ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

1. A 16-year-old girl arrives by EMS after a seizure following an ingestion possibly including “a heart medicine, a depression medicine, and a sleep medicine.” She has an abnormal rhythm on the cardiac monitor. 2. A 25-year-old woman presents with nausea and vomiting after taking an overdose of a supplement roughly 13 hours earlier. Vital signs: BP, 119/81 mmHg; HR, 130/min; RR, 18/min; T, 98.9 F; SaO2 100% RA. 3. A 49-year-old man presents 2 hours after being bit by a black widow spider. Minutes after the bite he began experiencing severe pain to his legs, back and abdomen and complaining of muscle spasms. VS on arrival: BP 207/97, HR 77, Temp 97.9F, SaO2 96% on RA.

1. A 60-year-old man presents to the ED after a snakebite to the ankle. He has rapid cardiovascular decompensation, progressing to cardiopulmonary arrest. 2. A 38-year-old Eastern European woman and a 59-year-old South Asian man present independently to the ED with the sudden onset of vomiting, diarrhea, and abdominal pain followed by acute hepatic injury. 3. A 13-year-old boy with spasticity for which he has an intrathecal baclofen pump presents with myoclonus and agitation. His vital signs are: BP, 136/77; HR, 107; RR, 19; T, afebrile.

This month's topic is the Toxikon Consortium. The articles will be reviewed by the Toxikon Consortium, led by Steven E. Aks.

Presented by Adam Algren, MD Associate Professor of Emergency Medicine and Pediatrics, Truman Medical Center/Children's Mercy Hospital.

1. A previously healthy 4-year-old girl presents with left upper arm pain and swelling after a possible insect or spider bite. Within 24 hours she develops massive hemolysis and is transferred to the PICU. 2. A 16-year-old girl with developmental delay on lithium presents with a serum lithium concentration of 4 mEq/L and creatinine of 6 mg/dL. Although on a stable dose of lithium, the foster mother states that the lithium level was ‘high’ two months earlier but no dose adjustments were made. 3. 28-year-old nurse is splashed in one eye with 5-10 mL of a cisplatin solution meant for intravenous administration. She is 3 months pregnant.