Massive Atropine Eye Drop Ingestion Treated with High-Dose Physostigmine to Avoid Intubation

Case: A 34-year-old male presented after ingesting 150 mg of atropine. He had altered mental status, sinus tachycardia, dry mucosa, flushed skin, and hyperthermia. Sequential doses of physostigmine, totaling 14 mg, were successful in reversing antimuscarinic toxicity and prevented the need to perform airway control with endotracheal intubation. At completion of treatment, heart rate and mental status had improved, and intubation was never performed. Discussion: Atropine causes anticholinergic toxicity; physostigmine reverses this by inhibiting acetylcholinesterase. Atropine eye drop ingestions are rare. The 14 mg of physostigmine administered is much higher than typical dosing. It is likely the physostigmine prevented intubation. Atropine eye drops can be dangerous, and physostigmine should be considered in treatment. [West J Emerg Med. 2012;13(1):77–79.

No Established Link between Repeated Transient Chokes and Chronic Traumatic Encephalopathy Related Effects. Comment on Lim, L.J.H. et al. Dangers of Mixed Martial Arts in the Development of Chronic Traumatic Encephalopathy. <i>Int. J. Environ. Res. Public Health</i> 2019, <i>16</i>, 254

This letter to the editor is in response to &#8220;Dangers of Mixed Martial Arts in the Development of Chronic Traumatic Encephalopathy&#8222; by authors Lim, Ho, and Ho, which was published in the International Journal of Environmental Research and Public Health (2019; 16: 254). This communication clarifies some potentially misleading word choices by the authors and addresses the insinuated, but not established, link between repeated transient choking episodes during martial arts training and a gradual decline in neuropsychiatric testing in the patient presented in the report

Holiday Plants with Toxic Misconceptions

Several plants are used for their decorative effect during winter holidays. This review explores the toxic reputation and proposed management for exposures to several of those, namely poinsettia (Euphorbia pulcherrima), English holly (Ilex aquifolium), American holly (Ilex opaca), bittersweet (Solanum dulcamara), Jerusalem cherry (Solanum pseudocapsicum), American mistletoe (Phoradendron serotinum), and European mistletoe (Viscum album)

Holiday Plants with Toxic Misconceptions

Several plants are used for their decorative effect during winter holidays. This review exploresthe toxic reputation and proposed management for exposures to several of those, namelypoinsettia (Euphorbia pulcherrima), English holly (Ilex aquifolium), American holly (Ilex opaca),bittersweet (Solanum dulcamara), Jerusalem cherry (Solanum pseudocapsicum), Americanmistletoe (Phoradendron serotinum), and European mistletoe (Viscum album). [West J Emerg Med.2012;13(6):538-542

Holiday Plants with Toxic Misconceptions

Several plants are used for their decorative effect during winter holidays. This review exploresthe toxic reputation and proposed management for exposures to several of those, namelypoinsettia (Euphorbia pulcherrima), English holly (Ilex aquifolium), American holly (Ilex opaca),bittersweet (Solanum dulcamara), Jerusalem cherry (Solanum pseudocapsicum), Americanmistletoe (Phoradendron serotinum), and European mistletoe (Viscum album). [West J Emerg Med.2012;13(6):538-542

Bath Salts: The Ivory Wave of Trouble

[West J Emerg Med. 2012;13(1):58–62.

Bath Salts: The Ivory Wave of Trouble

[West J Emerg Med. 2012;13(1):58–62.