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A novel multi-drug treatment protocol for fentanyl/xylazine “tranq dope” withdrawal did not result in clinically significant increases in QTc. However, less than half of the patients adhered to the protocol.
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Assessing the Cardiac Safety of a Multimodal Protocol for ‘Tranq Dope’ Withdrawal: A Retrospective QTc Analysis. Am J Emerg Med. 2026 Jan;99:313-324. doi: 10.1016/j.ajem.2025.10.033. Epub 2025 Oct 17. PMID: 41151217.
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This retrospective analysis found an increased rate of repeat naloxone administration in US EDs from 2016–2022.
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Use of Multiple Naloxone Administrations in the Emergency Department: A Retrospective Claims-Based Analysis. J Emerg Med. 2025 Dec;79:111-122. doi: 10.1016/j.jemermed.2025.04.022. Epub 2025 May 8. PMID: 41129837.
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Nitazenes (a class of synthetic opioids) entered the international drug market in 2019 and are becoming a more frequently encountered substance in the ED.
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Clinical Experiences With the Nitazene Class of Synthetic Opioids: A Cohort Study. Ann Emerg Med. 2025 Nov;86(5):475-483. doi: 10.1016/j.annemergmed.2025.06.619. Epub 2025 Aug 14. PMID: 40810707.
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Nitazenes are novel and extremely potent synthetic opioids, often adulterants. They are undetectable by drug screens and treatable by naloxone.
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Nitazenes: Are Pain Physicians Aware of the Risks? Pain Med. 2025 Sep 14:pnaf127. doi: 10.1093/pm/pnaf127. Epub ahead of print. PMID: 40971704.
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Polydrug overdoses that include synthetic opioids (for example, cocaine + fentanyl) are a significant and rising cause of overdose deaths for adolescents. However, death rates from synthetic opioids alone continue to rise rapidly and are still more common than polydrug + synthetic opioid deaths in this age group.
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Changes in Synthetic Opioid-Involved Youth Overdose Deaths in the United States: 2018-2022. Pediatrics. 2025 Jun 1;155(6):e2024069488. doi: 10.1542/peds.2024-069488. PMID: 40392279
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Ingesting household bleach rarely causes esophageal or gastric injury in children, making routine endoscopy unnecessary in most cases.
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The effects of liquid bleach ingestion on children’s esophageal and gastric mucosa. J Pediatr Gastroenterol Nutr. 2025 May 8. doi: 10.1002/jpn3.70063. Epub ahead of print. PMID: 40341791
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Hyperbaric oxygen (HBO2) therapy may lead to slightly improved delayed neurologic outcomes – particularly improved memory – when compared to non-HBO2 in patients with acute carbon monoxide (CO) poisoning.
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A Critical Issue in the Management of Adult Patients Presenting to the Emergency Department With Acute Carbon Monoxide Poisoning: Approved by the ACEP Board of Directors January 22, 2025. Ann Emerg Med. 2025 Apr;85(4):e45-e59. doi: 10.1016/j.annemergmed.2024.12.005. PMID: 40118649
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Hyperbaric oxygen is a seldom-used but effective adjunct when specific indications are met. Here’s what you need to know.
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Hyperbaric Oxygen Therapy: An Evidence-Based Primer for Emergency Physicians. J Emerg Med. 2025 Mar;70:35-44. doi: 10.1016/j.jemermed.2024.09.009. Epub 2024 Oct 9. PMID: 39939188
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In this letter to the editor and reply, the goal of antivenom in crotalid envenomations is debated and clarified.
Sources
Letter to the editor re: Comparing the Use of Crotaline-Polyvalent Immune Fab (Ovine) Versus Observation in Children. Pediatr Emerg Care. 2024;40(11):e270-e276. Pediatr Emerg Care. 2025 Mar 20. doi: 10.1097/PEC.0000000000003373. Epub ahead of print. PMID: 40108879
Reply: Comparing the Use of Crotaline-Polyvalent Immune Fab (Ovine) Versus Observation in Children. Pediatr Emerg Care. 2025 Mar 20. doi: 10.1097/PEC.0000000000003380. Epub ahead of print. PMID: 40111158
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With notable exclusion criteria, the incidence of intubation in opiate overdose patients after 4 hours was rare in this study: 9/1591 (0.6%).
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Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department. Ann Emerg Med. 2025 Mar 3:S0196-0644(25)00060-5. doi: 10.1016/j.annemergmed.2025.01.022. Epub ahead of print. PMID: 40047773