Question Of The Day

Historical QOD 4/9/09: Ciguatera fish poisoning results from eating predatory ocean dwelling fish contaminated with ciguatoxins. Approximately how many cases of ciguatera fish poisoning are reported worldwide on an annual basis? Ciguatera fish poisoning is endemic in tropical and subtropical regions of the Pacific basin,…

When managing the patient with severe organophosphate poisoning, what is a recommended endpoint for oxime therapy? According to the cited reference, the oxime infusion should be continued until the patient is extubated and atropine has not been needed for 12–24 hours Eddleston, M., Buckley, N….

What is the recommended duration of hemodialysis for patients with lithium toxicity when levels are not readily measurable? According to the cited reference, extracorporeal treatments should be continued for a minimum of 6 hours if the Li+ level is not readily measurable. Decker BS, Goldfarb…

What are the indications for hemodialysis in lithium toxicity? According to the cited reference, extracorporeal treatment is recommended in severe lithium poisoning. Extracorporeal treatment is recommended if kidney function is impaired and the lithium concentration is >4.0 mEq/L, or in the presence of a decreased…

What QRS duration may predict a risk of ventricular dysrhythmias in TCA overdose? According to the cited reference, determination of the maximal limb-lead QRS duration predicts the risk of seizures and ventricular arrhythmias in acute overdose with tricyclic antidepressants. In this study, ventricular dysrhythmias were…

Historical QOD 4/3/09: Para-chloroaniline is found as a product in the dye, pharmaceutical and herbicide industries. What is the primary potential health threat from p-chloroaniline following unprotected exposure for workers in these settings? P-chloroaniline is a potent methemoglobin inducer. In fact, p- chloroaniline is reportedly…

What QRS duration may predict a risk of seizure in TCA overdose? According to the cited reference, determination of the maximal limb-lead QRS duration predicts the risk of seizures and ventricular arrhythmias in acute overdose with tricyclic antidepressants. In this study, patients with QRS duration…

According to an observational cohort study of 5,784 patients who received droperidol in an academic emergency department, what was the incidence of akathisia? The authors did not find akathisia or dystonia coded in the electronic dataset. Among 796 independently reviewed charts, 2.9% (N = 23)…

Why is sodium bicarbonate generally thought to be ineffective in treating QRS widening as a result of bupropion overdose? Bupropion toxicity widens QRS by inhibiting cardiac gap junctions, whereas sodium bicarbonate corrects the QRS complex in situations where the widening is a result of sodium…

After pancreatic secretion, biological insulin has a half-life of between 3 and 10 min. In a recent case report, what were the kinetics of exogenous insulin in two patients who received the high dose insulin therapy? In both patients, insulin elimination followed apparent first order…