RCEM Learning May 2025
May 7, 2025
In this episode, a systematic review reveals that metoprolol may have fewer adverse effects than diltiazem for treating atrial fibrillation with rapid ventricular response. The hosts explore new guidelines for managing suspected poisoning in the emergency department, emphasizing a structured assessment approach. Practical tips for handling toxicology in adolescents are shared, along with humorous anecdotes. The conversation wraps up by highlighting new medical articles that cover crucial topics such as urgent eye conditions and informed consent.
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Episode notes
Metoprolol Safer than Diltiazem in AF
- Intravenous metoprolol causes fewer adverse events than diltiazem for fast atrial fibrillation.
- Patients with higher initial heart rates have greater risk of hypotension or bradycardia after rate control.
Toxicology History Essentials
- Take an accurate toxicology history focusing on timing, agents, dose, and release form.
- Document prescribed and accessed medications including herbal, illicit, and environmental exposures.
Use Toxbase Symptom Search Tool
- Use the Toxbase symptom search tool to identify possible toxins based on clinical features.
- Enter up to two symptoms to generate a differential diagnosis including rare and high-risk poisons.