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.

Safe Consumption/OD Prevention Sites Field Work and Perspectives

1. A 56-year-old man with a history of diabetes, hypertension, severe restrictive lung disease secondary to covid pneumonia presents with one day of fatigue, dyspnea on exertion, dry cough, and hypoxia (79% at home pulse oximetry). Patient states the symptoms began acutely, two hours after getting home from work the day prior. He reports that a few other co-workers have similar symptoms as him or they have nausea, abdominal pain, vomiting. He thinks a virus is going around his workplace. 2. A 51-year-old man presents with a diffuse rash over the past 6 days that developed after he ingested a product for sexual stimulation called “royal honey” that he obtained at a local shop. His VS are normal and he is in no distress. 3. A 2-year-old girl is extracted from underneath debris from a structural fire; she was found covered in soot and is pulseless. CPR is initiated and ROSCis achieved within minutes. She arrives to the ED with the following vital signs: BP, 95/58; HR, 130; RR, 28; SaO2, 100% on NRB; T, 98.6F. She is only responsive to pain and is promptly intubated.

On-Demand

This webinar was originally presented on September 15, 2021. Air pollution is one of the most encountered environmental hazards in early life.

This month's topic is Pepper Spray and Tear Gas Agents. The articles will be reviewed by the University of Virginia Program in Medical Toxicology, led by Program Director Heather Borek.

This month's topic is Burn Patients: The Oxalate Nephropathy and Hydroxocobalamin Debate. The articles will be reviewed by the DO and the Lehigh Valley Health Network, led by Dr. Robert Cannon.

Changing Toxicity of PM2.5 in a Period of Declining Concentrations: Examples from New York and California

Presented by John W. Downs, MD, MPH, FACP, FACOEM, Chief, Occupational & Environmental Medicine, Walter Reed National Military Medical Center.

This month's topic is CO and Coagulation. The articles will be reviewed by the Washington University Medical Toxicology Program, led by Drs. Rob Hendrickson and Zane Horowitz.

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 27-year-old woman is found inside her car unconscious with jerking movements of her body. Next to her is a container containing a murky green liquid connected to a hose. 2. A 37-year-old man presents with vomiting and fatigue after working in the basement of his house the day before. Initial labs are notable for AST, 2982 U/L; ALT, 6390 U/L; Tbili: 2.8 mg/dL. 3. A 29-year-old woman presents with a syncopal episode after an intentional overdose. Her vital signs are as follows: BP, 195/113 mmHg; HR, 87/min; RR, 20/min; T, 98.6F; O2 sat, 100% on RA.

This Grand Rounds webinar was originally presented on June 12, 2019. This webinar is part of an ongoing series of educational presentations by experts on issues that focus on current and emerging aspects of pediatric and reproductive environmental health.

The presentations focus on the impact of environmental exposures to chemicals on human health at the vulnerable stages of in utero and pediatric development.

This Grand Rounds webinar was originally presented on April 17, 2019. This webinar is part of an ongoing series of education presentations by experts on issues that focus on current and emerging aspects of pediatric and reproductive environmental health.

Presented by Robert G. Hendrickson, MD, FACMT, Professor of Emergency Medicine, Oregon Health and Sciences University.

Developing a Carbon Monoxide Poisoning Antidote Using an Engineered Scavenging Molecule

1. A 53-year-old woman develops convulsions followed by cardiac arrest while undergoing an outpatient cosmetic surgical procedure. 2. A 19-month-old is found playing with medications stored on top of the microwave in the kitchen. She vomits at home, and is brought to the ED by her mother 2 hours after the incident. The child's vital signs are: HR, 145/min; RR, 22/min; O2 saturation, 99%; Temp 97.3. 3. A 27-year-old, 5-week pregnant, woman presents to the ED by EMS after 2 people in her apartment building are found deceased. She complains only of headache. Her vital signs are: BP, 130/71 mmHg; HR, 101/min; RR, 18/min, O2 saturation, 97%. A prehospital carboxyhemoglobin level is 29%.

1. A 19-year-old female college student texts a friend that she is going to poison herself using a laboratory chemical. The friend calls police, who find the patient hypotensive, cyanotic, and obtunded. In the ED, her pH is 7, and her serum lactate is 16 mmol/L. 2. A 38-year-old male firefighter presents to the ED unresponsive with agonal respirations. An Initial venous blood gas is: pH, 7.21; pCO2, 42; pO2, 26; bicarb, 18 mmol/L.