Toxicology

Infant Botulism

Victoria Morris, MD*, Robert Wians, MD, MPH*, Jessica Wilson, MD* and Gowri Stevens, MD* 

DOI: https://doi.org/10.21980/J8X35W Issue 7:2[mrp_rating_result]
After 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. 
PediatricsSimulationToxicology

Let’s Escape Didactics: Virtual Escape Room as a Didactic Modality in Residency

Anisha Turner, MD*, Aleksandr M Tichter, MD, MS* and M Tyson Pillow, MD, MEd*

DOI: https://doi.org/10.21980/J8CH2X Issue 6:2[mrp_rating_result]
By 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.
Small Group LearningToxicology

Botulism

John Thompson, MD*, Zane Horowitz, MD* and Adam Blumenberg, MD*^

DOI: https://doi.org/10.21980/J8FD0R Issue 6:1[mrp_rating_result]
By 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.
ToxicologyNeurologySimulation

Approach to the Poisoned Patient

Kennon Heard, MD* and Matthew Zuckerman, MD*

DOI: https://doi.org/10.21980/J8264S Issue 6:1[mrp_rating_result]
By 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.
ToxicologyLectures
Creative Commons images

Case Report: Antifreeze Ingestion and Urine Fluorescence

Taras Varshavsky, MD* and Meigra Myers Chin, MD *

DOI: https://doi.org/10.21980/J8G05T Issue 5:1[mrp_rating_result]
The 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.
ToxicologyVisual EM

Tricyclic Antidepressant Overdose

Patrick G Meloy, MD*, Amit Bhambri, MD^ and Megan C Henn, MD*

DOI: https://doi.org/10.21980/J85W50Issue 4:3 [mrp_rating_result]
At 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.
ToxicologyCertifying Exam Cases

Ethylene Glycol Ingestion

Matthew Schwab, MD* and Jennifer Yee, DO*

DOI: https://doi.org/10.21980/J8M620Issue 4:2[mrp_rating_result]
By 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).
SimulationToxicology

Iron Overdose

James Roy Waymack, MD*, Marit Tweet, MD* and Richard Austin, MD*

DOI: https://doi.org/10.21980/J8MD1P Issue 4:1[mrp_rating_result]
By 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.
ToxicologyCertifying Exam Cases