Systemic Toxicity after Rattlesnake Envenomation in Patients Using Angiotensin Converting Enzyme Inhibitors: A North American Snakebite Registry Study.

Background: Some North American rattlesnake venoms and angiotensin converting enzyme inhibitor (ACEI) medications each increase bradykinin levels in humans, with clinical effects attributable to bradykinin described in exposed populations. Influence of ACEI exposure on persons with snake envenomation has not been studied. We used data from the ACMT North American Snakebite Registry (NASBR) to determine if use of ACEI medications at the time of rattlesnake envenomation is associated with increased rate of systemic toxicity.

Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department.

Study Objective: The objective of this study was to evaluate the optimal duration of monitoring for patients with presumed opioid overdoses prior to a non-ICU admission, particularly in the context of the increasing prevalence of fentanyl analogs and other potent synthetic opioids. Given the critical role of emergency physicians in managing this public health crisis, the study aims to inform clinical decisionmaking regarding patient disposition after the initial overdose treatment.

Methods: The Fentalog Study, conducted through the American College of Medical Toxicology's Toxicology Investigators Consortium, is a prospective, multi-institutional project designed to identify patients presenting to the emergency department with acute opioid overdose, gather clinical details, and confirm substances through biologic testing.

Wearable technology and daily diaries for studying mental health: lessons learned from pilot studies in Kampala, Uganda.

Wearable technology and daily diaries offer insights into everyday behaviors that can further health research and treatment globally. However, the use of these methodologies outside of high-income settings has been limited. We conducted two pilot studies that enrolled 60 young women in the urban slums of Kampala, Uganda to understand design considerations associated with using wearable technology and daily diaries in this context.

Medical Toxicology Consultations and Mortality Among Patients With Poisonings in the PICU.

Importance: Poisonings are a leading cause of preventable mortality and morbidity among children. Pediatric poisonings are commonly managed in pediatric intensive care units (PICUs) and may require complex treatment and specialized evaluation. Physicians specializing in medical toxicology are trained to treat poisoned patients of all ages; however, they are not universally part of the medical staff across hospital systems.

Manual Ventilation Performance With Safety Device in Normal Versus Decreased Lung Compliance: A Single-Center Simulation Study.

Resuscitator bags are commonly utilized in acute care settings; however, poor performance occurs irrespective of a provider's qualifications or experience. A new flow-limiting device (Sotair by SafeBVM, Boston, Massachusetts) limits inspiratory flow during manual ventilation, thus minimizing peak inspiratory pressures. This study examined the differences in flow, pressure, and tidal volume (V) during ventilation with a manual resuscitator connected to the flow-limiting device versus a mechanical ventilator.