and Jerry Hoffman as they pass off the lead anchoring duties on Emergency Medicine Abstracts to a new generation of medical educators.

I think Mel’s piece captures the impact and influence of the Abstracts perfectly. When I started listening to the monthly tapes in the …

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