josh wang
@joshwangmd
emergency medicine - toxicology - bike bike bike
Henry Bazett (1885-1950) derived his QT correction formula from 42 adults and 5 children in exercise his QTc was NEVER intended to predict TdP, which was only described by Dessertenne in 1966

salicylate "allergy" is not a contraindication for physostigmine salicylate: - most salicylate "allergies" are dose-related and not IgE-mediated - 2 mg of physostigmine salicylate contains 0.5 mg of salicylate
adverse reactions to NAC: - itching, flushing, nausea, vomiting - mild INR elevation - hypotension - hemolytic anemia, cerebral edema in overdose - financial ruin if you are American
a classic inferior AST-elevation MI presenting with chest pain, nausea, and vomiting AST 201 U/L (ULN = 35)

bad news: diazepam and nordiazepam have prolonged action in cirrhotic patients with alcohol withdrawal good news: diazepam and nordiazepam have prolonged action in cirrhotic patients with alcohol withdrawal
lily of the valley in May are too mature to be mistaken for ramps and insufficiently appealing for kids to ingest

for uncomplicated alcohol intoxication in the ED: - blood [ETOH] doesn't matter - hyperlactatemia is routine and not prognostic - saline bolus doesn't alter clinical course or LOS check the cap glucose, skip the IV, monitor for aspiration, then DC when walking
sir, please put down the fomepizole Osm gaps are routinely elevated in patients with DKA/HHS thieme-connect.com/products/ejour…

common toxic exposures like ethanol and opioids are under-reported to poison centres ionizing radiation is an even more extreme example doi: 10.1080/15563650.2024.2412423
