PEARL: Pharmacy Education Applied to Resident Learners.

Introduction: Emergency medicine residents typically train with the support of emergency medicine pharmacists (EMP), but many EM residents will practice in post-graduation settings without EMP assistance. Therefore, a novel pharmacy curriculum for postgraduate year-1 (PGY-1) EMRs was developed, implemented, and assessed.

Methods: We performed a controlled study of 25 residents from two separate EM programs in Detroit, MI.

Fewer Opioids but More Benzodiazepines? Prescription Trends by Specialty in Response to the Implementation of Michigan's Opioid Laws.

Objectives: To characterize the effects of Michigan's controlled substance legislation on acute care prescriber behavior by specialty, in a single hospital system.

Design: A retrospective study of opioid and benzodiazepine prescription records from a hospital electronic medical record system between August 1, 2016, and March 31, 2019, in Detroit, Michigan.

Setting: Discharges from inpatient and emergency department visits.

Truncal Ataxia and Prolonged Coma in an Exploratory Pediatric Perampanel Ingestion.

Introduction: Several overdoses of the antiepileptic drug perampanel have been reported in adults, but very few have been reported in children. We report the case of an observed exploratory ingestion of perampanel in a 2-year-old child that resulted in ataxia and prolonged coma.

Case Report: A previously healthy 2-year-old female patient presented to the emergency department (ED) 30 minutes after the witnessed ingestion of 30 mg of perampanel (2 mg/kg).

Pennies for Your Thoughts: A Case Series of Pancytopenia Due to Zinc-induced Copper Deficiency in the Same Patient.

A 47-year-old schizophrenic male presented on three separate occasions with pancytopenia and sideroblastic anemia due to copper deficiency from massive zinc penny ingestion. The poisoning was treated differently on each visit: intravenous (IV) copper plus surgical decontamination and chelation with calcium disodium versenate (CaNa2EDTA); IV copper plus whole bowel irrigation; and IV copper with surgical decontamination only. Serum zinc half-lives were 80.

Hyperbaric oxygen therapy for systemic gas embolism after hydrogen peroxide ingestion.

Background: Hydrogen peroxide is a commonly available product and its ingestion has been demonstrated to produce in vivo gas bubbles, which can embolize to devastating effect.

Objective: We report two cases of hydrogen peroxide ingestion with resultant gas embolization, one to the portal system and one cerebral embolus, which were successfully treated with hyperbaric oxygen therapy (HBO), and review the literature.

Case Report: Two individuals presented to our center after unintentional ingestion of concentrated hydrogen peroxide solutions.

Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients.

Introduction: Early, effective lactate clearance has been shown to be associated with improved mortality in patients with trauma, burns, and sepsis. We investigated whether early, high lactate clearance was associated with reduced mortality in post-cardiac arrest patients.

Methods: We performed a retrospective analysis of post-cardiac arrest patients in an urban emergency department.