Saturday with SMACC: The Art and Science of Fluid Responsiveness
Haney Mallemat – The Art and Science of Fluid Responsiveness from Social Media and Critical Care on Vimeo.
From SMACC Gold: In a great talk, Haney Mallemat from the University of Maryland discusses the limitations of static indices of fluid responsiveness such as blood pressure and respiratory-induced changes in inferior vena cava diameter. He argues persuasively that dynamic indices — such as change in stroke volume with passive leg raise — are more accurate and precise, although measurement is technically more difficult.
(Source: The Poison Review)
Source: The Poison Review - September 7, 2014 Category: Toxicology Authors: Leon Tags: Medical dynamic indices fluid responsiveness haney mallemat SMACC ultrasound Source Type: news
Must-read: consider hemodialysis in cases of massive acetaminophen overdose
4 out of 5 stars
Extracorporeal treatment of acetaminophen poisoning: Recommendations from the EXTRIP workgroup. Gosselin S et al. Clin Toxicol 2014 Aug 18:1-12. [Epub ahead of print]
Abstract
These recommendations come from the Extracorporeal Treatments in Poisoning (EXTRIP) workgroup, a project established to provide some guidance on the use of hemodialysis and other techniques in toxicology cases, an area where high-quality evidence simply does not exist. Although there has been some disagreement among toxicologists about the value of this effort, I have found the papers that come from EXTRIP extremely interesting a...
Source: The Poison Review - September 6, 2014 Category: Toxicology Authors: Leon Tags: Medical acetaminophen enhanced elimination extracorporeal treatment extracorporeal treatments in poisoning workgroup extrip massive overdose N-acetylcysteine paracetamol tylenol Source Type: news
Synthetic cannabinoid XLR-11 and driving
XLR-11
3 out of 5 stars
Driving Under the Influence of Synthetic Cannabinoid Receptor Agonist XLR-11. Lemos NP. J Forensic Sci 2014 Aug 3. doi: 10.1111/1556-4029.12550. [Epub ahead of print]
Abstract
XLR-11 is one of the many different synthetic cannabinoid compounds found in samples of smokeable herbs sometimes sold as “Spice” or “Legal Marijuana.” Exposure to XLR-11 has been associated with cases of acute kidney injury.
This case report describes a 22-year-old male who appeared “really high on weed” after being involved in a traffic accident. The man admitted to using “Blueb...
Source: The Poison Review - September 4, 2014 Category: Toxicology Authors: Leon Tags: Medical driving synthetic cannabinoid xlr-11 Source Type: news
Severed snake head bites, kills chef in China
Indonesian spitting cobra
USA Today reports that a chef in China died recently after being bitten by the decapitated head of an Indonesian spitting cobra, possibly Naja sputatrix. Chef Peng Fan beheaded the snake in preparation for making traditional cobra soup at his restaurant in Guangdong province. Ten to twenty minutes later, when he was disposing of the head, it bit him. “We did not know what was happening” one diner said, “but could hear screams coming from the kitchen.” The chef was dead before medical help could arrive. Cobra venom is predominantly neurotoxic and cardiotoxic. Death could ...
Source: The Poison Review - September 1, 2014 Category: Toxicology Authors: Leon Tags: Medical chef China fatal injury peng fan spitting cobra Source Type: news
Tox Tunes #87: Cocaine Blues (Bob Dylan 1961)
http://www.youtube.com/watch?v=x8a6eRME6po
This version of “Cocaine Blues” by a very young Bob Dylan was recorded in 1961, possibly shortly before he left Minnesota for New York City. It’s hard to believe that this was over half a century ago.
Related posts:
Cocaine Blues (Dave Van Ronk)
Cocaine Blues (Roy Hogsed)
Cocaine Blues (Nick Drake)
Cocaine Blues (Townes Van Zandt)
Cocaine Blues (Luke Jordan)
Cocaine Habit Blues (Memphis Jug Band)
Cocaine Blues (Keith Richards) (Source: The Poison Review)
Source: The Poison Review - August 31, 2014 Category: Toxicology Authors: Leon Tags: Medical bob dyland cocaine blues tox tunes Source Type: news
Saturday with SMACC: Resuscitation Dogmalysis
Reid, Cliff — Resuscitation Dogmalysis from Social Media and Critical Care on Vimeo.
From SMACC Gold 2014: Cliff Reid demonstrates that everything you thought you knew about treating critically ill patients may not be true. (Source: The Poison Review)
Source: The Poison Review - August 31, 2014 Category: Toxicology Authors: Leon Tags: Medical dogmalysis resuscitation SMACC Gold Source Type: news
Treating digoxin toxicity: is less more?
3 out of 5 stars
Digoxin-specific antibody fragments in the treatment of digoxin toxicity. Chan BSH, Buckley NA. Clin Toxicol 2014 Aug 4 [Epub ahead of print]
Abstract
This long detailed paper seems to be a manifesto masquerading as a review article. It is quite informative and well worth reading. But I’d keep in mind that the authors appear to have a (not so) hidden agenda: to decrease the dose of digoxin-specific antibody fragments administered in most cases of acute and chronic digoxin toxicity.
The authors state their objective up front:
To review the pharmacology, efficacy, effectiveness, indications, safety an...
Source: The Poison Review - August 29, 2014 Category: Toxicology Authors: Leon Tags: Medical digibind digifab digoxin specific antibody fragments digoxin toxicity Source Type: news
Hydrogen peroxide ingestion: can bedside ultrasound help?
http://www.youtube.com/watch?v=ed6mpRKmx14
3 out of 5 stars
Young Woman With Epigastric Pain and Vomiting. Manning EP et al. Ann Emerg Med 2014 Sep;64:330.
Full Text
This brief case is part of the Annals of Emergency Medicines‘s series “Image of the Month.” A 23-year-old woman develops epigastric pain and vomiting after investing a cleaning agent. Abdominal exam was unremarkable. a CT of the abdomen demonstrated gas in the portal veins.
The cleaning agent was hydrogen peroxide, which causes injury by two mechanisms: 1) corrosive tissue injury, and 2) gas formation. A previous case report indicated that...
Source: The Poison Review - August 29, 2014 Category: Toxicology Authors: Leon Tags: Medical bedside emergency ultrasound gas in portal vein hydrogen peroxide ingestion overdose Source Type: news
Blowguns, poison darts, and tajem
This interesting short film illustrates the meticulous care that goes into making a poison dart blowgun. The poison mentioned in the video — tajem — is made from latex obtained from the bark of a specific tree. I was not able to find out details about how it acts, but it appears to be cardiotoxic and produce fatal arrhythmias. One source mentions that there are several natural antidotes. Hunting with tajem-tipped poison darts is practiced by the Penan people in Borneo. (Source: The Poison Review)
Source: The Poison Review - August 27, 2014 Category: Toxicology Authors: Leon Tags: Medical blowgun cardiotoxicity pen an people poison darts Source Type: news
Blowguns, poison darts, and tajem poison
This interesting short film illustrates the meticulous care that goes into making a poison dart blowgun. The poison mentioned in the video — tajem — is made from latex obtained from the bark of a specific tree. I was not able to find out details about how it acts, but it appears to be cardiotoxic and produce fatal arrhythmias. One source mentions that there are several natural antidotes. Hunting with tajem-tipped poison darts is practiced by the Penan people in Borneo. (Source: The Poison Review)
Source: The Poison Review - August 27, 2014 Category: Toxicology Authors: Leon Tags: Medical blowgun cardiotoxicity pen an people poison darts Source Type: news
Body packers: can CT determine the number of drug packets?
Body packer
2.5 out of 5 stars
Sensitivity and specificity of CT scanning for determining the number of internally concealed packages in ‘body-packers.’ Asha SE et al. Emerg Med J 2014 Feb 19. doi: 10.1136/emermed-2013-203389. [Epub ahead of print]
Abstract
Although the abdominal CT scan has been shown to be relatively accurate for determining the presence or absence of drug packets in suspected body packers, there is no good data as whether or not the test is accurate in determining the number of such packets.
The abstract of this paper suggests that the authors — from Sydney’s St. George Hospital — ...
Source: The Poison Review - August 26, 2014 Category: Toxicology Authors: Leon Tags: Medical body packer CT mule radiography Source Type: news
CPC: salicylate toxicity
Discussion of salicylate toxicity misses several key points
Pearl: falsely normalized anion gap in salicylate overdose
Excellent guidelines for managing salicylate overdose
Salicylate toxicity can present with a normal-anion-gap metabolic acidosis
Salicylate toxicity: the great masquerader
(Source: The Poison Review)
Source: The Poison Review - August 25, 2014 Category: Toxicology Authors: Leon Tags: Medical aspiring poisoning case records of the massachusetts general hospital salicylate toxicity Source Type: news
Tox Tunes #86: Let’s Go Get Stoned (Big Mama Thornton)
http://www.youtube.com/watch?v=spkcAjt-TKU
Big Mama Thornton (1926-1984) was a powerful rhythm and blues singer who recorded and/or wrote a number of songs that were big hits for other artists. “Let’s Go Get Stoned” — written by Nickolas Ashford, Valerie Simpson, and Josephine Armstead — went to the top of th eR&B charts when Ray Charles released his version in 1966. Thornton recorded Leiber and Stoller’s song “Hound Dog” in 1952. It was popular, but not the monster hit Elvis Presley had with the song in 1956.
Thornton recorded her own song “Ball and Chain” in the ear...
Source: The Poison Review - August 25, 2014 Category: Toxicology Authors: Leon Tags: Medical big mama thornton let's go get stoned tox tunes Source Type: news
Saturday with SMACC: 17 Minutes
17 Minutes from Social Media and Critical Care on Vimeo.
It’s been 5 months since I returned from Brisbane and Australia’s Gold Coast where I attended the 2014 SMACC Gold conference — by far the most inspiring and creative medical conference I’ve ever been to. This brilliant video presentation from one of the plenary sessions is a perfect example of how SMACC differs from most other professional meetings. I’ll say no more about it, except to mention that it’s a definite must-see.
SMACC 2015 will take place June 23-25 next year and will be in my home town, Sweet Home Chicago! In addition to ...
Source: The Poison Review - August 23, 2014 Category: Toxicology Authors: Leon Tags: Medical 17 Minutes SMACC social media and critical care Tamara Hills Source Type: news
California counties sue makers of opioid analgesics
In May, two counties in California sued 5 pharmaceutical companies that make opioid analgesic medication, claiming that they waged a battle to create a “sea-change in medical and public perception” about the relative risks and benefits of these drugs by establishing a “deeply deceptive marketing campaign.” My Emergency Medicine News column about this suit is online and can be read here. (Source: The Poison Review)
Source: The Poison Review - August 22, 2014 Category: Toxicology Authors: Leon Tags: Medical big pharma California law suit opiates opioid analgesics Source Type: news
