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Beta-blocker overdose — ABEM Board MCQ

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HardToxicologyBeta-blocker overdoseABEM Board

A 57-year-old man arrives after ingesting propranolol. Triage acuity is ESI 1; BP 68/38 mm Hg, HR 42/min, glucose 48 mg/dL. He is lethargic with cool extremities. ECG shows sinus bradycardia and QRS 122 ms. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Give glucagon, dextrose, vasopressors, and consider high-dose insulin therapy

Beta-blocker overdose causes bradycardia, hypotension, and hypoglycemia; management includes glucagon, glucose, vasopressors, and high-dose insulin in severe cases.

Reference: ACMT beta-blocker poisoning guidance