Clinical pearls picked up from AnnalsofEM this month: •don't worry about over oxygenating TBIs in the first 4 hours •dilt .25mg/kg is probably the ideal starting dose for AFib rate control •rattlesnakes in Southern California can be neurotoxic

Our case shows CVVHDF reduces metformin half-life after overdose. Due to nursing shortages we were forced to switch from HD to CVVHDF. Happy to see this get published.

Landmark techniques for central access in snakes seem a lot harder than in humans

Does taking opioids while breastfeeding place infants at risk of opioid toxicity? Our new study in The BMJ led by Jonathan Zipursky finds no signal of harm in >85,000 infants of moms started on opioids after delivery. Not one death. bmj.com/content/380/bm…

Currency contamination? Old studies suggested cocaine commonly contaminates paper currency. A couple weeks ago we took cash from wallets/purses of 5 attendings/fellows, rinsed the bills with methanol, and screened for presence of cocaine & methamphetamine.

Dr. Spyres just gave a great talk on treatment of opioid use disorder in pregnancy at #ACMT2023. Thank you meghan spyres !

Google finds my work related internet searches concerning

The best part of Pharmacy and Therapeutics committee is seeing all the new potential drugs. The worst part is seeing a fecal transplant med costs $9000 per enema

20-something with huge verapamil overdose and cardiogenic shock hqmeded-ecg.blogspot.com/2023/05/20-som…

One of our fellows has this as a computer desktop background. Should I be concerned? The Tox And The Hound

3 years later I finally got the book I helped write a chapter for

Got to share my experience managing snake envenomations today at the zoo with our ED residents, zoo staff, and the local news