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Emergency Medicine Cases

Ep 180 Acetaminophen Poisoning – Pitfalls in Assessment and Management

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7602 Ratings

🗓️ 14 March 2023

⏱️ 79 minutes

🧾️ Download transcript

Summary

In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes? What are the common ways in which we misinterpret the Rumack-Matthew nomogram? What are indications for fomepizole and dialysis after acetaminophen poisoning? Is hyperphosphatemia the best predictor of need for liver transplant in acetaminophen poisoning? and many more... Please support EM Cases by giving a donation: https://emergencymedicinecases.com/donation/

Transcript

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0:00.0

Welcome to the Emergency Medicine Cases podcast.

0:05.0

I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.

0:13.9

EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research

0:21.1

and education. The opinions expressed on this podcast are intended for information and education

0:24.2

purposes only and should not be used to diagnose treat or prevent any medical condition,

0:26.4

nor should they be used as a substitute for medical advice from qualified practicing physician.

0:29.4

A whopping one billion doses of acetaminopin, or paracetamol, as it's called in some countries,

0:35.5

are taken safely each year. But with that much

0:39.6

acetaminopin being ingested, it's no surprise that about 10,000 people in Canada every year

0:45.0

overdose on it. Some acetaminopin overdoses are easy to diagnose and relatively straightforward to

0:51.0

manage in the ED, but there are many points along the way of taking care of

0:55.1

these patients where pitfalls can rear their ugly heads leading to less than ideal outcomes.

1:00.3

And that's what this episode is going to be about. So pitfalls in the recognition and management

1:04.4

of acetaminifin poisoning. We're hoping that by the end of this episode, you'll recognize

1:08.4

all the places where it's easy to trip up in managing

1:11.0

these patients and provide stellar care for your next acetaminopin overdose patient.

1:15.4

And I'm so happy to have back on the show, our go-to-em-toxicologists.

1:19.9

You've likely heard many times before on EM cases, my personal favorite being episode 90

1:25.4

on low and slow poisoning. The wonderful doctor is Emily Austin and

1:29.6

Dr. Margaret Thompson, who work at St. Michael's Hospital in Toronto and at the Ontario Poison Center.

1:35.8

At the Poison Center, they help docs like you and I manage hundreds of talks patients a year.

1:40.0

Welcome back and thanks so much for coming on the show and sharing your blinding brilliance with us.

...

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