Predicting delirium tremens in patients with alcohol withdrawal seizures

April 13, 2015, 9:16 pm

delirium_tremens_label_2★★☆☆☆

Clinical predictors for delirium tremens in patients with alcohol withdrawal seizures. Kim DW et al. Am J Emerg Med 2015 Feb 23 [Epub ahead of print]

Abstract

Being able to predict which patients with alcohol withdrawal seizures will go on to develop delirium tremens (DTs) may lead to improved clinical outcomes and decreased morbidity and mortality.  The goal of this …

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Risk of completed suicide after initial hospitalization for deliberate overdose

April 11, 2015, 11:58 am

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Risk of Suicide Following Deliberate Self-poisoning. Finkelstein Y et al. JAMA Psychiatry 2015 Apr 1 [Epub ahead of print]

Abstract

The authors primary objective was to determine the risk of subsequent successful suicide in patients discharged from hospital after a first suicide attempt. They used multiple healthcare databases to identify patients hospitalized for first suicide attempt in Ontario, Canada from …

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Less is more: fatal C. difficile colitis after empiric antibiotics

April 9, 2015, 12:05 am

Aspiration pneumonitis

Aspiration pneumonitis

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Antibiotics “Just-In-Case” in a Patient With Aspiration Pneumonitis. Joundi RA et al. JAMA Intern Med 2015 Apr 1;175:489-490

Reference

This very brief but very important case report contains more key points than most papers 10 times as long. The case describes a 50-year-old man with cerebral palsy and a known seizure disorder who had several witnessed tonic-clonic seizure …

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Factors associated with emergency department opioid-related adverse drug events

April 7, 2015, 10:22 pm

hydromorphone★★★½☆

Preventing Iatrogenic Overdose: A Review of In-Emergency Department Opioid-Related Adverse Drug Events and Medication Errors. Beaudoin FL et al. Ann Emerg Med 2014 Apr;65:423-431.

Abstract 

The authors retrospectively reviewed records of patients from 2 academic urban hospitals who were treated with naloxone after receiving an opioid in the emergency department (ED). Their goal was to identify factors associated with opioid-related …

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“Flakka”: one of the most bizarre drugs yet

April 3, 2015, 8:11 pm

South Florida has recently seen a number of cases associated (at least by history) by exposure to a street drug called “Flakka”:

In Lake Worth, a naked man brandishing a handgun stood on the roof of an apartment building, shouting “I feel delusional, and I’m hallucinating.”

In Fort Lauderdale, a man tried to kick in the door of

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Do we know the best treatment for jellyfish stings?

April 1, 2015, 9:01 pm

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What is the Most Effective Treatment for Relieving the Pain of a Jellyfish Sting? Ostermayer DG, Koyfman A.  Ann Emerg Med 2015 Apr;65:432-433.

Reference

This short article manages to pack a maximum amount of confusion into a very small space. The authors perform a literature search to find evidence that would answer their title question, but come up with only …

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3 die in Rochester NY after smoking cocaine/fentanyl combination

March 31, 2015, 11:30 pm

Several days ago, WHEC NBC news in Rochester NY reported that in the previous week at least 3 people in the area died after smoking a mixture of cocaine and fentanyl. There may have been as many as 4 additional recent deaths associated with this combination.

Late last year, there were 3 similar deaths in North Carolina.

HT: …

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ACEP Toxicology Section Antidote App (free)

March 27, 2015, 12:28 pm

Screen Shot 2015-03-27 at 11.39.48 AM

This simple but very useful app, from the Toxicology Section of the American College of Emergency Physicians, provides basic information about uses and dosing of basic antidotes used in toxicology. Version 1.1 covers approximately 50 different antidotes from A (acetylcysteine) to T (thiamine).

Of course, clinical judgment is still required when considering these treatments, and most situations requiring use of …

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Review: 23 patients with laboratory-confirmed MDPV exposure

March 24, 2015, 7:48 pm

Methylenedioxypyrovalerone (MDPV)

Methylenedioxypyrovalerone (MDPV)

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Acute Methylenedioxypyrovalerone Toxicity. Fruberg BA et al. J Med Toxicol 2014 Dec 3 [Epub ahead of print]

Abstract

This is an impressive paper, but for reasons the authors thoroughly discuss in their limitations sections, there is somewhat less here than meets the eye.

The authors retrospectively reviewed patients seen over a 2-year period at 10 different hospitals who …

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