Emergency Medical Minute5 Juli 2022

Podcast 795: Lithium Toxicity

Contributor: Peter Bakes, MD

Educational Pearls:

Lithium remains a commonly used medication for treating bipolar disorder
Lithium toxicity can be acute, acute-on-chronic, or chronic
Measuring blood lithium level

Therapeutic range of lithium is around 1.6-1.8 mEq/L
>2 mEq/L is likely to cause significant toxicity
>4 mEq/L necessitates lifesaving treatment
The lethal dose of lithium is 700 mg/kg
Lithium can have delayed absorption resulting in levels increasing during hospitalization

Symptoms associated with acute lithium toxicity

Gastrointestinal

Nausea, vomiting, abdominal pain

Neurological

Tremor, nystagmus, CNS depression (late finding)

Cardiovascular

Bradycardia, QT prolongation, EKG changes

Treatment for lithium toxicity

ABCs
Get a good history
GI Decontamination:

Whole bowel irrigation if patient ingested extended-release tablets

Dialysis

Most effective treatment for lithium toxicity

References

Baird-Gunning J, Lea-Henry T, Hoegberg LCG, Gosselin S, Roberts DM. Lithium Poisoning. J Intensive Care Med. 2017;32(4):249-263.

McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379(9817):721-728.

Summarized by Mark O'Brien, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!

Det här avsnittet är hämtat från ett öppet RSS-flöde och publiceras inte av Podme. Det kan innehålla reklam.

Avsnitt(1175)

Podcast 1020: Benign Paroxysmal Positional Vertigo (BPPV)

Contributor: Alec Coston, MD Educational Pearls: Benign Paroxysmal Positional Vertigo (BPPV) Common inner ear condition that can cause dizziness Diagnosis of BPPV can help to avoid admissions and ...

7 Sep 6min

Podcast 1019: Trauma Blunt Cardiovascular Injuries (BCVI)

Contributor: Aaron Lessen, MD Educational Pearls: Blunt cerebrovascular injury (BCVI) BCVI is a traumatic injury to the carotid or vertebral arteries Patients may initially have no neurologic sy...

31 Aug 3min

Podcast 1018: Occult Ventricular Fibrillation on Echocardiography

Contributor: Aaron Lessen, MD Educational Pearls: Big question in cardiac arrest: is the rhythm shockable? Shockable: ventricular fibrillation (VF) and pulseless ventricular tachycardia Non-sho...

24 Aug 2min

Podcast 1017: CPR Hand Placement

Contributor: Taylor Lynch, MD Educational Pearls: CPR is an important life-saving measure designed for anyone to perform. Chest compressions works by two mechanisms: Cardiac pump: Direct squ...

17 Aug 2min

Podcast 1016: Hypokalemia

Contributor: Meghan Hurley, MD Educational Pearls: What is hypokalemia? Hypokalemia is when the measured blood level of potassium falls below 3.5 mEq/L (normal 3.5 - 5.2 mEq/L). Can generally be ...

10 Aug 6min

Podcast 1015: Calcium in Hyperkalemia

Contributor: Meghan Hurley, MD Educational Pearls: What is hyperkalemia? Hyperkalemia is when the measured blood level of potassium reaches above 5.2 - 5.5 mEq/L (normal 3.5 - 5.2 mEq/L). What ar...

3 Aug 7min

Podcast 1014: Eating and Drinking on Shift

Contributor; Aaron Lessen, MD Educational Pearls: A 2026 survey asked Canadian emergency medicine (EM) physicians about their eating and drinking habits while on shift. Among 527 respondents, 35%...

27 Juli 2min

Podcast 1013: Thoracotomy Indications

Contributor; Taylor Lynch, MD Educational Pearls: Thoracotomy Thoracotomy is used in traumatic cardiac arrest to replace conventional CPR with direct access to the chest. Goals include identif...

20 Juli 3min