Illicit drug-induced hyperthermia presents difficult decisions under time pressure. This review discusses recognition, heat production, cooling and supportive care, drawing on clinical cases and examining the practical pitfalls of managing these uncommon emergencies.
How do intramuscular olanzapine and haloperidol compare for acute agitation in the ED? Greg Yates examines a small open-label randomised trial, considering sedation outcomes, adverse events and how blinding and patient selection affect the conclusions.
How can we improve acute pain relief for patients who use opioids? Greg Yates reviews a trial of low-dose ketamine added to morphine, looking at short-term analgesia, adverse effects and the limits of applying its findings to patients using illicit opioids.
PodcastEvidence-Based Medicine
The October 2024 podcast round-up covers emerging poisoning trends, defibrillator pad position and tranexamic acid dosing in trauma. The discussion also reflects on the RCEM conference and the importance of recognising successes within the team.
What can a Japanese surveillance study tell us about the safety of fomepizole in suspected methanol and ethylene glycol poisoning? Greg Yates reviews the reported adverse reactions, the study's limitations and the uncertainty when the initial diagnosis is wrong.
What happens after an overdose of a GLP-1 agonist such as semaglutide? This appraisal examines US poison-centre data on dosing errors, reported symptoms and hypoglycaemia, and considers how incomplete reporting and broad outcome definitions limit what the study can tell emergency clinicians.
Practical perspectives on trauma care and team leadership.
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