Smoke and Mirrors
A 42M factory worker presents to the ED w/ shortness of breath, chest tightness, and skin burning over the past 6 hours. At work, he spilled liquid phosgene on himself but initially had no symptoms. What is the first step in his management?
What is decontamination
What is the main risk of administering flumazenil in benzodiazepine overdose?
What are seizures
You are caring for a patient presenting for a beta blocker overdose. After going through the ACLS bradycardia algorithm, and starting an epinephrine drip, what other medication can you consider?
What is glucagon or insulin
This treatment, used in severe cyanide poisoning, works by binding cyanide and converting it into a nontoxic compound that is excreted in urine.
What is hydroxycobalamin (cyanokit)
This opioid can lead to QTc prolongation and torasades de pointes.
What is methadone
This is a group question. Each contestant to name one physical exam finding concerning for smoke inhalation.
What are singed nasal airs, facial burns, soot in nose and pharynx, stridor, voice hoarseness, wheezing or rhonchi, soot in oropharynx, black sputum
What class of psychiatric medication in overdose would most classically cause these ECG findings
Tricyclic antidepressants
You are managing a patient with a quinidine (class IA antiarrhythmic) overdose. Their ECG is as shown. What medication is immediately indicated.
What is sodium bicarbonate
A 27-year-old pregnant female is brought to the ED after being found unconscious at home. Her husband reports that she had been complaining of a severe headache, nausea, and dizziness earlier before she collapsed. You suspect carbon monoxide poisoning. Besides 100% on nonrebreather, what therapy may be indicated?
What is hyperbaric oxygen.
A 35M presents code 3 for shortness of breath, cyanosis, and aO2 saturation of 84% despite 15L on a nonrebreather. Prior to symptom onset, he used a medication he purchased at a gas station in order to enhance sexual pleasure. What quick bedside test can help support the diagnosis.
What is an ABG
As a child, Hamzah maintained his neighbor’s pool when they were out of town. His first task involved opening a large tub of white tablets to place in the pool. After repeated misadventures, he eventually learned he needed to hold his breath while opening the tub because inhaling resulted in an immediate sharp chest. Upon reflection at the age of 29, what gas was he exposing himself to?
Chlorine gas
What is the most common ECG finding in bupropion overdose?
What is sinus tachycardia
A 79F with dementia p/w bradycardia and hypotension. You are unable to clarify her medication list or medical history. Based on her ECG below, what treatment is indicated.
What is Digifab/Digibind
What is an alternative IV treatment to methylene blue in the management of methemoglobinemia?
What is ascorbic acid (Vitamin C)
n a small mixing bowl, add 40 mg ketamine, 80 mg MDMA, 200 mg methamphetamine, 100 mcg fentanyl, 100 mg cocaine, and pink food coloring. Mix thoroughly. (Then discard). What do you get?
What is pink cocaine, pink panther, Tusi, 2C
A 34F is admitted to SICU at SCVMC for burns after a house fire. She is intubated for airway edema. On day 2 of hospitalization, she develops progressively worsening hypoxia. What is the most likely cause of her worsening respiratory status?
What is ARDS
This partial mu receptor agonist, in overdose, is most commonly associated with serotonin syndrome.
What is tramadol.
A 56F presents for V-tach cardiac arrest after she accidentally took too many of her daily flecainide tablets. You achieve ROSC after one round of compressions. However, she continues to have additional episodes of polymorphic V-tach that respond to defibrillation. What is one treatment option specifically using the Zoll to prevent additional episodes of cardiac arrest.
What is overdrive pacing
Name an ECG finding that may be associated with CO poisoning.
ST-segment elevation or depression, T-wave inversions, or new-onset left bundle branch block (LBBB), any ischemic changes.
This recreational drug which has become increasingly popular over the past 2 years, is clinically similar to clonidine or dexmedetomidine, sometimes used as an adulterant to fentanyl, causes bradycardia, respiratory depression, and hypotension?
What is Xylazine, or tranq