Cardiology , Infectious Disease , Wilderness Medicine , Toxicology

Case Report: Heart Block Stemming from Lyme Disease

10/31/2024 Puja Singh, MD , Marian Gambrell, MD

We present a case of bradycardia and dyspnea in an otherwise healthy young male found to have EKG abnormalities inclusive of third-degree heart block. The culprit? Lyme disease.

Toxicology , Neurology

An Unusual Cause of Stuttering: A Case Report

10/31/2024 Grace Cheetany , Charles Worth, DO , Kristina Domanski, MD

Vague neurologic symptoms, including impaired speech, can be difficult to diagnose and – for female patients – dismissed as behavioral. But commonly prescribed medications such as SSRIs may be a cause

Patient Interactions , Toxicology , Pharmacology

Introducing the Fiver: A Modernized Alternative to the B-52 for Acute Agitation Control

10/22/2024 Matthew J. Christensen, MD, LT, MC, USN

Violence against health-care workers caused by acutely agitated patients is an unfortunate reality for many of us. When attempts at verbal redirection do not successfully de-escalate the situation, ex

Patient Interactions , Medications

Introducing the ‘Fiver’: A Modernized Alternative to the ‘B-52’ for Acute Agitation Control

7/22/2024 Matthew J. Christensen, MD, LT, MC, USN

Violence against health-care workers caused by acutely agitated patients is an unfortunate reality for many of us. When attempts at verbal redirection do not successfully de-escalate the situation, ex

Nephrology , Toxicology

Blue Dye, Gotta Try: A Case of Metformin-Associated Lactic Acidosis

7/15/2024 Marlee Thomas, DO , Howard Levitin, MD, FACEP , Ryan Stuart, MD , Maria Lucarelli, MD

MALA is a difficult diagnosis to make due to lack of specific lab testing revealing toxicity. However, this disorder should be considered in patients presenting with marked hemodynamic instability wit

Toxicology , Toxicology Committee

Xylazine, Illicit Drug Combo: Deadly Cocktail on the Rise

6/7/2024 Brittany (Ladson) Garza, DO , Laura Szczesniak, MD , Mason Jackson, MD

Emergency physicians must keep multiple things in mind when treating patients presenting with suspected xylazine exposure. First and foremost, it may be difficult to diagnose, as routine urine drug sc

Toxicology

A Case of Paralytic Shellfish Toxin Poisoning in the Aleutian Islands

4/15/2024 Sarah Spelsberg, MD, FAWM, FEWM , Megan Sarnecki, MD , Sara Filmalter, MD, CAQSM, FAWM, DiDMM , Abraham Boxx, BCP, NR-P, FP-C, BSN, FAWM , Heather Edmison, FP-C , Holli Carter, RN, BSN, CCRN, CFRN

Paralytic shellfish poisoning (PSP) is caused by eating filter feeders contaminated by paralytic shellfish toxin from algae. Toxin levels contained in a single shellfish can be fatal to humans. In cas

Toxicology , Cardiology , Addiction Medicine

Dangerous Pill to Swallow: A Case Report

4/15/2024 Alaina Royalty, MD , Matthew Eisenstat, MD, FAAEM

Recent literature shows that illicit benzodiazepines have been associated with significant impairment, have higher potencies than standard benzodiazepines, and are harder to identify via screening met

Op-Ed , Addiction Medicine , Recreational Drugs

The Fentanyl-Tainted Drug Supply Requires EDs to do More

3/26/2024 Timothy Kelly, MD

The ever-growing frequency of patients presenting to the emergency department with fentanyl overdoses — and fentanyl’s surging presence in cocaine and other black-market drugs — demands that we, as em

Addiction Medicine , Toxicology , Medications

Case Report: A Review of Clonidine Overdose Management

3/19/2024 Rachel Martin, MD , Andrew Morgan, DO , Mark Gustafson, DO

Clonidine is a widely available drug and has been seen as the culprit in an increased number of intentional and accidental overdoses. Symptoms of toxicity include hypertension or hypotension, bradycar

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