Toxicology
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.
Propafenone Overdose-induced Arrhythmia and Subsequent Correction After Administration of Sodium Bicarbonate
DOI: https://doi.org/10.21980/J8D925The first ECG in this case showed sinus tachycardia with a widened QRS (black arrow), a rightward axis, prolonged corrected QT interval (QTc), and terminal R wave in AVR (white arrow). There are several potential causes for these ECG findings, but put together with the patient’s history, we were suspicious of sodium channel blockers being the most likely cause. The second ECG, after sodium bicarbonate was administered, demonstrated a normal QRS (black arrow) and no rightward axis deviation, reduction of the QTC and resolution of the terminal R wave (white arrow). We later learned that the patient’s cardiologist recently increased her propafenone dose.
The Toxiscape Hunt: An Escape Room-Scavenger Hunt for Toxicology Education
DOI: https://doi.org/10.21980/J8NW58By the end of the activity, learners should be able to: 1) Calculate an anion and osmolal gap. 2) Recognize poisonings amenable to hemodialysis. 3) Interpret EKG changes related to a variety of ingestions, including beta-blockers and calcium channel blockers, digitalis, and tricyclic antidepressants. 4) Recognize poisonous plants and their clinical toxidromes. 5) Calculate loading dose of N-acetylcysteine as antidote for acute acetaminophen ingestion. 6) Collaborate as a team to arrive at solutions of problems. 7) Recognize poisons that have available antidotes 8) Know the clinical effect of various types of snake envenomations. 9) Recognize the toxicity associated with at least four household chemicals. 10) Know the antidotes for six common poisonings.
Hemodialysis in the Poisoned Patient
DOI: https://doi.org/10.21980/J88S68By the end of this cTBL, the learner will: 1) recognize laboratory abnormalities related to toxic alcohol ingestion; 2) calculate an anion gap and osmolal gap; 3) know the characteristics of drugs that are good candidates for HD; 4) discuss the management of patients with toxic alcohol ingestions; 5) discuss the management of patients with salicylate overdose; 6) know the indications for HD in patients with overdoses of antiepileptic drugs; 7) discuss the management of patients with lithium toxicity.
Altered Mental Status: Epilepsy, Acute Psychosis, Intoxication or Delirium Tremens?
DOI: https://doi.org/10.21980/J8G592At the end of this simulation session the learner will: 1) Recognize signs and symptoms of delirium tremens (DT); 2) promptly treat DT with benzodiazepines and supportive care; 3) appropriately manage a patient with DT and effectively communicate with nurses and other team members during the resuscitation of an acutely ill patient.