Deep Dive MW R12
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 16 September 2023
⏱️ 16 minutes
🧾️ Download transcript
Summary
Introduction
* Used as pesticides
* Used as weapons (nerve agents)
* Sarin Gas, VX Gas, Novichok
* Transdermal, Inhalation, Ingestion
Clinical Presentation
* Muscarinic Activation (Dumbels Mnemonic)
* Defication
* Urination
* Myosis
* Bradycardia, Bronchospasm, and Bronchorrhea
* “The Killer B’s”
* Emesis
* Lacrimation
* Salivation and Sweating
* Nicotinic Activation
* Muscle weakness and paralysis
* CNS Activation
* Respiratory Depression
* Altered Mental Status
* Seizures
Treatment
* Atropine
* Reverses Dumbels
* Keep giving and doubling the dose until brochorrhea and bradycardia resolve
* Pralidoxime
* Only works before ‘aging’ occurs
* Diazepam
* Stops the seizures
Transcript
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| 0:00.0 | Hello, residents. My name is Mike Estefan, and I thank you for joining me on this month's |
| 0:06.6 | deep dive episode on the EM Clerkship podcast. We're going to be talking about organophosphate poisoning |
| 0:14.3 | today. But before we begin, just a quick word from our sponsors over at Pearson Rabbit's |
| 0:19.8 | insurance. Pearson Rabbit Insurance. |
| 0:21.6 | Pearson Rabbit is my personal disability insurance broker and soon-to-be life insurance broker. |
| 0:28.6 | Pearson Rabbit was founded by Stephanie Pearson and OBGYN who suffered a career-ending injury while on the job. |
| 0:36.6 | She had disability insurance herself through her employer, but ultimately had to spend |
| 0:41.7 | years in court fighting her case. |
| 0:44.7 | This is how she ended up in the insurance industry. |
| 0:47.9 | She wanted to make sure that no physician or other healthcare professional goes through |
| 0:53.1 | what she had to. |
| 0:55.0 | Pearson Rabbit will find you a real own occupation disability insurance policy, one that you won't |
| 1:02.0 | spend years in court fighting for your benefits if you are injured. |
| 1:06.0 | Importantly, the agents at Pearson Rabbit do not get any kickbacks or any commission to sell you one |
| 1:12.5 | company's policy over the other. This means that they are truly looking out for your best interests. |
| 1:19.2 | Don't wait until it's too late. Check out Pearson Rabbits at www.com and schedule a consultation appointment today. Don't forget to mention |
| 1:30.9 | EM clerkship when you do. And now back to the episode. Organophosphate poisoning. Not something |
| 1:39.5 | you see every day. But this stuff is fair game and high yield for exams, so it is important to learn. |
| 1:47.2 | First, we'll go through a general overview and quickly review the relevant physiology and pathophysiology. |
| 1:54.1 | After that, we'll discuss the clinical presentation of patients who have been poisoned by organophosphate, |
| 1:59.7 | and then finally we'll end the episode |
| 2:01.5 | by discussing the treatment. |
... |
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