Reposted by Josh Kimbrell
everyone learns about TCA overdose in med school, but not bupropion XR overdose
time to level up
bupropion XR overdose is increasingly common & VERY dangerous
ongoing drug absorption creates a "toxin bomb" wherein patients look OK initially, but deteriorate later on... (#1/2) #EMIMCC
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CS:GO Bomb Defuse Timer Countdown Animation
ALT: CS:GO Bomb Defuse Timer Countdown Animation
![Methods
Four emergency medical services agencies contributed patients who received TCP from 2017-2024. Data were abstracted from electronic health records and cardiac monitor files. Sustained electrical capture was defined as a wide QRS complex with a T-wave after each pacer impulse for at least 90% of a 60 second period, followed by electrical capture for 90% of the remainder of the TCP attempt. Multivariable logistic regression modeling was used to estimate the association between variables of interest and sustained electrical capture.
Results
Of 299 patients, 29 (9.7%) had sustained electrical capture. Our cohort was a median 73 [62, 82] years of age, 48.5% (n=145) female, and 33.8% (n=101) had post-ROSC TCP. The median body weight was 78.3 [68-95.3] kilograms, pre-TCP heart rate was 38 [30, 45] beats per minute (bpm) and maximum TCP current was 90 [70-110] mA. Lower weight (aOR: 0.95 [0.93, 0.98] per kg; n=208), lower pre-TCP heart rate (aOR: 0.96 [0.93, 0.99] per bpm; n=297), and higher delivered current (aOR: 1.25 [1.08, 1.45] per 10 mA; n=208) were associated with higher odds of sustained electrical capture](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:vim26qfkrqvvp65z6eajaldy/bafkreibao6j6lnpvohxzenrynrurpespsi7dliggsajwmye67z5lafkmry)
