National Case Conference

ACMT's National Case Conference (NCC) is a monthly webinar for ACMT members that features interesting cases seen by medical toxicologists nationwide. NCC is an educational endeavor and a quality improvement effort intended to improve patient care. It is not intended to define standard of care. Attempts have been made to ensure HIPAA compliance. All data and information provided in this activity is for informational purposes only. ACMT makes no representations as to accuracy, completeness, currentness, suitability, or validity of the content and will not be liable for any errors or omissions in this information or any losses, injuries, or damages arising from its display or use.

This activity is open to ACMT Members only. Questions or suggestions for future cases? Write to: events@acmt.net

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  • Contains 4 Component(s) Includes a Live Web Event on 10/20/2022 at 1:00 PM (EDT)

    Cases coming soon!

  • Contains 1 Component(s)

    1. A 66-year-old woman with sarcoidosis presents with dysphagia 4 days after receiving a medication to relieve her symptoms. 2. A 70-year-old woman with a history of anaplastic large T-cell lymphoma presents with shortness of breath for three days. She has a heart rate of 125/min, is tachypneic, and requires 4L nasal cannula to maintain her oxygen saturation. 3. A 7-year-old girl presents with one day of fever and a diffuse erythematous maculopapular rash sparing the palms and soles. VS: HR 145 bpm, BP 115/79 mm Hg, RR 28 b/min, SaO2 93% on RA, Temp 103.1F.

  • Contains 1 Component(s) Recorded On: 05/19/2022

    1. A 2-year-old child eats some midwinter buds and presents to the emergency department with nausea and vomiting. 2. A 59-year-old woman comes to the ED from an urgent care center with several days of hematuria and intermittent epistaxis. The bleeding does not resolve with oxymetazoline or nasal packing. 3. A 32-year-old woman with a history of diabetes and opioid use disorder develops sudden onset respiratory distress while awaiting placement into an inpatient treatment program.

  • Contains 1 Component(s)

    1. A 15-year-old boy, admitted for toxic encephalopathy after a polypharmacy ingestion, develops recurrence of symptoms after complete resolution. 2. An 11-year-old girl is admitted with arthralgia, morbilliform rash, and severe headache unresponsive to typical analgesics. She has difficult to control hypertension and has a seizure. Other family members also developed a similar rash. 3. A 42-year-old man with a history of chronic LBP is found by EMS to have ventricular tachycardia, for which he received IV lidocaine. After conversion, his vital signs are: BP,144/76; HR,44; RR, 20; O2, 96%; Temp, 98.2

  • Contains 1 Component(s)

    1. A 62-year-old man and a 59-year-old woman present together with eye burning, conjunctival injection, and decreased visual acuity the morning after attending a family fish fry. 2. A toddler, found with a bottle of crafting material by their mother, presents with drooling and progressive oropharyngeal edema. 3. A 56-year-old man, found altered in his garage, now complains of sudden vision loss after a miscalculated ingestion.

  • Contains 1 Component(s)

    1. An infant is found blue and apneic by his mother. He is fed by both formula and breast milk and his mother is on MOUD. 2. A 19-year-old woman takes 16 tablets of her father’s medication in front of her boyfriend in a self-harm attempt. She arrives in the ED 2 hours later, with the following vital signs: BP, 79/46; HR, 85; RR, 20; T, 97.9; O2 sat, 96%RA. 3. A 65-year-old man with a previous history of autoimmune disease presents to the ED after a syncopal episode. In the ED, he is lethargic and tremulous. His vital signs are: BP, 101/45; HR, 98; RR, 24; T, 37.5; O2 sat, 98% RA.

  • Contains 1 Component(s)

    1. An 18-year-old female presents with posturing and seizure activity after a suspected overdose of her medication. She was last seen normal 2 hours prior to arrival. 2. A 2-year-old child presents with painless hematuria after a recent case of acute otitis media. The father noticed blood while changing the child’s diaper. Initial vital signs were unremarkable. 3. An 18-year-old woman presents with progressive metabolic acidosis and develops cardiovascular collapse several hours after a medication overdose.

  • Contains 1 Component(s)

    1. A 40-year-old woman with a history of fentanyl use now on methadone adamantly denies relapsing despite positive LC/MS confirmatory testing for fentanyl. 2. An elderly woman with ALS is found down surrounded in her own vomit and presents to the hospital with increasing oxygen requirements. 3. A 45 year-old male military veteran presented to a specialty dyspnea clinic with ongoing dyspnea on exertion and hypoxia unexplained despite an extensive workup.

  • Contains 1 Component(s)

    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.

  • Contains 1 Component(s)

    1. A 36-year-old man reports nausea, vomiting, and diarrhea after using an over-the-counter remedy for toothache. 2. A 35-year-old and a 20-year-old are found collapsed in a tanker. The younger patient is pronounced dead on scene and the older patient is transported to the hospital unconscious. He is noted to be covered in a "liquidy black silt." 3. A 62-year-old with end-stage liver disease presents with critical hyperkalemia a week after starting a new medication.