Toxicology

Board Review: Toxicology

A 30 year-old female presents altered and minimally responsive. She was found next to an empty bottle of Valproic Acid. Her blood pressure is 130/80, heart rate is 90, afebrile and without tachypnea or hypoxia. You stabilize her. Depakote level is 550. What is the treatment of the choice? 

A. L-carnitine 

B. Naloxone

C. Carbapenem

D. Fomepizole

E. N-acetylcysteine 

F. Hemodialysis 

 

 

 

 

 

 

Answer: A, L-carnitine

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Back to Basics: Infantile Botulism

This post was inspired by a recent clinical case in our department. A 7 week full term infant s/p spontaneous vaginal delivery with a normal maternal prenatal screen and course presents to your ED for not eating x 12 hours. On exam, you note decreased spontaneous movements, a weak suck and a weak cry noted. Vitals are normal. What's the diagnosis? 

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Back to Basics: Succinylcholine and Hyperkalemia

“Airway cart to 9A. Intern, this tube is yours. What meds do you want?”

After the initial self-pulse check and change of scrub pants, two words come to mind: SOAP ME. Not in the literal sense, which may or may not be necessary depending on how nervous one is, but in the handy-dandy-easy-to-remember-in-high-pressure-situations-mnemonic sense. The deer-in-headlights (AKA intern-in-headlights look aside), this edition aims to take a look into an expected adverse reaction with a commonly used rapid sequence intubation (RSI) medication: hyperkalemia associated with succinylcholine administration.

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