The Case:

A 48 yo M with a past medical history of hypertension and heroin use disorder presents to the Emergency Department (ED) with body aches and vomiting since this morning in the context of 14 hours since last heroin used. You note the patient is diaphoretic and restless with moderately dilated pupils, rhinorrhea, and a slight tremor. You are concerned the patient is in withdrawal. He is interested in getting into a medication-assisted treatment (MAT) program; however, he is currently undomiciled and does not know if he can follow up outpatient tomorrow. Here we discuss options to treat the patient's withdrawal and help bridge to outpatient MAT. 

Taylor Wahrenbrock, MD and Michael Nelson, MD

A 4-year-old boy born with no past medical history presents in cardiac arrest. As resuscitation measures are underway, you obtain collateral from EMS and parents. The patient’s sibling was recently diagnosed with a viral upper respiratory infection and was prescribed a cough suppressant. Unfortunately, the medication had been left within reach of the child, and an unknown number of capsules were ingested.

Here we will lead you through the management of the cough suppressant “Tesselon Perles”.

Sumeet Sandhu, DO & Jenny Lu, MD