The American journal of emergency medicine
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Metformin toxicity is a rare but serious condition that carries with it a high rate of morbidity and mortality. ⋯ An understanding of metformin toxicity can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
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Overdose fatalities are increasingly attributed to synthetic opioids, including fentanyl, which may be added to samples of illicit substances unknowingly to the user. As recently as April 2023, the Centers for Disease Control and Prevention has also raised awareness of the risks of xylazine, an animal tranquilizer that has been found in adulterated samples of illicit substance. ⋯ In this article, we advocate for emergency medical services to distribute fentanyl and xylazine test strips. We also critically evaluate legal and other barriers to implementation.