My EpiPen expired! Can I still use it?

EpiPenThe above question is common from patients with a history of an allergic reaction seen for a repeat emergency department visit. The manufacturers of EpiPen caution not to use the pen beyond the expiration date, and if the drug solution becomes discolored (oxidation). But EpiPens are expensive! Is there harm in using the pen beyond the expiration date? What should we tell our patients?1

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By |2017-07-05T14:48:04-07:00Jul 6, 2017|Tox & Medications|

AIR Series: Toxicology Module (2017)

Welcome to the Toxicology Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index the ALiEM AIR Team is proud to present the highest quality toxicology content. Below we have listed our selection of the 6 highest quality blog posts within the past 12 months (as of January 2017) related to Toxicologic emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 0 AIRs and Honorable Mentions. We recommend programs give 2 hours (about 20 minutes per article) of III credit for this module. As of June 2017, the AIR series is now being used by over 125 residency programs with over 1,200 residents completing at least one module in the 2016-2017 academic year.

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EM Pharmacotherapy Guidelines and Position Statements: Resource for ED Rotations

EM Pharmacotherapy GuidelinesSeveral years ago I created a resource for my ED rotation that I share with pharmacy students, pharmacy residents, and EM physician residents. It contains most of the guidelines and position statements on EM drug therapy that I utilize most often and is updated as new iterations are published. We’d like to share this tool with you to be used/modified to meet your rotation needs.

Last updated: February 22, 2018
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ACMT Toxicology Visual Pearls: Exotic Viper Envenomation

exotic snake envenomation

A man was bitten twice on the dorsal radial aspect of his right hand while feeding his pet West African Bush Viper. The patient immediately tied multiple tourniquets around his right arm before presenting to the emergency department. During examination he is complaining of swelling and severe pain in his right upper extremity, but has no other complaints. What are the appropriate next steps in managing this patient?

  1. Apply ice to the bites
  2. Measure compartment pressures in the right arm and forearm
  3. Perform a fasciotomy
  4. Remove the tourniquets and order hematologic studies
  5. Use a venom extractor to reduce venom burden

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