The Orange Juice Clue
The parents of a 16-month-old boy who presented to the ED were concerned that he was too sleepy. His initial point-of-care glucose was noted to be 42 mg/dL, and he was somnolent but arousable, and was given orange juice.
Twenty minutes later, the child’s symptoms had completely resolved. Toxicology was consulted for evaluation of a possible toxic ingestion, and a medication inventory was recommended.
Differential Diagnosis of Hypoglycemia in Children
n Ethanol intoxication
n Beta blocker intoxication
n Salicylate toxicity
n Sulfonylurea
n Insulin injection
n Endocrine disorder (hypopituitarism, Addison’s disease,...
Source: The Tox Cave - September 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Orange Juice Clue
The parents of a 16-month-old boy who presented to the ED were concerned that he was too sleepy. His initial point-of-care glucose was noted to be 42 mg/dL, and he was somnolent but arousable, and was given orange juice.
Twenty minutes later, the child’s symptoms had completely resolved. Toxicology was consulted for evaluation of a possible toxic ingestion, and a medication inventory was recommended.
Differential Diagnosis of Hypoglycemia in Children
n Ethanol intoxication
n Beta blocker intoxication
n Salicylate toxicity
n Sulfonylurea
n Insulin injection
n Endocrine disorder (hypopituitarism, Addison’...
Source: The Tox Cave - September 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
"But So Does Aspirin"
We examined the impacts of aspirin and metformin on the life history of the cricket Acheta domesticus (growth rate, maturation time, mature body size, survivorship, and maximal longevity). Both drugs significantly increased survivorship and maximal life span. Maximal longevity was 136 days for controls, 188 days (138% of controls) for metformin, and 194 days (143% of controls) for aspirin. Metformin and aspirin in combination extended longevity to a lesser degree (163 days, 120% of controls). Increases in general survivorship were even more pronounced, with low-dose aspirin yielding mean longevity 234% of controls (i.e., h...
Source: Fight Aging! - July 20, 2015 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
No good options for chronic pain
In some not so good news, the FDA has substantially strengthened its warning on the risk of non-steroidal anti-inflammatory drugs, NSAIDS. Although aspirin is literally a non-steroidal anti-inflammatory, and has overlapping mechanisms of action with these drugs, it is not formally classified as an NSAID, basically because the term is designed to exclude it, as I will explain.NSAIDS include ibuprofen, naproxen, and celecoxib, which was at one time heavily advertised based on safety claims. These are widely used by people with osteoarthritis and other chronic pain conditions. The problem, as the FDA now concludes, is that th...
Source: Stayin' Alive - July 14, 2015 Category: American Health Source Type: blogs
Heavy Metal
Let's face it, he was heavy metal the minute he picked up his first guitar. Well, not really, but he is certainly cool enough to be...We finally got the boy in his braces. Sorry to all the Goldenhar patients that don't have a cleft palate, insurance will likely NOT pay for the braces. But that's okay. He is in them, and will be for a while. They only put on the top row this go around and will add the bottoms at a later appointment. He will also add the spacer later as well. He didn't want to put everything in his mouth at once and have the Gman super uncomfortable. The braces hurt bad enough, but nothing a little ibuprofen...
Source: Cochlear Kids - July 12, 2015 Category: Audiology Authors: VBnBama Source Type: blogs
Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.
Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have a...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.
Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Aspirin in Kawasaki disease
Aspirin is given both for its anti inflammatory effect and antiplatelet effect in Kawasaki disease. In the early stage it is for anti inflammatory effect while later it is for antiplatelet effect in case of coronary artery involvement. Anti inflammatory dose is high in the range of 80 to 100 milligrams per kilogram body weight and is given for only a short period. Only low dose in the range of three to five milligrams per kilogram body weight is needed for antiplatelet effect and is given for a longer period.
Aspirin – ibuprofen interaction
Ibuprofen can interfere with the antiplatelet effect of low dose aspirin and ...
Source: Cardiophile MD - June 1, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
District Court Dismisses Chicago's Painkiller Marketing Lawsuit Against Four of Five Opioid Manufacturers; Purdue Pharma Still on the Hook
District Court Judge Jorge Alonso of the Northern District of Illinois recently dismissed the City of Chicago’s lawsuit against four out of five pharmaceutical manufacturers that the city accused of marketing opioids in violation of Illinois’ consumer fraud laws and for causing doctors and pharmacies to submit, and the city to pay, claims that were false. Judge Alonso found the majority of allegations lacked the necessary specificity needed for a successful case. For example, while the City alleged fraudulent marketing schemes in fairly good detail, the complaint failed to mention the names of Chicago doctors or consum...
Source: Policy and Medicine - May 13, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Tenosynovitis: Two-Touch Diagnosis
Today you are the fast-track provider, and you are on the hunt for procedures. You notice a 35-year-old woman signing into triage with a chief complaint of wrist pain.
This patient looks otherwise healthy, is pushing a stroller with her right hand, and is carrying a second child on her left. What’s the emergency? There isn’t one, but it is an emergency to this patient because she cannot push that stroller another day! If she cannot push the stroller, then she cannot get the kids to day care. And, if she cannot get the kids to day care, then she cannot go to work. Ask anyone with children, it is an emergency.
This...
Source: The Procedural Pause - May 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Tenosynovitis: Two-Touch Diagnosis
Today you are the fast-track provider, and you are on the hunt for procedures. You notice a 35-year-old woman signing into triage with a chief complaint of wrist pain.
This patient looks otherwise healthy, is pushing a stroller with her right hand, and is carrying a second child on her left. What’s the emergency? There isn’t one, but it is an emergency to this patient because she cannot push that stroller another day! If she cannot push the stroller, then she cannot get the kids to day care. And, if she cannot get the kids to day care, then she cannot go to work. Ask anyone with children, it is an emergency.
...
Source: The Procedural Pause - May 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
General Guidelines Related to Abscess Incision and Drainage: Part II
Greetings! We’re excited to continue our series on abscess incision and drainage. This procedure should be loved and adored, because another abscess is waiting just behind the curtain. This month we will highlight (in video format) the final cut of abscess incision and drainage. We will follow up with some additional videos in the months to follow focusing on scalp, vaginal, and facial abscesses. And, just when you think you have seen it all, we will reveal a few more surprises.
The Approach
· Identification of an abscess appropriate for I&D
· If unsure, use ultrasound guide...
Source: The Procedural Pause - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Pearls for Abscess Incision and Drainage
Part 2 in a Series
Abscess incision and drainage should be loved and adored by all emergency providers because another abscess is waiting just behind the curtain. This month we highlight general guidelines for abscess incision and drainage, and show how to treat one in the video below. We will follow up with some additional videos in the months to come focusing on scalp, vaginal, and facial abscesses. And, just when you think you have seen it all, we will reveal a few more surprises.
Axillary abscess from hidradenitis. Photo by Martha Roberts.
The Approach
n Identification of an abscess appropriate for I&D....
Source: The Procedural Pause - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
