To Dive or not to Dive

Introduction  Carbon monoxide (CO) poisoning results in approximately 50,000 emergency room visits per year. Further, it is the leading cause of death due to poisoning. When CO binds to hemoglobin it causes toxicity by creating carboxyhemoglobin (COHb). CO binds hemoglobin with 200 times greater affinity than does oxygen. Therefore, CO poisoning reduces the oxygen carrying … Continue reading To Dive or not to Dive

Psychogenic Polydipsia and the Case of Severe Hyponatremia

The Case The ambulance company calls in asking your emergency department to prepare for an agitated adult female with known psychiatric history.  Depending on where you work, this may involve having security at the ready with physical restraints and your best (strongest?) nurse with Haldol and Ativan in hand, for the patient’s safety and your … Continue reading Psychogenic Polydipsia and the Case of Severe Hyponatremia

ED Management of CCB Overdose: what works and where to start

From the moment I called Toxicology regarding a recent life-threatening Verapamil overdose, I realized that the number and variety of potential treatments for this toxicity can be overwhelming in an emergent situation. I was instructed to give “10-20mL of 10% calcium chloride followed by 48.75mEq/hour or 19.5-39mL/hour of 10% calcium chloride if needed.” None of … Continue reading ED Management of CCB Overdose: what works and where to start