Toxicology
Management of Poisoned Patients: Implementing a Blended Toxicology Curriculum for Emergency Medicine Residents
DOI: https://doi.org/10.21980/J8C937The goal of this curriculum is to introduce EM residents to core toxicology concepts and to reinforce toxicology principles through a multimodal approach that leads to increased confidence in the management of poisoned patients on shift.
Infant Botulism
DOI: https://doi.org/10.21980/J8X35WAfter this simulation learners should be able to: 1) develop a differential diagnosis for the hypotonic infant, 2) recognize signs and symptoms of infant botulism, 3) recognize respiratory failure and secure the airway with appropriate rapid sequence intubation (RSI) medications, 4) initiate definitive treatment of infant botulism by mobilizing resources to obtain antitoxin, 5) continue supportive management and admit the patient to the pediatric intensive care unit (PICU), 6) understand the pathophysiology and epidemiology of infant botulism, 7) develop communication and leadership skills when evaluating and managing critically ill infants.
Let’s Escape Didactics: Virtual Escape Room as a Didactic Modality in Residency
DOI: https://doi.org/10.21980/J8CH2XBy the end of the activity, learners should be able to: 1) identify the hazardous chemicals associated with house fires; 2) classify burn injury according to depth, extent and severity based on established standards; 3) recall the actions to take in response to fire emergencies (R.A.C.E. and P.A.S.S. acronyms); 4) recall key laboratory features of cyanide and carbon monoxide poisonings; 5) identify appropriate management strategies for smoke inhalation injuries; 6) recite the treatment for cyanide and carbon monoxide poisonings; 7) describe the management of the burn injuries; 8) communicate and collaborate as a team to arrive at solutions of problems; 9) display task-switching and leadership skills during exercise; and 10) evaluate virtual escape room experience.
Botulism
DOI: https://doi.org/10.21980/J8FD0RBy the end of this simulation learners will be able to: 1) develop a differential for descending paralysis and recognize the signs and symptoms of botulism; 2) understand the importance of consulting public health authorities to obtain botulinum antitoxin in a timely fashion; 3) recognize that botulism will progress during the time period antitoxin is obtained. Early indications of respiratory compromise are expected to worsen during this time window. Secondary learning objectives include: 4) employ advanced evaluation for neurogenic respiratory failure such as physical examination, negative inspiratory force (NIF), forced vital capacity (FVC), and partial pressure of carbon dioxide (pCO2), 5) discuss and review the pathophysiology of botulism, 6) discuss the epidemiology of botulism.
Approach to the Poisoned Patient
DOI: https://doi.org/10.21980/J8264SBy the end of the lecture, learners should be able to: 1) initiate the evaluation of a poisoned patient, 2) identify key interventions to support airway, breathing, and circulation, 3) identify the three components of risk assessment in the poisoned patient, 4) list the four options for gastric decontamination, and 5) select standard diagnostic labs and tests commonly used in evaluating poisoned patients.
Case Report: Antifreeze Ingestion and Urine Fluorescence
DOI: https://doi.org/10.21980/J8G05TThe patient’s urine sample (right) was compared to a control (left) using a Wood’s lamp. It revealed light green fluorescence under ultraviolet light, which increased suspicion for ethylene glycol poisoning from antifreeze ingestion.
Tricyclic Antidepressant Overdose
DOI: https://doi.org/10.21980/J85W50At the end of this oral boards session, learners will be able to: 1) discuss the appropriate laboratory testing and workup for a patient with undifferentiated altered mental status, 2) discuss the importance of obtaining an ECG in a timely manner in order to investigate the broad differential of altered mental status, 3) identify the classic ECG findings of a patient with TCA overdose, 4) review the treatment of TCA overdose, 5) discuss the appropriate disposition of a patient with TCA overdose.
Ethylene Glycol Ingestion
DOI: https://doi.org/10.21980/J8M620By the conclusion of the simulation session, learners will be able to: 1) obtain a thorough toxicologic history, including intent, timing, volume/amount, and assessment for co-ingestions, 2) distinguish the variable clinical signs and symptoms associated with toxic alcohol ingestions, 3) identify metabolic derangements associated with toxic alcohol ingestions, 4) discuss the management of toxic alcohol ingestion, 5) appropriately disposition the patient for admission to intensive care unit (ICU).
Iron Overdose
DOI: https://doi.org/10.21980/J8MD1PBy the end of this oral boards case, learners will: 1) demonstrate evaluation of a patient presenting with toxic ingestion, including obtaining pertinent history, 2) review the signs and symptoms of the different presenting phases of acute iron ingestion, and 3) demonstrate appropriate treatment of iron overdose, namely, iron chelation therapy with deferoxamine.
Cocaine-induced Myocardial Infarction and Pulmonary Edema
DOI: https://doi.org/10.21980/J8ZS87By the end of this simulation session, the learners will be able to:1) Determine appropriate diagnostics in a patient with likely cocaine toxicity. 2) Identify and manage respiratory failure. 3) Identify and manage a ST-elevation myocardial infarction (STEMI) and pulmonary edema. 4) Identify and manage cocaine toxicity with benzodiazepines. 5) Determine appropriate disposition of the patient to the cardiac catheterization lab and an intensive care unit (ICU). 6) Demonstrate effective communication and teamwork during resuscitation of a critically ill patient.
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