Toxic Alcohol Poisoning.

This article reviews the background, metabolism, clinical effects, and treatment of toxic alcohols, specifically ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropyl alcohol. This article also reviews the importance of an anion gap metabolic acidosis in relation to toxic alcohols and explores both the utility and the limitations of the osmol gap in patient management.

Emerging Agents of Substance Use/Misuse.

Over the last decade, the use of novel psychoactive substances (NPS) has increased. Some substances are derived from plants but an increasing number are synthetically produced. Examples include synthetic cannabinoids, synthetic cathinones, kratom, phenibut, designer opioids, and benzodiazepines.

Toxic Alcohols.

This article reviews the background, metabolism, clinical effects, and treatment of toxic alcohols, specifically ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropyl alcohol. This article also reviews the importance of an anion gap metabolic acidosis in relation to toxic alcohols and explores both the utility and the limitations of the osmole gap in patient management.

Opioid Exposures Reported to U.S. Poison Centers.

Objective: Opioid-related deaths are a leading cause of accidental deaths in the United States (U.S.).

Trends and risk markers of student hazardous drinking: a comparative analysis using longitudinally linked datasets in a public university.

This study compares the incidence and risk-markers of student alcohol intoxication-related emergency department (ED) visits and alcohol-related incidents reported to student affairs. Enrollment data were linked to ED visits with alcohol intoxication and to alcohol-related incidents reported to campus authorities within one year following the first (index) annual enrollment. Incidence, annual trends and associated risk markers were analyzed.

Accidental Pediatric Paliperidone Ingestion Resulting in Delayed Profound Tachycardia.

Background: Paliperidone is an atypical antipsychotic that is approved to treat schizophrenia in patients 12 years of age and older. There are minimal data on the clinical effects of exposure in the < 12-year-old age group.

Case Report: We report the case of a 7-year-old girl who was accidentally dosed with paliperidone for 3 days.

How not to train your dragon: a case of a Komodo dragon bite.

Komodo dragons (Varanus komodoensis) are the world's largest lizards, known for killing prey that exceed their body mass. Reports of bites to humans in the popular press suggest high degrees of morbidity and mortality. Reports in the medical literature are lacking.

Survival of acute hypernatremia due to massive soy sauce ingestion.

Background: Intentional massive sodium chloride ingestions are rare occurrences and are often fatal.

Objectives: There are a variety of treatment recommendations for hypernatremia, ranging from dialysis to varying rates of correction. We report a case of acute severe hypernatremia corrected with rapid free-water infusions that, to our knowledge, has not been previously reported.

Toxidromes.

The critical care physician is often called to care for poisoned patients. This article reviews the general approach to the poisoned patient, specifically focusing on the utility of the toxidrome. A toxidrome is a constellation of findings, either from the physical examination or from ancillary testing, which may result from any poison.

Hyperthermia and multiorgan failure after abuse of "bath salts" containing 3,4-methylenedioxypyrovalerone.

"Bath salts" are being increasingly used as drugs of abuse. These products have been found to contain a variety of compounds, including 3,4-methylenedioxypyrovalerone (MDPV). We present a case of a 25-year-old man who injected bath salts and acutely developed severe agitation, hyperthermia, and tachycardia.

Electrical therapies in cardiac arrest.

Recognition and appropriate treatment of ventricular fibrillation or pulseless ventricular tachycardia is an essential skill for healthcare providers. Appropriate defibrillation can improve survival and benefit patient outcome. Similarly, increased public access to automatic electronic defibrillators has been shown to improve out-of-hospital survival for cardiac arrest.

A case of cyanide poisoning and the use of arterial blood gas analysis to direct therapy.

Cyanide poisoning is a difficult diagnosis for health care professionals. Existing reports clearly demonstrate that the initial diagnosis is often missed in surreptitious cases. The signs and symptoms can mimic numerous other disease processes.