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Should digoxin immune fab be administered based solely on reported ingested amount in acute digoxin poisoning?
Am J Emerg Med
January 2025
Minnesota Regional Poison Center, Department of Pharmacy, Hennepin Healthcare, Minneapolis, MN, USA; Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA. Electronic address:
Acute digoxin poisoning is increasingly uncommon in emergency medicine. Furthermore, controversy exists regarding indications for antidotal digoxin immune fab in acute poisoning. In healthy adults, the fab prescribing information recommends administration based on "known consumption of fatal doses of digoxin: ≥10mg," while many emergency medicine textbooks suggest fab administration be driven by clinical features or potassium concentration.
View Article and Find Full Text PDFDataset and analysis of automated and manual methods to differentiate wide QRS complex tachycardias.
Data Brief
February 2025
Department of Medicine, Division of Cardiovascular Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Article Synopsis
- Differentiating between ventricular tachycardia (VT) and supraventricular wide tachycardia (SWCT) using 12-lead ECG is challenging and has traditionally depended on manual interpretation, which can be limited by the user's expertise.
- Recent research has introduced automated algorithms that may offer improved accuracy over manual methods, but there has been little direct comparison between these two approaches.
- A study by LoCoco et al. (2024) evaluated the effectiveness of traditional manual ECG differentiation methods against five automated algorithms, analyzing 213 ECGs to assess their diagnostic performance.
Automated differentiation of wide QRS complex tachycardia using QRS complex polarity.
Commun Med (Lond)
December 2024
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Background: Wide QRS complex tachycardia (WCT) differentiation into ventricular tachycardia (VT) and supraventricular wide complex tachycardia (SWCT) remains challenging despite numerous 12-lead electrocardiogram (ECG) criteria and algorithms. Automated solutions leveraging computerized ECG interpretation (CEI) measurements and engineered features offer practical ways to improve diagnostic accuracy. We propose automated algorithms based on (i) WCT QRS polarity direction (WCT Polarity Code [WCT-PC]) and (ii) QRS polarity shifts between WCT and baseline ECGs (QRS Polarity Shift [QRS-PS]).
View Article and Find Full Text PDFChallenges to Contemporary Wide Complex Tachycardia Criteria: A Single-center Case Series of 1:1 Atrial Flutter.
J Innov Card Rhythm Manag
October 2024
Department of Internal Medicine, Section of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Atrial flutter with 1:1 atrioventricular conduction is a rare cause of wide complex tachycardia, which presents a diagnostic challenge. This report describes a series of eight cases of 1:1 atrial flutter compiled during 2018-2022. The cases in this report include patients without class 1 anti-arrhythmic use or pre-excitation.
View Article and Find Full Text PDFDiphenhydramine Overdose: A Case Report and Topic Review of Prehospital Diagnosis and Treatment.
Cureus
October 2024
Emergency Medicine, Florida State University College of Medicine, Sarasota, USA.
Diphenhydramine (DPH), a readily available first-generation H1 receptor antihistamine, can have severe consequences when taken in excessive amounts and can lead to grave outcomes such as seizures, dysrhythmias, coma, and death. Recognizing the early signs and symptoms of DPH toxicity is crucial. Fortunately, fatal adult cases of DPH overdose are rare.
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