Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Contributors: Travis Barlock MD, Ian Gillman PA, Jacob Altholz MD, Jeffrey Olson MS4

In this episode, EM attending Travis Barlock and medical student Jeffrey Olson listen in to the two remaining cases presented from EMM's recent event, Tox Talk 2025.

Talk 1- Methemoglobinemia- Ian Gillman

  • Cyanosis + chocolate-colored blood + normal PaO₂ + pulse ox stuck at ~85% = Methemoglobinemia → Treat with methylene blue

  • The medications that can cause it can be remembered with…

  • Watch out with methylene blue as it can cause serotonin syndrome

  • While treating with methylene blue the pulse ox can drop dramatically but this is not a real drop in oxygenation but rather an effect of how the methylene blue affects the sensor

  • BADNAPS: causes of methemoglobinemia

    • Benzocaine

    • Aniline Dyes

    • Dapsone

    • Nitrites/Nitrates (Found in meds, preservatives, and well water)

    • Antimalarials

    • Pyridium

    • Sulfonamides

Talk 2- Intratecal TXA and Hierarchy of Controls for Error Avoidance - Jacob Altholz

  • Hierarchy of Controls in terms of error prevention includes all of the layers of protection which can be categorized as elimination, substitution, engineering controls, administration controls, and PPE

References

  • Centers for Disease Control and Prevention. (2022, April 28). Hierarchy of controls. National Institute for Occupational Safety and Health. https://www.cdc.gov/niosh/learning/safetyculturehc/module-3/2.html

  • Pushparajah Mak RS, Liebelt EL. Methylene Blue: An Antidote for Methemoglobinemia and Beyond. Pediatr Emerg Care. 2021 Sep 1;37(9):474-477. doi: 10.1097/PEC.0000000000002526. PMID: 34463662.

Produced by Jeffrey Olson, MS4

Donate: https://emergencymedicalminute.org/donate/

Join our mailing list: http://eepurl.com/c9ouHf

Jaksot(1146)

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Contributor: Ricky Dhaliwal MD Educational Pearls: Etomidate was previously the drug of choice for rapid sequence intubation (RSI) However, it carries a risk of adrenal insufficiency as an adver...

23 Joulu 20244min

Episode 935: Pregnancy Extremis - TOLDD

Episode 935: Pregnancy Extremis - TOLDD

Contributor: Aaron Lessen MD Educational Pearls: Pregnant patients at high risk of cardiac arrest, in cardiac arrest, or in extremis require special care A useful mnemonic to recall the appropriat...

16 Joulu 20243min

Episode 934: Subendocardial Ischemia

Episode 934: Subendocardial Ischemia

Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of v...

9 Joulu 20243min

Episode 933: Benign Convulsions with Gastroenteritis

Episode 933: Benign Convulsions with Gastroenteritis

Contributor: Alec Coston MD Educational Pearls: Causes of seizures in a fairly well-appearing child with diarrhea: Electrolyte abnormalities: hypocalcemia, hyponatremia Also hyperkalemia which...

2 Joulu 20243min

Episode 932: Induction Agent Hypotension

Episode 932: Induction Agent Hypotension

Contributor: Aaron Lessen MD Educational Pearls: Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting Many emerge...

25 Marras 20242min

Episode 931: Naloxone in Cardiac Arrest

Episode 931: Naloxone in Cardiac Arrest

Contributor: Aaron Lessen MD Educational Pearls: Can opioids cause cardiac arrest? Opioids can cause respiratory suppression and the subsequent low oxygen levels can lead to arrhythmias and eventual...

18 Marras 20243min

Episode 930: Holding Costs

Episode 930: Holding Costs

Contributor: Aaron Lessen MD Educational Pearls: A study evaluated the patient-care impact and financial costs of holding patients in the ED, a nationwide issue Prospective, observational study o...

15 Marras 20242min

Episode 929: Traumatic Aortic Injury

Episode 929: Traumatic Aortic Injury

Contributor: Aaron Lessen MD Educational Pearls: Aortic injury occurs in 1.5-2% of patients who sustain blunt thoracic trauma Majority are caused by automobile collisions or motorcycle accidents ...

4 Marras 20245min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
rss-astetta-parempi-elama-podcast
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
filocast-filosofian-perusteet
rss-ammamafia
rss-tiedetta-vai-tarinaa
rss-lapsuuden-rakentajat-podcast
rss-sosiopodi