Is possible chest wall rigidity after illicit intravenous fentanyl administration clinically significant?

March 25, 2016, 6:05 pm

fentanyl★★★☆☆

Could chest wall rigidity be a factor in rapid deaths from illicit fentanyl abuse? Burns G et al. Clin Toxicol 2016 Mar 21 [Epub ahead of print]

Abstract

Wooden chest syndrome” describes marked muscle rigidity — especially involving the thoracic and abdominal muscles — that is an occasional adverse effect associated with the intravenous administration of lipophilic synthetic …

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TPR Podcast Episode #11: Google Glass and the Toxicologist

March 19, 2016, 5:31 pm

TPR Podcast Episode #11: Google Glass and the Toxicologist, with Dr. Peter Chai

 

Written by Leon Gussow MD FACMT

 

In this episode, Steve Aks and I talk to Dr. Peter Chai, a senior medical toxicology fellow at the University of Massachusetts in Worcester, about his research on Google Glass and its potential use as an aid to consultation on …

Podcast Episode
Play

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Sunday with SMACC: Amal Mattu on Lessons Learned from The Princess Bride

February 28, 2016, 7:52 pm

As the 2016 Social Media and Critical Care (SMACC) conference fast approaches — it will take place June 13-16 in Dublin — let’s look back on one my favorite talks from last years smaccCHICAGO get together. It’s Amal Mattu reflecting on lessons important to both life and emergency medicine contained in the 1987 film The Princess Bride. As with …

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Shiitake happens: dermatitis from uncooked mushrooms

February 20, 2016, 12:18 pm

puttography/shutterstock.com

puttography/shutterstock.com

★★★½☆

Shiitake dermatitis: the tale of an under-recognised, undercooked fungus. McNally A et al. Med J Aust 2016 Feb 15;204:124-6

Reference

 

Just when you thought it was safe to go back to the farmers’ market . . .

This interesting paper presents a series of 3 cases of flagellate dermatitis following consumption of raw or undercooked shiitake mushrooms. …

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Tox Tunes #106: Mountain Dew (The Stanley Brothers)

February 15, 2016, 12:43 am

Long before there was the soft drink, the term “mountain dew” referred to bootleg whiskey. Actually, the use of the term may have been brought over from Ireland. According to the Merriam-Webster dictionary, the use of the term to denote illegal alcohol goes back to the 1800s.

When I went to camp as a teenager, this was one of …

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Saturday with SMACC: Ho v Bellezzo debate — ECMO is a step too far

February 13, 2016, 7:20 pm

smacc-dublin

One of my favorite sessions from SMACC Chicago last year was the the debate between Chris Ho and Joe Bellezzo — both from Sharp Memorial Hospital in San Diego. Dr. Ho — on the resolution: ECPR (extracorporeal cardiopulmonary resuscitation) is a step to far. Dr. Ho took the affirmative side, arguing that ECPR (with is the same as ECMO) was …

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Severe bupropion overdose and ECMO: two great saves

February 12, 2016, 12:29 am

ChaNaWiT/shutterstock.com

ChaNaWiT/shutterstock.com

★★★½☆

Two Cases of Refractory Cardiogenic Shock Secondary to Bupropion Successfully Treated with Veno-Arterial Extracorporeal Membrance Oxygenation. Heise CW et al. J Med Toxicol 2016 Feb 8 [Epub Ahead of Print]

Abstract

This awesome, exciting paper from Banner University Medical Center in Phoenix describes two teenagers with severe bupropion overdose who survived refractory cardiac arrest after veno-arterial extracorporeal membrane oxygenation

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Case report: Amanita muscaria (fly agaric) poisoning

February 8, 2016, 11:05 pm

Mikhail Kochlev/shutterstock.com

Mikhail Kochlev/shutterstock.com

★★☆☆☆

Coma in the course of severe poisoning after  consumption of red fly agaric (Amanita muscaria). Mikaszewska-Sokolewicz MA et al. Acta Biochim Pol 2016 Feb 1 [Epub ahead of print]

Full Text

Probably the most recognizable mushroom in the world is Amanita muscaria (the “fly agaric”), This striking red-and-white fungus contains several distinct neurotoxins:

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W-18, a synthetic opiate 100 times more potent than fentanyl

February 4, 2016, 2:01 pm

W-18

W-18

Last August, Canadian police seized 110 illegal fentanyl pills at a home in Alberta province. Yesterday, Global News reported that some of the pills have tested positive for an extremely potent opioid called W-18.

This is certainly a disturbing development, since W-18 is a μ-receptor agonist 100 times more potent than fentanyl. According to B.C. Centre for Disease

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