ACMT Total Tox Course | Full Course Package
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Register
- Non-member - Tier I - $575
- Non-member - Tier II - $575
- Non-member - Tier III - $350
- Non-member - Tier IV - $200
- Member - Tier I - $500
- Member - Tier II - $500
- Member - Tier III - $275
- Member - Tier IV - $125
The American College of Medical Toxicology (ACMT) presents the Total Tox Full Course Package!
Tailored for healthcare professionals, this self-paced course offers an in-depth exploration of toxicology, covering Pharmaceuticals, Substance Use, Emergency Preparedness, and Non-Pharmaceutical toxicology. Enjoy the freedom to learn at your own pace, with access to all lectures and slides for 90 days. Lead by prominent experts in medical toxicology and emergency medicine, this three section course focuses on medical toxicology topics of interest to emergency providers, including toxicological issues of current clinical and public health importance. Learners will be presented with state-of-the-art updates on the evaluation and initial management of poisoning and exposure to medications, drugs of abuse, chemical terrorism, and environmental toxins.
The content of this course consists of recordings from the 2024 ACMT Total Tox Course. The content has been edited and packaged into this on-demand version featuring 40 asynchronous lectures from experts in the field of medical toxicology.
During this course, earn valuable continuing education credits, learn from leading experts and peers, and enhance your clinical skills and preparedness for a wide range of toxicological emergencies. Included with your registration fee are up to 24.0 (8.0 per activity) of continuing education credits for Physicians, Physician Assistants, Pharmacists, Nurses, and Nurse Practitioners. Learn from leading experts and peers, and enhance your clinical skills and preparedness for a wide range of toxicological emergencies. Secure your spot in the ACMT Total Tox Course today!
Target Audience
This course is designed for a diverse audience including physicians, pharmacists, advanced practice nurses, nurses, physician assistants, medics, EMTs, SPIs, laboratorians, poison center educators, first responders, and residents and students eager to expand their expertise.
Continuing Education
Enduring continuing education credits for Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners is provided by AKH Inc., Advancing Knowledge in Healthcare. It is expected that learners will receive up to 8.0 credits for learning and change per activity. Each activity will have their CE certificate.
For more information, click here.
Questions?
Please write to ACMT at events@acmt.net
Syllabus
Total Activity Length: approximately 24 hours (1,405 minutes)
Session 1
PRE-TEST | 15 min
12 multiple-choice questions to ascertain your baseline knowledge on the topic.
From Toxidromes to Activated Charcoal: A Rational Approach For Managing the Poisoned Patient | 45 min
Ann Arens, MD Associate Professor of Emergency Medicine, University of Minnesota, Minneapolis, MN
Dr. Ann Arens identifies the most common interventions performed in acute poisoning, and examines a poisoned patient to identify what to look for in common poisonings. She discusses different treatment options for common toxidromes.
Over-the-Counter Poisons #1: Acetaminophen | 28 min
Neeraj Chhabra, MD, MSCR Medical Toxicologist & Emergency Medicine Physician, Cook County Health & NorthShore University HealthSystem, Chicago, IL
Dr. Neeraj Chhabra discusses acetaminophen ingestions. He explains how to recognize which patients require treatment and identifies novel treatments for acetaminophen-related poisoning.
Over-the-Counter Poisons #2: NSAIDS and ASA | 46 min
Renee Petzel Gimbar, PharmD Clinical Associate Professor, University of Illinois Chicago College of Pharmacy, Chicago, IL
Dr. Renee Petzel Gimbar describes the treatment of NSAID poisoning, discusses the pathophysiology of salicylate poisoning, and examines the difference between treatment for NSAID and salicylate poisoning.
Over-the-Counter Poisons #3: Antihistamines & Antitussives | 30 min
Michelle Hieger, DO Emergency Physician and Medical Toxicologist, WellSpan Health & VCU Health System, York, PA
Dr. Michelle Hieger describes the action of antitussive medications and the pharmacology of antihistaminics with emphasis on clinical uses, adverse drug reactions and interactions. She also identifies major antihistamines used to treat breathing problems.
The Ins and Outs of Ups and Downs #1: Tricyclic Antidepressants & Antipsychotics | 48 min
J.J. Rasimas, MD, PhD, FAACT, FACLP, FACMT, FACPsych Professor of Psychiatry & Emergency Medicine, University of Minnesota & Penn State College of Medicine, Minneapolis, MN
Dr. J.J. Rasimas explains the pharmacologic, toxicity, and treatment differences between Tricyclic Antidepressants and Antipsychotics. He discusses "typical" vs. "atypical" antipsychotics and describes the overlapping features of Serotonin Syndrome, Anticholinergic Syndrome, and NMS produced by TCAs and Antipsychotics.
The Ins and Outs of Ups and Downs #2: SSRIs and Lithium | 32 min
Katherine Katzung, MD, FACEP, FASAM Director of Addiction & Toxicology Program & Emergency Care Physician, Abbott Northwestern Hospital & Emergency Care Consultants, Minneapolis, MN
Dr. Katherine Katzung identifies unique concerns of specific antidepressants in overdose and compares differences in acute vs. chronic lithium toxicity. She also discusses drug discontinuation syndrome as it applies to SSRIs & atypical antidepressants.
Beta Blockers and Calcium Channel Blockers: When the Antagonists Become Antagonistic | 29 min
William "Russ" Kerns, II, MD, FACMT, FACEP Emeritus Professor of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
Dr. Russ Kerns examines treatment options focusing on high-dose insulin vs vasopressor controversy and discusses mechanisms of toxicity, clinical manifestations, and updates on optimal therapy for beta-adrenergic blocking drugs and calcium channel antagonists drugs.
Drug-Induced Dysrhythmias: When You Can't Control the Rhythm | 25 min
William "Russ" Kerns, II, MD, FACMT, FACEP Emeritus Professor of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
Dr. Russ Kerns identifies optimal treatment of drug-induced dysrhythmias and discusses how the optimal management of drug-induced dysrhythmias differs from AHA ACLS algorithms.
Anticoagulants and Antithrombotics: When You Can't Control the Bleeding | 46 min
Nena Bowman, PharmD, DABAT Director of Vaccine Operations, Vaccine Preventable Diseases and Immunization Program, Tennessee Department of Health, Nashville, TN
Dr. Nena Bowman identifies appropriate uses of reversal agents for common anticoagulants and summarizes the latest data in NOAC trials. She also reviews the mechanism of action, indications, contraindications, adverse reactions, and common drug interactions of warfarin.
Out of Balance: Toxicity of Endocrine Agents | 34 min
Charles McKay, MD, FACMT Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT
Dr. Charles McKay identifies management issues with overdose of endocrine drugs, and discusses endocrine clues and mimics and endocrine function impact of ‘non-endocrine’ medications.
Anticonvulsants: When the Level Makes You Unsteady | 28 min
Daniel J. Sessions, MD Medical Toxicologist, Ochsner Medical Center, New Orleans, LA
Dr. Daniel Sessions identifies treatment options for anticonvulsant toxicity, examines laboratory testing is required for toxicity from anticonvulsant agents, and discusses the toxicity of common anticonvulsants.
Antimicrobials & Antivirals: When the Cure Becomes Toxic | 32 min
Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT Emergency Medicine Attending Physician and Associate Professor Of Emergency Medicine, MedStar Washington Hospital Center & Georgetown University Hospital, Washington, D.C.
Dr. Maryann Amirshahi discusses the mechanism of action of the five major classes of antimicrobials. She describes the potential toxicities of commonly prescribed antimicrobial treatments and assesses the likelihood of a cross-reaction between penicillin and cephalosporin.
Case Panel - Advanced Acetaminophen | 14 min
Several speakers from previous lectures return to review and discuss clinical cases on acetaminophen toxicity.
Case Panel - Beta Blockers and Calcium Channel Blockers | 14 min
Several speakers from previous lectures return to review clinical cases on beta blockers and calcium channel blockers.
POST-TEST | 15 min
Retake the same 12 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.
Session 2
PRE-TEST | 15 min
12 multiple-choice questions to ascertain your baseline knowledge on the topic.
The New Dangers of Opioid Addiction | 42 min
Lewis Nelson, MD, FACEP Chair of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ
Dr. Lewis Nelson describes opioid use disorder and explains how to initiate treatment for opioid use disorders. He highlights harm reduction efforts that can reduce the adverse consequences of opioid use.
Management Options for Opioid Use Disorder | 30 min
Rachel Wightman, MD, FACMT Assistant Professor of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
Dr. Rachel Wightman reviews the misuse, abuse, & criteria for diagnosing opioid use disorder. She identifies psychosocial treatments for opioid use disorder and describes the medication-assisted treatments for Buprenorphine, Methadone, and Naltrexone.
Cannabis & Cannabis Toxicity | 28 min
Mark Neavyn, MD, FACMT Medical Director & Emergency Medicine Physician, Northern New England Poison Center & Maine Medical Center, Portland, ME
Dr. Mark Neavyn examines the symptoms of cannabis toxicity and describes the treatment approach to cannabis toxicity.
What's New in Your Neighborhood? | 19 min
Stephanie Weiss, MD, PhD Staff Clinician, Translational Addiction Medicine Branch, National Institute on Drug Abuse, Baltimore, MD
Dr. Stephanie Weiss discusses the epidemiology of new fentalogues and explains how to initiate treatment for fentanyl-related overdose.
Drug Screen Pitfalls | 29 min
Paul M. Wax, MD, FACMT Executive Director, American College of Medical Toxicology (ACMT), Phoenix, AZ
Dr. Paul Wax Identifies toxicology tests available in the ED. He discusses which tests should be requested in specific situations and describes how test ordering changes treatment outcomes.
Inhaled Toxicants: Simple Asphyxiants & Respiratory Irritants | 43 min
Charles McKay, MD, FACMT Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT
Dr. Charles McKay discusses the role of water solubility in the clinical presentation of pulmonary irritants and describes the clinical presentation of pulmonary irritants.
Chemical Suicide & Mitochondrial Asphyxiants | 29 min
Paul M. Wax, MD, FACMT Executive Director, American College of Medical Toxicology (ACMT), Phoenix, AZ
Dr. Paul Wax examines the sources and uses of chemical asphyxiants, their basic mechanisms of toxicity, and their clinical presentations. He identifies the differences between simple asphyxiants and chemical asphyxiants and compares therapies used to treat asphyxiant poisoning.
Carbon Monoxide Poisoning: High Flow Oxygen or the Hyperbaric Chamber | 27 min
Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT Medical Director, National Capital Poison Center & MedStar Georgetown University Hospital, Washington, DC
Dr. Kelly Johnson-Arbor identifies different types of radiation, describes the consequences of exposure to radiation, and discusses the diagnosis and management of radiation casualties and radiation mass casualty events.
Disaster Preparedness #1: Radiation Events | 32 min
Joseph K. Maddry, Lt Col, USAF, MC, FS, MD, FACMT Deputy Commander, Department of Emergency Medicine, US Army Institute of Surgical Research, Houston, TX
Dr. Joseph Maddry discusses the diagnosis and management of radiation casualties and radiation mass casualty events. He identifies different types of radiation and describes the consequences of exposure to radiation.
Disaster Preparedness #2: Organophosphates & New Agents | 34 min
Christina Hantsch, MD, FACEP, FACMT, FAACT Emergency Physician and Medical Toxicologist, Loyola University Chicago Stritch School of Medicine Maywood, IL
Dr. Christina Hantsch discusses management options for patients with organophosphate insecticide or nerve agent toxicity and explains cholinergic toxidrome. She lists specific organophosphate insecticides and chemical weapon nerve agents.
Disaster Preparedness #3: Other Chemical & Biological Terrorism | 44 min
Aaron Frey, DO Emergency Medicine Attending Physician and Medical Toxicology Fellow, Richmond Emergency Physicians, Inc. & University of Virginia, Richmond, VA
Dr. Aaron Frey examines the diagnosis and management of casualties resulting from terrorism and mass casualty events and discusses the history of bioterrorism as a tool for warfare. He explains and evaluates the agents used in bioterrorist events.
Case Panel - Addiction | 41 min
Several speakers from previous lectures return to review clinical cases on addiction.
Case Panel - Emergency Preparedness | 44 min
Several speakers from previous lectures return to review educational cases on emergency preparedness.
POST-TEST | 15 min
Retake the same 12 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.
Session 3
PRE-TEST | 15 min
12 multiple-choice questions to ascertain your baseline knowledge on the topic.
Hospital Hazards #1: Anesthetic Toxicity & Malignant Hyperthermia | 24 min
Shaun D. Carstairs, MD, FACMT Medical Toxicologist, 98point6, Inc., Seattle, WA
Dr. Shaun Carstairs discusses the history and pharmacology of local anesthetics and the unique characteristics and common clinical use for each prototypical local anesthetic. He assesses the most commonly caused several complications of local anesthetics and identifies general thermoregulatory principles. He reviews the following hyperthermic syndromes & discusses treatment options: Serotonin Syndrome, Neuroleptic Malignant Syndrome, and Malignant Hyperthermia.
Hospital Hazards #2: Methemoglobinemia | 27 min
Andrea Carlson, MD Emergency Medicine Physician, Advocate Christ Medical Center, Oak Lawn, IL
Dr. Andrea Carlson discusses the common agents causing Methemoglobinemia. She identifies Methemoglobinemia mechanisms of toxicity and describes the best practices in clinical management of Methemoglobinemia.
Heavy Metals In the ED: Lead, Arsenic & Mercury | 28 min
Evan Schwarz, MD, FACMT Associate Professor of Emergency Medicine, Washington University School of Medicine, St. Louis, MO
Dr. Evan Schwarz reviews the signs and symptoms of lead toxicity. He discusses the role of chelation in heavy metal toxicity and compares and contrasts the toxicity caused by different forms of mercury.
Ethanol Intoxication: Too Much Of a Good Thing | 44 min
Anthony Pizon, MD, FACMT Chief of Medical Toxicology Division, Professor of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA
Dr. Anthony Pizon examines the prevalence of ethanol AUD in patients presenting to the Emergency Department. He discusses the genetic vs. environmental factors for ethanol AUD and assesses the most critical laboratory tests for symptomatic patients who have suspected ethanol intoxication.
When It's Not Ethanol: Demystifying Toxic Alcohols | 41 min
Bram Dolcourt, MD Clinical Assistant Professor Department of Emergency Medicine, Wayne State University, Detroit, MI
Dr. Bram Dolcourt describes toxicity & time course of methanol (MeOH) and ethylene glycol (EthGly) exposures, identifies two stand-in tests for MeOH and EthGly, noting limitations, and presents a rationale for treatment with ethanol, fomepizole, and/or hemodialysis.
Ethanol Withdrawal: When the Good Times End | 31 min
Jerrold Blair Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM Adjunct Clinical Professor Division of Environmental and Occupational Health Sciences & Professor of Medicine, University of Illinois Chicago and Rosalind Franklin University of Medicine & Science, North Chicago, IL
Dr. Jerrold Leikin discusses appropriate treatment so that complications are prevented. He examines alcohol withdrawal symptoms and describes the principles of detoxification.
Don't Touch That! Marine, Arthropod & Reptile Envenomations | 36 min
Michael Levine, MD, FACMT Associate Professor of Emergency Medicine, University of California Los Angeles, Los Angeles, CA
Dr. Michael Levine identifies various toxic envenomations and describes the characterization of Black Widow envenomation and management options. He discusses management options for pit viper envenomations.
The Toxic Yard | 28 min
Fiona Garlich Horner, MD Head of Toxicology & Assistant Professor of Clinical Emergency Medicine, LAC+USC Medical Center & University of Southern California Keck School of Medicine, Los Angeles, CA
Dr. Fiona Garlich Horner examines different classes of plant derived toxins and their effects on humans and identifies hazards of different mushrooms and clinical toxidromes associated with mushrooms.
The Toxic House | 29 min
Ashley Haynes, MD, FACEP Medical Director, Addiction Toxicology of Kansas, Wichita, KS
Dr. Ashley Haynes discusses common household exposures and their implications and reviews toxicity of common household cleaners and toys.
The Toxic Cabinet | 26 min
Stephen Wood, MS, ACNP-BC, FEWM Acute Care Nurse Practitioner & Director of Advanced Practice Providers, St. Elizabeth’s Medical Center, Brighton, MA
Nurse Practitioner Stephen Wood reviews toxicity of essential oils and examines risks associated with the use of dietary supplements.
The Toxic Garage | 34 min
Andrew King, MD Associate Professor in the Department of Emergency Medicine & Medical Director, Wayne State University School of Medicine & Michigan Poison and Drug Information Center, Detroit, MI
Dr. Andrew King discusses common toxins and exposures of chemicals commonly found in the garage. He reviews toxicity and management of chemicals and other substances commonly found in the garage.
Case Panel - The Hot Patient | 60 min
Several speakers from previous lectures return to review clinical cases on novel treatments for the Hot Patient.
Case Panel - The Unknown Tox Patient | 29 min
Several speakers from previous lectures return to review a case of an unknown tox patient.
POST-TEST | 15 min
Retake the same 12 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.
Registration Rates
Registration includes:
- 90-day access to all course content
- Access to the Speaker slides
- 24.0 Continuing Education Certificate. Available for: Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners.
Are you a member of any of the following organizations: AAEM, AAENP, APC, APAMT, EAPCCT, SOT, MENATOX? You may be eligible for a registration discount! Please email us at events@acmt.net for more information.
Member Rates
Member Tier I: Full, Affiliate, International, Emeritus |
$500 |
Member Tier II: Fellows |
$500 |
Member Tier III: Residents, International - Developing Country |
$275 |
Member IV: Medical Students |
$125 |
Non-Member Rates
Non-member Tier I: Physicians, Pharmacists, Lawyers, "Other" |
$575 |
Non-member Tier II: Fellows, SPIs, Nurses, etc. |
$575 |
Non-member Tier III: Educators & Emergency Responders |
$350 |
Non-member IV: Residents & Students |
$200 |
ACMT Membership
ACMT Members receive a discounted rate. Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership
Group Discounts Available
Is your hospital or medical group interested in enrolling multiple employees in our course? We offer special discounts for organizations with multiple participants. Contact us at events@acmt.net for more details!
Refunds and Cancellations
For information on ACMT's Cancellation and refund policy, click here.
Questions?
For any questions, please email us at events@acmt.net.
Continuing Education
CE credit provided by AKH Inc., Advancing Knowledge in Healthcare.
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s)™ per activity. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
Credit being awarded: 8.0 ANCC contact hours per activity.
Nurse Practitioners
This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803. This activity is approved for 8.0 contact hour(s) per activity (which includes 8.0 hour(s) of pharmacology per activity).
Physician Associate
AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 8.0 AAPA Category 1 CME credits per activity.
PAs should only claim credit commensurate with the extent of their participation.
Pharmacists
AKH Inc., Advancing Knowledge in Healthcare designates this continuing education activity for 8.0 contact hours per activity.
Commercial Support
This activity is supported from an independent medical education grant from BTG international lnc.,
Disclosures
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with ineligible companies whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.
Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participants misunderstanding of the content. If you would like to opt out from future communications from AKH please send an email to optout@akhcme.com with your information with "Opt Out" in the subject line.
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Contains 40 Component(s), Includes Credits
Anti-Inflammatories, Antihistamines, Antitussives, Antidepressants, Antipsychotics, Antimicrobials, and more!
ACMT presents the ACMT Total Tox Course activity on Pharmaceuticals! In this self-paced activity, expert speakers delve into systematic approaches for managing poisoned patients. It will cover the mechanisms of toxicity and treatment guidelines for substances like acetaminophen, NSAIDs, and SSRIs. Interactive case studies allow you to apply theoretical knowledge to real-world scenarios, strengthening your clinical decision-making skills.
The content of this course consists of recordings from the live, virtual Pharmaceuticals activity of the 2024 ACMT Total Tox Course. The content has been edited and packaged into this on-demand version featuring 14 asynchronous lectures from experts in the field of medical toxicology.
Registration for this activity includes 90 day access to the on-demand material and up to 8.00 Continuing Education credits.
Target Audience
This activity is designed for a diverse audience including physicians, pharmacists, advanced practice nurses, nurses, physician assistants, medics, EMTs, SPIs, laboratorians, poison center educators, first responders, and residents and students eager to expand their expertise.
Continuing Education
Enduring continuing education credits for Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners is provided by AKH Inc., Advancing Knowledge in Healthcare. Learners will receive up to 8.0 credits for learning and change.
For more information, click here.
Learning Objectives
After Completing This Program You Should Be Able To:
- Discuss general care of poisoned patients including clinical toxidromes, common diagnostic tests, antidotes and other treatment options.
- Recognize, and understand treatment of, specific over-the-counter agent poisonings such as acetaminophen, NSAIDs, and antihistamines.
- Evaluate the toxicity of psychiatric, cardiovascular, anticonvulsant and other prescription medication classes including therapeutic management advances.
Questions?
Please write to ACMT at events@acmt.net
If you are interested in the other activities in this course, check out the links below!
Syllabus
Total Activity Length: approximately 8 hours (481 minutes)
PRE-TEST | 15 min
12 multiple-choice questions to ascertain your baseline knowledge on the topic.
From Toxidromes to Activated Charcoal: A Rational Approach For Managing the Poisoned Patient | 45 min
Ann Arens, MD Associate Professor of Emergency Medicine, University of Minnesota, Minneapolis, MN
Dr. Arens will identify the most common interventions performed in acute poisoning, and will examine a poisoned patient to identify what to look for in common poisonings. She will also discuss different treatment options for common toxidromes.
Over-the-Counter Poisons #1: Acetaminophen | 28 min
Neeraj Chhabra, MD, MSCR Medical Toxicologist & Emergency Medicine Physician, University of Illinois Chicago, Chicago, IL
Dr. Chhabra will discuss acetaminophen ingestions. He will explain how to recognize which patients require treatment and identify novel treatments for acetaminophen-related poisoning.
Over-the-Counter Poisons #2: NSAIDS and ASA | 46 min
Renee Petzel Gimbar, PharmD Clinical Associate Professor, University of Illinois Chicago College of Pharmacy, Chicago, IL
Dr. Petzel Gimbar will describe the treatment of NSAID poisoning, discuss the pathophysiology of salicylate poisoning, and examine the difference between treatment for NSAID and salicylate poisoning.
Over-the-Counter Poisons #3: Antihistamines & Antitussives | 30 min
Michelle Hieger, DO Emergency Physician and Medical Toxicologist, WellSpan Health & VCU Health System, York, PA
Dr. Hieger will describe the action of antitussive medications and the pharmacology of antihistaminics with emphasis on clinical uses, adverse drug reactions and interactions. She will also identify major antihistamines used to treat breathing problems.
The Ins and Outs of Ups and Downs #1: Tricyclic Antidepressants & Antipsychotics | 48 min
J.J. Rasimas, MD, PhD, FAACT, FACLP, FACMT, FACPsych Professor of Psychiatry & Emergency Medicine, University of Minnesota & Penn State College of Medicine, Minneapolis, MN
Dr. Rasimas will explain the pharmacologic, toxicity, and treatment differences between Tricyclic Antidepressants and Antipsychotics. He will discuss "typical" vs. "atypical" antipsychotics and describe the overlapping features of Serotonin Syndrome, Anticholinergic Syndrome, and NMS produced by TCAs and Antipsychotics.
The Ins and Outs of Ups and Downs #2: SSRIs and Lithium | 32 min
Katherine Katzung, MD, FACEP, FASAM Director of Addiction & Toxicology Program & Emergency Care Physician, Abbott Northwestern Hospital & Emergency Care Consultants, Minneapolis, MN
Dr. Katzung will identify unique concerns of specific antidepressants in overdose and compare differences in acute vs. chronic lithium toxicity. She will also discuss drug discontinuation syndrome as it applies to SSRIs & atypical antidepressants.
Beta Blockers and Calcium Channel Blockers: When the Antagonists Become Antagonistic | 29 min
William "Russ" Kerns, II, MD, FACMT, FACEP Emeritus Professor of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
Dr. Kerns will examine treatment options focusing on high-dose insulin vs vasopressor controversy and discuss mechanisms of toxicity, clinical manifestations, and updates on optimal therapy for beta-adrenergic blocking drugs and calcium channel antagonists drugs.
Drug-Induced Dysrhythmias: When You Can't Control the Rhythm | 25 min
William "Russ" Kerns, II, MD, FACMT, FACEP Emeritus Professor of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
Dr. Kerns will return after the case conference to examine optimal treatment of drug-induced dysrhythmias and discuss how the optimal management of drug-induced dysrhythmias differs from AHA ACLS algorithms.
Anticoagulants and Antithrombotics: When You Can't Control the Bleeding | 46 min
Nena Bowman, PharmD, DABAT Director of Vaccine Operations, Vaccine Preventable Diseases and Immunization Program, Tennessee Department of Health, Nashville, TN
Dr. Bowman will identify appropriate uses of reversal agents for common anticoagulants and summarize the latest data in NOAC trials. She also will review the mechanism of action, indications, contraindications, adverse reactions, and common drug interactions of warfarin.
Out of Balance: Toxicity of Endocrine Agents | 34 min
Charles McKay, MD, FACMT Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT
Dr. McKay will examine management issues with overdose of endocrine drugs, and discuss endocrine clues and mimics and endocrine function impact of ‘non-endocrine’ medications.
Anticonvulsants: When the Level Makes You Unsteady | 28 min
Daniel J. Sessions, MD Medical Toxicologist, Ochsner Medical Center, New Orleans, LA
Dr. Sessions will identify treatment options for anticonvulsant toxicity, examine laboratory testing is required for toxicity from anticonvulsant agents, and discuss the toxicity of common anticonvulsants.
Antimicrobials & Antivirals: When the Cure Becomes Toxic | 32 min
Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT Emergency Medicine Attending Physician and Associate Professor Of Emergency Medicine, MedStar Washington Hospital Center & Georgetown University Hospital, Washington, D.C.
Dr. Amirshahi will discuss the mechanism of action of the five major classes of antimicrobials. She will describe the potential toxicities of commonly prescribed antimicrobial treatments and assess the likelihood of a cross-reaction between penicillin and cephalosporin.
Case Panel - Advanced Acetaminophen | 14 min
Several speakers from previous lectures return to review and discuss clinical cases on acetaminophen toxicity.
Case Panel - Beta Blockers and Calcium Channel Blockers | 14 min
Several speakers from previous lectures return to review clinical cases on beta blockers and calcium channel blockers.
POST-TEST | 15 min
Retake the same 12 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.
Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT
Emergency Medicine Attending Physician, Professor Of Emergency Medicine, Co-Medical Director
MedStar Washington Hospital Center, Georgetown University Hospital, National Capital Poison Center
Dr. Maryann Amirshahi is a Professor of Emergency Medicine at Georgetown University School of Medicine and practices clinically at MedStar Washington Hospital Center, where she specializes in toxicology, addiction care, and emergency medicine. She holds a PharmD and medical degree, alongside an MPH focusing on environmental and occupational health, and a PhD in pharmacology and public health. Dr. Amirshahi is board-certified in emergency medicine, medical toxicology, addiction medicine, and clinical pharmacology, and is a registered pharmacist with over a decade of practice. Nationally recognized, she serves on the Board of Directors for the American College of Medical Toxicology and as co-medical director of the National Capital Poison Center. With nearly 200 peer-reviewed publications, her research spans medication safety, drug shortages, addiction treatment, and prescription drug misuse.
Ann Arens, MD
Emergency Medicine Physician
Ochsner Medical Center
Dr. Arens is an Emergency Medicine physician who practices at Ochsner Medical Center in New Orleans, LA. Dr. Arens completed her Emergency Medicine training at the Denver Health Residency in Emergency Medicine, and her medical toxicology training at the University of California – San Francisco. She was amongst the first toxicologists to identify and describe counterfeit fentanyl products, and has continued to identify outbreaks of new drugs of abuse. She has a broad range of research interests including: the identification of new drugs of abuse including novel opioids contributing to the current opioid epidemic, the use of antidotes, and advanced supportive care of the poisoned patient.
Nena Bowman, PharmD, DABAT
Director of Vaccine Operations
Vaccine Preventable Diseases and Immunization Program, Tennessee Department of Health
Nena Bowman received her Bachelor of Science in Biochemistry at Middle Tennessee State University in 2010 and her Doctorate of Pharmacy at Lipscomb University College of Pharmacy in 2014. Bowman completed a specialty fellowship in Toxicology with the Utah Poison Control Center at the University of Utah in Salt Lake City, Utah in 2016. She is board certified as a clinical toxicologist, Diplomate of the American Board of Applied Toxicology (DABAT). Dr. Bowman currently practices at the Tennessee Department of Health as the Director of Vaccine Operations and a Toxicologist Consult for the Emergency Preparedness Program. Bowman works closely with providers across the state to ensure proper utilization of federal vaccine program funds, and equal access to all ACIP recommended vaccines for underserved children and adults. She also teaches at Lipscomb University College of Pharmacy as an adjunct professor in toxicology and emergency preparedness curriculum. She is an Advanced Hazmat Life Support (AHLS) Provider and Instructor, and she is the immediate past president of the Nashville Area Pharmacists Association. She enjoys working in public health to educate providers, consulting on difficult toxicology situations, and problem solving to navigate unprecedented events and challenges.
Neeraj Chhabra, MD, MSCR
Medical Toxicologist & Emergency Medicine Physician
University of Illinois Chicago
Neeraj Chhabra, MD, MSCR is an Emergency Physician and Medical Toxicologist based in Chicago, Illinois. He provides medical toxicology consulting services for the Illinois Poison Center and Cook County Health. Dr. Chhabra completed his fellowship in medical toxicology with the Toxikon Consortium in 2017 and his master’s degree in clinical research at Rush University Graduate College in 2020. His clinical focus is on the acute management of poisonings and overdose.
Michelle Hieger, DO
Emergency Physician, Medical Toxicologist, and Addiction Medicine Physician
Wellspan Health, York, PA
I am a board-certified Medical Toxicologist, Addictionologist, and Emergency Medicine physician. I completed my residency at Memorial Hospital in York, PA. My fellowship was completed at Virginia Commonwealth University in Richmond, VA. I currently work at WellSpan York Hospital in York, PA, as an Emergency Physician, Medical Toxicologist, and working with in-patients starting treatment for addiction. I initiated the toxicology service at York Hospital and now I am the Medical Director for Medical Toxicology. I am interested in treating the poisoned patients at bedside, and especially interested in the antidotal therapy with physostigmine (if it returns) and flumazenil. I enjoy professional engagement with ACMT.
Katherine Katzung, MD, FACEP, FASAM
Director of Addiction & Toxicology Program & Emergency Care Physician
Abbott Northwestern Hospital & Emergency Care Consultants
Katherine Katzung, MD is an attending physician in the emergency department at Abbott Northwestern, where she serves as chair of the department. Additionally, she is the medical director of the hospital’s addiction medicine and toxicology program, which began in 2020 after she received grant funding to initiate a hospital-based toxicology/addiction medicine consult service as well as an emergency department-based addiction medicine "bridge" clinic to provide continuity of care for patients initiated on Suboxone. This innovative program allows patients evaluated at Abbott Northwestern in the emergency department or inpatient units continuity of care, while focusing on harm-reduction strategies, until they can be given a warm hand-off to community providers.
A graduate of the University of Minnesota School of Medicine, she completed emergency medicine training at Regions Hospital in St. Paul and additional fellowship training in medical toxicology. She is board certified in emergency medicine, medical toxicology, and addiction medicine. Her clinical interests surround the intersection of these 3 specialties, with special focus on early ED & hospital-based interventions to evaluate and treat substance use disorder, including initiation of medication assisted therapies.
She volunteers as a consultant for the Minnesota Poison Control System in addition to serving on the board of the Steve Rummler HOPE Network and acts as medical director of its overdose prevention program.
William "Russ" Kerns, II, MD, FACMT, FACEP
Emeritus Professor of Emergency Medicine
Carolinas Medical Center
Dr. Kerns trained in Emergency Medicine and Medical Toxicology and served as Professor in both disciplines at Carolinas Medical Center for 33 years. Faculty roles included leadership of the Medical Toxicology Fellowship and clinical division, consultation for the Carolinas Poison Center, and research. Research interests included antidotes, envenomation, and resuscitation of cardiotoxic drugs. He also served the ACMT focusing on advancing research and education.
Charles McKay, MD, FACMT
Associate Medical Director
CT Poison Control Center, University of Connecticut School of Medicine
Dr. McKay was trained in Anatomic and Surgical Pathology, Internal Medicine, Emergency Medicine, Medical Toxicology and was a Medical Director of Occupational Health and Medical Review Officer for a hospital system during more than 30 years of clinical practice, during which he provided toxicology consultation at 3 hospitals, directed a medical toxicology fellowship training program, and provided medical oversight of a regional poison control center. He provides medical legal consultation across the country on toxicology-related issues, and has testified in nearly 100 cases, many related to questions of alcohol- and -drug-induced impairment.
Renee Petzel Gimbar, PharmD
Clinical Associate Professor
University of Illinois Chicago College of Pharmacy
Renee Petzel Gimbar received her PharmD from the University of Illinois at Chicago College of Pharmacy and completed PGY-1 training at UIC and PGY-2 training at Rutgers University. She started emergency medicine pharmacy services at the University of Tennessee Medical Center Knoxville and Loyola University Medical Center. She was inducted as a fellow of the American Academy of Clinical Toxicology in 2019. She currently is a clinical associate professor in the department of pharmacy practice at UIC College of Pharmacy, an Emergency Medicine and Medical Toxicology Clinical Pharmacist at UI Health, and the Residency Program Director for the PGY-2 Emergency Medicine Pharmacy Residency. She has integrated herself in the emergency medicine and medical toxicology services at both Loyola and UIC, active in the acute care of patients, didactic and beside education of healthcare trainees. Dr. Petzel Gimbar has been involved in multiple research studies and publications related to emergency medicine and toxicology practice, including a current multi-year NIH study addressing emergency department hypertension in underserved patients. She has given invited lectures internationally and nationally on both emergency medicine and medical toxicology topics. At home, she attempts to manage her nine, seven, and five year olds without a toxic ingestion.
J.J. Rasimas, PhD, MD, FAACT, FACLP, FACMT, FACPsych
Professor of Psychiatry & Emergency Medicine
Dalhousie University, University of Minnesota, & Penn State College of Medicine
Dr. Rasimas has a Jesuit university background in biochemistry, mathematics, and philosophy. He completed the Medical Scientist Training Program, earning a PhD in chemical biology (2002) and MD (2003) from Penn State University. After Psychiatry residency at the Mayo Clinic, he was a clinical fellow at the National Institutes of Health in Washington, DC where he did translational research and trained in medical ethics. He also undertook formal education in psychoanalytic psychotherapy, completed the critical care based medical toxicology fellowship at Penn State, and became certified in Psychosomatic Medicine, Addiction Medicine, and Medical Toxicology. Further work at NIH has included the Undiagnosed Diseases Program and roles in research ethics and oversight. Dr. Rasimas was the Director of Consultation-Liaison Psychiatry and Co-Chair of the Biomedical Ethics Committee at Hennepin County Medical Center in Minneapolis, Minnesota before moving to Prince Edward Island, Canada in 2022. Based at Queen Elizabeth Hospital in Charlottetown, he served as the lead Psychiatrist for C-L and Addictions for the province. He has recently transitioned to Nova Scotia Health in an effort to build treatment programs for patients with complex psychosomatic illnesses and substance use. For PEI, Dr. Rasimas remains the Medical Director of the Atlantic Mentorship Network for Chronic Pain, Addictions, and Mental Illness. Dr. Rasimas is a university professor with continued involvement in medical education in both the US and Canada pursuing an academic medical career at the interface of psychosomatic medicine, medical toxicology, and psychodynamic psychotherapy with a primary clinical interest in the phenomenology of suicide.
Daniel J. Sessions, MD, FACMT, FASAM, FAAEM
Chief, Division of Medical Toxicology
Ochsner Medical Center
Dr. Sessions practices medical toxicology, emergency medicine and addiction medicine at Ochsner Health in the New Orleans area. Dr. Sessions has expertise in poisoning and drug overdose, envenomation, toxic occupational exposure, medication assisted therapy for opioid and alcohol use disorder and forensic toxicology. Dr. Sessions earned his degree in medicine from Louisiana State University School of Medicine in New Orleans in 2008. He is board-certified in emergency medicine and medical toxicology by the American Board of Emergency Medicine in 2012 and 2014. He completed a medical toxicology fellowship at the Rocky Mountain Poison & Drug Center at Denver health in Denver in 2013. He is board-certified in addiction medicine by the American Board of Preventative Medicine in 2022. Dr. Sessions actively participates in the American Academy of Emergency Medicine, the American College of Medical Toxicology, the American Academy of Clinical Toxicology and the American Society of Addiction Medicine.
Registration Rates
Registration includes:
- 90-day access to all course content
- Access to the Speaker slides
- 8.0 Continuing Education Certificate. Available credits: Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners.
Member Rates
Member Tier I: Full, Affiliate, International, Emeritus
$200
Member Tier II: Fellows
$200
Member Tier III: Residents, International - Developing Country
$125
Member IV: Medical Students
$75Non-Member Rates
Non-member Tier I: Physicians, Pharmacists, Lawyers, "Other"
$225
Non-member Tier II: Fellows, SPIs, Nurses, etc.
$225
Non-member Tier III: Educators & Emergency Responders
$150
Non-member IV: Residents & Students
$100
ACMT Membership
ACMT Members receive a discounted rate. Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership
Package Rates
Sign up for the full ACMT Total Tox Course and save $100!
Refunds and Cancellations
For information on ACMT's Cancellation and refund policy, click here.
Questions?
For any questions, please email us at events@acmt.net.
Instructions
Once you have completed your registration:
- Click on the Contents tab. This is where you will be able to see all lectures and required content for this course.
- Complete the Pre-Test. You are not required to pass the Pre-Test, this is to test your skills before you begin the on-demand course.
- Watch all lectures and case panels. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.
- Complete the Post-Test. These questions are based on content from the lectures to gauge your comprehension of the lectures. It requires a 80% to pass.
- Complete the CE Survey. These questions are required to claim your CE certificate.
- Claim your CE certificate. Once you have claimed your CE credit, you will not be able to change your CE certificate.
Full credit can only be claimed after completion of all required components.
Hardware/Software Requirements
Computer or Other Internet-Enabled Device; Internet Connection; Browser.
Materials
None.
Prerequisites
None.
Format
This is a self-guided course with CME, CNE, CPE, AAPA CME, and AANP CE.
Need Assistance or Have Questions?
For assistance logging in, accessing content, purchasing or completing Continuing Education credits, or for other questions, please contact us at events@acmt.net or visit our FAQ page.
If you are in need of accessible learning accommodations, please contact events@acmt.net for additional assistance.
Continuing Education
ACMT Total Tox Course – Pharmaceuticals
On-Demand CourseRelease Date: December 6, 2024
Expiration Date: December 6, 2025CE credit provided by AKH Inc., Advancing Knowledge in Healthcare.
Criteria for Success
To obtain a certificate of completion, a score of 70% or better on the post-test is required. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your certificate. You must participate in the entire activity to receive credit. There is no fee to participate in this activity. If you have questions about this activity, please contact AKH Inc. at events@acmt.net.Please claim your credit by December 6, 2025
If you have questions about this CE activity, please contact AKH Inc at bethany@akhcme.com
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Nurses
Credit being awarded: 8.0 ANCC contact hours.Nurse Practitioners
This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803. This activity is approved for 8.0 contact hour(s) (which includes 8.0 hour(s) of pharmacology).
Physician Associate
AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 8.0 AAPA Category 1 CME credits. Approval is valid until 12/6/2025.
PAs should only claim credit commensurate with the extent of their participation.
Pharmacists
AKH Inc., Advancing Knowledge in Healthcare designates this continuing education activity for 8.0 contact hours.
Commercial Support
This activity is supported from an independent medical education grant from BTG international lnc.,Disclosures
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with ineligible companies whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participants misunderstanding of the content. If you would like to opt out from future communications from AKH please send an email to optout@akhcme.com with your information with "Opt Out" in the subject line. -
Contains 31 Component(s), Includes Credits
Opioids, Withdrawal, Recreational Drugs, Opioids, Drug psychoses, Chemical Burns, Decon, Carbon Monoxide, Cyanides and more!
From American College of Medical Toxicology (ACMT), dive into Substance Use Disorder & Emergency Preparedness! In the first half of this activity, you’ll explore topics related to substance use, including opioid addiction, cannabis toxicity, emerging substances, drug screening challenges, pulmonary irritants, and the impact of mitochondrial asphyxiants on first responders in chemical suicide cases. The activity then transitions to disaster preparedness, covering radiation types and symptom management, nerve agents, and a brief history of bioterrorism and identification of key agents. Interactive case panels with expert insights will further deepen your understanding of substance use disorder and disaster preparedness.
The content of this course consists of recordings from the live, virtual SUD & Emergency Preparedness activity of the 2024 ACMT Total Tox Course on November 8, 2024. The content has been edited and packaged into this on-demand version featuring 13 asynchronous lectures from experts in the field of medical toxicology.
Registration for this course includes 90 day access to the on-demand material and up to 8.00 Continuing Education credits.
Target Audience
This activity is designed for a diverse audience including physicians, pharmacists, advanced practice nurses, nurses, physician assistants, medics, EMTs, SPIs, laboratorians, poison center educators, first responders, and residents and students eager to expand their expertise.
Continuing Education
Enduring continuing education credits for Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners is provided by AKH Inc., Advancing Knowledge in Healthcare. It is expected that learners will receive up to 8.0 credits for learning and change.
For more information, click here.
Learning Objectives
After Completing This Program You Should Be Able To:
- Discuss psychoactive substances as well as the diagnosis and treatment approaches for substance use disorders.
- Describe medication-assisted treatments for opioid use disorder, focusing on buprenorphine, methadone, and naltrexone.
- Explain medical management principles for CBRNE and other hazmat situations
Questions?
Please write to ACMT at events@acmt.net
If you are interested in the other sections of this course, check out the links below!
Syllabus
Total Activity Length: approximately 8 hours (472 minutes)
PRE-TEST | 15 min
12 multiple-choice questions to ascertain your baseline knowledge on the topic.
The New Dangers of Opioid Addiction | 42 min
Lewis Nelson, MD, FACEP Chair of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ
Dr. Nelson will describe opioid use disorder and explain how to initiate treatment for opioid use disorders. He will also highlight harm reduction efforts that can reduce the adverse consequences of opioid use.
Management Options for Opioid Use Disorder | 30 min
Rachel Wightman, MD, FACMT Assistant Professor of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
Dr. Wightman will review the misuse, abuse, & criteria for diagnosing opioid use disorder. She will identify psychosocial treatments for opioid use disorder and describe the medication-assisted treatments for Buprenorphine, Methadone, and Naltrexone.
Cannabis & Cannabis Toxicity | 28 min
Mark Neavyn, MD, FACMT Medical Director & Emergency Medicine Physician, Northern New England Poison Center & Maine Medical Center, Portland, ME
Dr. Neavyn will examine the symptoms of cannabis toxicity and describe the treatment approach to cannabis toxicity.
What's New in Your Neighborhood? | 19 min
Stephanie Weiss, MD, PhD Staff Clinician, Translational Addiction Medicine Branch, National Institute on Drug Abuse, Baltimore, MD
Dr. Weiss will discuss the epidemiology of new fentalogues and explain how to initiate treatment for fentanyl-related overdose.
Drug Screen Pitfalls | 29 min
Paul M. Wax, MD, FACMT Executive Director, American College of Medical Toxicology (ACMT), Phoenix, AZ
Dr. Wax will Identify toxicology tests available in the ED. He will discuss which tests should be requested in specific situations and describe how test ordering changes treatment outcomes.
Inhaled Toxicants: Simple Asphyxiants & Respiratory Irritants | 43 min
Charles McKay, MD, FACMT Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT
Dr. McKay will discuss the role of water solubility in the clinical presentation of pulmonary irritants and describe the clinical presentation of pulmonary irritants.
Chemical Suicide & Mitochondrial Asphyxiants | 29 min
Paul M. Wax, MD, FACMT Executive Director, American College of Medical Toxicology (ACMT), Phoenix, AZ
Dr. Wax will return to examine the sources and uses of chemical asphyxiants, their basic mechanisms of toxicity, and their clinical presentations. He will identify the differences between simple asphyxiants and chemical asphyxiants and compare therapies used to treat asphyxiant poisoning.
Carbon Monoxide Poisoning: High Flow Oxygen or the Hyperbaric Chamber | 27 min
Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT Medical Director, National Capital Poison Center & MedStar Georgetown University Hospital, Washington, DC
Dr. Johnson-Arbor will identify different types of radiation, describe the consequences of exposure to radiation, and discuss the diagnosis and management of radiation casualties and radiation mass casualty events.
Disaster Preparedness #1: Radiation Events | 32 min
Joseph K. Maddry, Lt Col, USAF, MC, FS, MD, FACMT Deputy Commander, Department of Emergency Medicine, US Army Institute of Surgical Research, Houston, TX
Dr. Maddry will discuss the diagnosis and management of radiation casualties and radiation mass casualty events. He will also identify different types of radiation and describe the consequences of exposure to radiation.
Disaster Preparedness #2: Organophosphates & New Agents | 34 min
Christina Hantsch, MD, FACEP, FACMT, FAACT Emergency Physician and Medical Toxicologist, Loyola University Chicago Stritch School of Medicine Maywood, IL
Dr. Hantsch will discuss management options for patients with organophosphate insecticide or nerve agent toxicity and explain cholinergic toxidrome. She will list specific organophosphate insecticides and chemical weapon nerve agents.
Disaster Preparedness #3: Other Chemical & Biological Terrorism | 44 min
Aaron Frey, DO Emergency Medicine Attending Physician and Medical Toxicology Fellow, Richmond Emergency Physicians, Inc. & University of Virginia, Richmond, VA
Dr. Frey will examine the diagnosis and management of casualties resulting from terrorism and mass casualty events and discuss the history of bioterrorism as a tool for warfare. He will explain and evaluate the agents used in bioterrorist events.
Case Panel - Addiction | 41 min
Several speakers from previous lectures return to review clinical cases on addiction.
Case Panel - Emergency Preparedness | 44 min
Several speakers from previous lectures return to review educational cases on emergency preparedness.
POST-TEST | 15 min
Retake the same 12 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.
Aaron Frey, DO
Core Faculty & Medical Toxicologist
WellSpan Health at York Hospital
Dr Aaron Frey is an emergency medicine physician and medical toxicologist. He studied government and international studies at Campbell University in North Carolina and Spanish at Middlebury College in Vermont. He worked as a firefighter, emergency medical technician, and search and rescue diver during his undergraduate career. The experiences he had in those roles are what influenced him to become a physician. His particular interests include hazardous materials and chemical, biological, radiological, and nuclear (CBRN) weapons, remote, austere, and wilderness medicine, and damage control resuscitation. He currently practices emergency medicine and toxicology at the Wellspan York Hospital in York, PA and holds an academic appointment of assistant professor of emergency medicine and medical toxicology at Drexel University College of Medicine.
Ashley Haynes, MD, FACEP
Medical Toxicologist, Addiction Medicine Specialist
Veterans Health Administration
Dr. Haynes completed training in a combined emergency medicine-internal medicine program in 2014, and a toxicology fellowship at UTSW in 2016. She has been treating substance use disorders as part of her practice since that time and is board certified in addition medicine. She currently works for the VA at the Robert J Dole Veterans Medical Center in Wichita, KS, treating patients in a residential treatment center, as well as clinic, and performing bedside consults.
Christina Hantsch, MD, FACEP, FAACT, FACMT
Emergency Physician and Medical Toxicologist
Dr. Hantsch is a graduate of the Honors Program in Medical Education at Northwestern University. She completed an emergency medicine residency, including a year as chief resident, at the Medical College of Wisconsin and then continued her training in a medical toxicology fellowship at Vanderbilt University. After her fellowship, she spent nearly 22 years at Loyola University Chicago Stritch School of Medicine and Loyola University Medical Center. There, she established an inpatient toxicology clinical service and clinical rotations for graduate medical trainees and students in multiple fields. With an interest in medication management and safety, she joined the hospital Pharmacy and Therapeutics Committee, serving as member for 6 years before being appointed chair and leading the committee for another 6 years. Dr. Hantsch earned the academic rank of Professor of Emergency Medicine, was Director of the Division of Toxicology, and Director of Academic Affairs in the Department of Emergency Medicine. As a clinical faculty member, she was appointed to the Stritch Committee on Academic Rank and Tenure, serving for 7 years including 2 as a subcommittee chair leading revision of the clinician educator track guidelines. In 2018, she was the founding Program Director of the Loyola emergency medicine residency. Dr. Hantsch served for more than 8 years as Medical Director of the Illinois Poison Center. In addition, she is a regular organizer and contributor to many local, regional, and national/international continuing education programs. After leaving academics, she worked for the U.S. FDA in pharmacovigilance for a year. As of 2022, she is board certified in addiction medicine in addition to emergency medicine and medical toxicology. Dr. Hantsch was elected to the ACMT Board of Directors in 2021, is a member of the Education Committee, and chair of the Practice Committee.
Robert Hendrickson, MD
Professor of Emergency Medicine, Medical Director, Program Director
Oregon Health and Science University, Oregon Poison Center, OHSU Fellowship in Medical Toxicology
Dr. Hendrickson graduated from the State University of New York, Downstate College of Medicine, and completed training in Emergency Medicine and Medical Toxicology at the Medical College of Pennsylvania. He is a Professor of Emergency Medicine at Oregon Health and Sciences University where he is Chief of the Section of Medical Toxicology, Program Director for the fellowship in medical toxicology, and the Medical Director of the Oregon Poison Center.
Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT
Medical Toxicology Physician and Medical Director of Hyperbaric Medicine
MedStar Georgetown University Hospital
Dr. Kelly Johnson-Arbor is a medical toxicology and hyperbaric medicine physician at MedStar Georgetown University Hospital. She is triple board-certified in Emergency Medicine, Medical Toxicology, and Undersea and Hyperbaric Medicine. She completed her undergraduate education at Harvard College and earned her medical degree from Loyola University Stritch School of Medicine. She completed a residency in Emergency Medicine at the University of Rochester, followed by a fellowship in Medical Toxicology at the University of Connecticut. From 2018 through 2023, she served as the co-medical director of National Capital Poison Center, and she has provided medical toxicology consultation services to the Connecticut Poison Control Center since 2006. Since 2015, she has served as medical director of hyperbaric medicine at MedStar Georgetown University Hospital, and she also maintains an outpatient medical toxicology clinic at this facility. She is an Assistant Professor of Plastic Surgery and Emergency Medicine at the Georgetown University School of Medicine and serves as an associate faculty member of the MedStar Institute for Quality and Safety.
An avid researcher and writer, Dr. Johnson-Arbor has published numerous articles in peer-reviewed medical journals including New England Journal of Medicine, JAMA Internal Medicine, and Annals of Emergency Medicine. She enjoys teaching toxicology principles and hyperbaric medicine to the public as well as medical professionals. Her work as both a hyperbaric medicine and medical toxicology physician has allowed her to gain unique perspectives on the diagnosis and treatment of acute and chronic carbon monoxide poisoning as well as their long-term complications.
Joseph K. Maddry, Lt Col, USAF, MC, FS, MD, FACMT
Deputy Commander
Department of Emergency Medicine, US Army Institute of Surgical Research
Lt Col Maddry earned his Bachelor’s Degree from the US Air Force Academy in 2001 as a Distinguished Graduate. His first assignment was as Officer in Charge of Bioenvironmental Engineering at Minot Air Force Base, North Dakota. During his tenure, he led his unit’s response to the largest anhydrous ammonia spill in U.S. history. He then attended medical school at the Uniformed Services University, earning Alpha Omega Alpha membership honors. He completed his emergency medicine residency at SAUSHEC and his medical toxicology fellowship at the Rocky Mountain Poison and Drug Center in Denver, Colorado.
Following fellowship, Lt Col Maddry returned to Brooke Army Medical Center as an emergency physician and medical toxicologist. He served as Chief of the BAMC Simulation Center from 2014 to 2015. Subsequently, he served as Director of the US Air Force En route Care Research Center (ECRC) from 2015 to 2020. In this position, he oversaw 20 personnel and a $14.8 million research portfolio. He is an author of over 100 peer reviewed publications and 150 research presentations and has been awarded over $28 million in research grants. The Society of Academic Emergency Medicine recognized Dr. Maddry’s research as one of the best publications of 2014. Lt Col Maddry was awarded the Defense Health Board Early Career Investigator Award, the 2017 USAF Outstanding Achievement in Clinical Research award and the 2018 Military Health System Research Symposium Small Team Research Accomplishment Award for Excellence.
Lt Col Joseph Maddry is currently the Deputy Commander of the US Army Institute of Surgical Research, overseeing over 700 personnel focused on optimizing combat casualty care. Dr. Maddry also serves as Director of Medical Toxicology at Brooke Army Medical Center and as the Director of the Clinical Resuscitation, Emergency Sciences, Toxicology, and Triage (CREST2) Research Program. He leads the development of the next generation of military researchers by serving as the Director of the SAUSHEC Military Emergency Medicine Research Fellowship and as Director of the Clinician Scientist Investigator Opportunity Network (CSION).
He is an Associate Professor of Emergency Medicine with the Uniformed Services University and has academic appointments at the University of Texas Health, Texas A&M, and the University of Colorado Denver. Lt Col Maddry has served in Afghanistan, Iraq, Haiti, Japan and Burkina Faso.
Charles McKay, MD, FACMT
Associate Medical Director
CT Poison Control Center, University of Connecticut School of Medicine
Dr. McKay was trained in Anatomic and Surgical Pathology, Internal Medicine, Emergency Medicine, Medical Toxicology and was a Medical Director of Occupational Health and Medical Review Officer for a hospital system during more than 30 years of clinical practice, during which he provided toxicology consultation at 3 hospitals, directed a medical toxicology fellowship training program, and provided medical oversight of a regional poison control center. He provides medical legal consultation across the country on toxicology-related issues, and has testified in nearly 100 cases, many related to questions of alcohol- and -drug-induced impairment.
Howard McKinney, PharmD, DABAT, FAACT
Secretary-Treasurer
American Board of Applied Toxicology & North American Society of Toxinology
Dr McKinney graduated in 1971 from the University of California San Diego, Revelle College with a Bachelor of Arts degree (BA), Biology major, Spanish Literature minor.
In 1978 he graduated from UCSF School of Pharmacy with a Doctor of Pharmacy degree (PharmD), and was recruited to be a founding staff member of the San Francisco Poison Center, where he worked until 1992.
In 1992 he passed the Boards to become a Diplomate of the American Board of Applied Toxicology DABAT), and was hired as a Clinical Pharmacist in Critical Care at Univ Calif Davis Medical Center in Sacramento California (UCDMC).
In 2018 he was approved as a Fellow of the American Academy of Clinical Toxicology (FAACT), and retired from UCDMC. He continues his work as Secretary-Treasurer of ABAT and NAST (North American Society of Toxincology), as well as his love of herpetology, hiking, photography, videography and music.
Mark Neavyn, MD, FACMT
Medical Director & Emergency Medicine Physician
Northern New England Poison Center & Maine Medical Center
Mark Neavyn, M.D. joined Maine Medical Center as the Medical Director for the Northern New England Poison Center in 2020. After earning his Bachelor of Arts degree in biology from Augustana College, he went on to earn his medical degree at Jefferson Medical College. He then completed his residency in emergency medicine at Drexel University, followed by a fellowship in Medical Toxicology at the University of Massachusetts.
His clinical interests include treatment and stabilization of patients after poisoning, drug overdose, and environmental exposures. He is particularly interested in the public health implications of cannabis use and emerging trends in novel psychoactive substances.
In his spare time Dr. Neavyn enjoys running on the beautiful trails in and around Portland, Maine.
Lewis Nelson, MD, MBA, FACMT, FASAM
Chair of Emergency Medicine
Rutgers New Jersey Medical School
Lewis S. Nelson, MD is Professor and Chair of the Department of Emergency Medicine at Rutgers New Jersey Medical School, Chief of Service for the Emergency Department at University Hospital of Newark, and Senior Consultant to the New Jersey Poison Information & Education System. Dr. Nelson is board certified in emergency medicine, medical toxicology, and addiction medicine. His areas of specific interest include preventing and managing the consequences of opioid and other substance use, multimodal pain management strategies, health policy, and medication safety.
Dr. Nelson has served as President of American College of Medical Toxicology and on the Board of Directors of both the American Board of Emergency Medicine and the Accreditation Council for Continuing Medical Education. He is currently the president of Association of Academic Chairs in Emergency Medicine. He is a long time consultant for several governmental agencies including the Centers for Disease Control and Prevention, the Department of Homeland Security, and the Food and Drug Administration. He is an editor of the textbook “Goldfrank’s Toxicologic Emergencies.
Paul M. Wax, MD, FACMT
Executive Director
American College of Medical Toxicology (ACMT)
Dr. Wax is the Executive Director of the American College of Medical Toxicology. He received his B.A from Dartmouth College, his M.D. from the Mount Sinai School of Medicine, his Emergency Medicine training at the UCLA Hospitals, and his Medical Toxicology training at Bellevue Medicine Center / New York University. He is Board-certified in both Medical Toxicology and Emergency Medicine, and is a Fellow of the American College of Medical Toxicology.
Stephanie Weiss, MD, PhD
Staff Clinician, Translational Addiction Medicine Branch
National Institute on Drug Abuse
Dr. Stephanie Weiss is the Staff Research Physician serving the Translational Addiction Medicine Branch of the National Institute on Drug Abuse’s Intramural Research Program. After earning a Ph.D. in pharmaceutical chemistry, Dr. Weiss received her medical degree in 2011. She is board certified in emergency medicine, addiction medicine, and medical toxicology and was selected to participate in the Boston University Research in Addiction Medicine Scholars Program prior to joining NIDA. Dr. Weiss is responsible for providing optimal, safe, and ethical care to study participants and clinical support toward the TAMB mission conducting inpatient and outpatient proof-of-concept human laboratory studies. Her research interests include novel psychoactive substances, medication misuse, and improving interpretation of urine drug testing.
Rachel Wightman, MD, FACMT
Assistant Professor of Emergency Medicine
The Warren Alpert Medical School of Brown University
Dr. Wightman is an Assistant Professor of Emergency Medicine at Alpert Medical School of Brown University. She is a triple board-certified practicing physician in medical toxicology, addiction medicine, and emergency medicine. She serves as Director of Toxicology Education for Brown Emergency Medicine and as faculty in the Addiction Medicine Fellowship at Rhode Island Hospital. She completed medical toxicology fellowship and emergency medicine residency at New York University School of Medicine/ Bellevue Hospital Center.
Dr. Wightman’s primary clinical expertise is in the evaluation and management of drug toxicity syndromes in complex medical patients and enhancing medication safety for high-risk drugs. Her research is focused on evaluation and tracking of emerging drug trends, cannabis hyperemesis syndrome, and medications for treatment of opioid use disorder.
Registration Rates
Registration includes:
- 90-day access to all course content
- Access to the Speaker slides
- 8.0 Continuing Education Certificate. Available credits: Continuing Medical Education (CME), Continuing Nursing Education (CNE), Continuing Pharmacy Education (CPE), Continuing Medical Education for Physician Associates (AAPA CME), and Continuing Education for Nurse Practitioners (AANP CE).
Member Rates
Member Tier I: Full, Affiliate, International, Emeritus
$200
Member Tier II: Fellows
$200
Member Tier III: Residents, International - Developing Country
$125
Member IV: Medical Students
$75Non-Member Rates
Non-member Tier I: Physicians, Pharmacists, Lawyers, "Other"
$225
Non-member Tier II: Fellows, SPIs, Nurses, etc.
$225
Non-member Tier III: Educators & Emergency Responders
$150
Non-member IV: Residents & Students
$100
ACMT Membership
ACMT Members receive a discounted rate. Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership
Package Rates
Sign up for the full ACMT Total Tox Course and save $100!
Refunds and Cancellations
For information on ACMT's Cancellation and refund policy, click here.
Questions?
For any questions, please email us at events@acmt.net.
Instructions
Once you have completed your registration:
- Click on the Contents tab. This is where you will be able to see all lectures and required content for this course.
- Complete the Pre-Test. You are not required to pass the Pre-Test, this is to test your skills before you begin the on-demand course.
- Watch all lectures and case panels. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.
- Complete the Post-Test. These questions are based on content from the lectures to gauge your comprehension of the lectures. It requires a 80% to pass.
- Complete the Course and CE Survey. These questions are required to claim your CE certificate.
- Claim your CE certificate. Once you have claimed your CE credit, you will not be able to change your CE certificate.
Full credit can only be claimed after completion of all required components.
Hardware/Software Requirements
Computer or Other Internet-Enabled Device; Internet Connection; Browser.
Materials
None.
Prerequisites
None.
Format
This is a self-guided course with CME, CNE, CPE, AAPA CME, and AANP CE.
Need Assistance or Have Questions?
For assistance logging in, accessing content, purchasing or completing Continuing Education credits, or for other questions, please contact us at events@acmt.net or visit our FAQ page.
If you are in need of accessible learning accommodations, please contact events@acmt.net for additional assistance.
Continuing Education
ACMT Total Tox Course - SUD & Emergency Preparedness
On-demand Course
Release Date: December 6, 2024
Expiration Date: December 6, 2025CE credit provided by AKH Inc., Advancing Knowledge in Healthcare.
Criteria for Success
To obtain a certificate of completion, a score of 70% or better on the post-test is required. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your certificate. You must participate in the entire activity to receive credit. There is no fee to participate in this activity. If you have questions about this activity, please contact AKH Inc. at events@acmt.net.Please claim your credit by December 6, 2025
If you have questions about this CE activity, please contact AKH Inc at bethany@akhcme.com
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Nurses
Credit being awarded: 8.0 ANCC contact hours.Nurse Practitioners
This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803. This activity is approved for 8.0 contact hour(s) (which includes 8.0 hour(s) of pharmacology).
Physician Associate
AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 8.0 AAPA Category 1 CME credits. Approval is valid until 12/6/2025.
PAs should only claim credit commensurate with the extent of their participation.
Pharmacists
AKH Inc., Advancing Knowledge in Healthcare designates this continuing education activity for 8.0 contact hour
Commercial Support
This activity is supported from an independent medical education grant from BTG international lnc.,Disclosures
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with ineligible companies whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participants misunderstanding of the content. If you would like to opt out from future communications from AKH please send an email to optout@akhcme.com with your information with "Opt Out" in the subject line. -
Contains 33 Component(s), Includes Credits
Methemglobinemia, Heavy metals, Hydrocarbons, Ethanol, Methanol, Marine, Reptiles, Arthropods, Mushrooms, Herbicides, insecticides and more!
From American College of Medical Toxicology (ACMT), join us for an exhilarating education on Non-Pharmaceuticals! Lectures will include topics such as the toxicology of plants and mushrooms, and envenomations from reptiles, marine life, and arthropods. Experts will also discuss anesthetic toxicity, malignant hyperthermia, and methemoglobinemia, as well as provide insights into managing heavy metal poisoning and the complexities of ethanol and toxic alcohol intoxication. This activity features interactive case panels on novel treatments for critically ill patients and approaches to evaluating unknown toxicology issues, allowing you to apply your knowledge from the entire Total Tox Course.
The content of this course consists of recordings from the live, virtual Non-Pharm activity of the 2024 ACMT Total Tox Course. The content has been edited and packaged into this on-demand version featuring 13 asynchronous lectures from experts in the field of medical toxicology.
Registration for this activity includes 90 day access to the on-demand material and up to 8.00 Continuing Education credits.
Target Audience
This activity is designed for a diverse audience including physicians, pharmacists, advanced practice nurses, nurses, physician assistants, medics, EMTs, SPIs, laboratorians, poison center educators, first responders, and residents and students eager to expand their expertise.
Continuing Education
Enduring continuing education credits for Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners is provided by AKH Inc., Advancing Knowledge in Healthcare. It is expected that learners will receive up to 8.0 credits for learning and change.
For more information, click here.
Learner Objectives
After Completing This Program You Should Be Able To:
- Identify non-pharmaceutical poisons found in various locations including home, cabinet, garage, and yard.
- Discuss current and emerging management options for ethanol intoxication, withdrawal, and use disorder.
- Examine other toxicological concerns including heavy metals, methemoglobin-forming agents, toxic hyperthermia, and venomous creatures
Questions?
Please write to ACMT at events@acmt.net
If you are interested in the other sections of this course, check out the links below!
Syllabus
Total Activity Length: approximately 8 hours (452 minutes)
PRE-TEST | 15 min
12 multiple-choice questions to ascertain your baseline knowledge on the topic.
Hospital Hazards #1: Anesthetic Toxicity & Malignant Hyperthermia | 24 min
Shaun D. Carstairs, MD, FACMT Medical Toxicologist, Rady Children's Hospital, San Diego, CA
Dr. Carstairs will discuss the history and pharmacology of local anesthetics and the unique characteristics and common clinical use for each prototypical local anesthetic. He will assess the most commonly caused several complications of local anesthetics and identifies general thermoregulatory principles. He will also review the following hyperthermic syndromes & discusses treatment options: Serotonin Syndrome, Neuroleptic Malignant Syndrome, and Malignant Hyperthermia.
Hospital Hazards #2: Methemoglobinemia | 27 min
Andrea Carlson, MD Emergency Medicine Physician, Advocate Christ Medical Center, Oak Lawn, IL
Dr. Carlson will discuss the common agents causing Methemoglobinemia. She will identify methemoglobinemia mechanisms of toxicity and describe the best practices in clinical management of methemoglobinemia.
Heavy Metals In the ED: Lead, Arsenic & Mercury | 28 min
Evan Schwarz, MD, FACMT, FASAM, FACEP Medical Toxicology Fellowship Director, University of California, Los Angeles, Los Angeles, CA
Dr. Schwarz will review the signs and symptoms of lead toxicity. He will discuss the role of chelation in heavy metal toxicity and compare and contrast the toxicity caused by different forms of mercury.
Ethanol Intoxication: Too Much Of a Good Thing | 44 min
Anthony Pizon, MD, FACMT Chief of Medical Toxicology Division, Professor of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA
Dr. Pizon will examine the prevalence of ethanol AUD in patients presenting to the Emergency Department. He will also discuss the genetic vs. environmental factors for ethanol AUD and assess the most critical laboratory tests for symptomatic patients who have suspected ethanol intoxication.
When It's Not Ethanol: Demystifying Toxic Alcohols | 41 min
Bram Dolcourt, MD Clinical Assistant Professor Department of Emergency Medicine, Wayne State University, Detroit, MI
Dr. Dolcourt will describe toxicity & time course of methanol (MeOH) and ethylene glycol (EthGly) exposures, identify two stand-in tests for MeOH and EthGly, noting limitations, and present a rationale for treatment with ethanol, fomepizole, and/or hemodialysis.
Ethanol Withdrawal: When the Good Times End | 31 min
Jerrold Blair Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM Adjunct Clinical Professor Division of Environmental and Occupational Health Sciences & Professor of Medicine, University of Illinois Chicago and Rosalind Franklin University of Medicine & Science, North Chicago, IL
Dr. Leikin will discuss appropriate treatment so that complications are prevented. He will examine alcohol withdrawal symptoms and describe the principles of detoxification.
Don't Touch That! Marine, Arthropod & Reptile Envenomations | 36 min
Michael Levine, MD, FACMT Associate Professor of Emergency Medicine, University of California Los Angeles, Los Angeles, CA
Dr. Levine will identify various toxic envenomations and describe the characterization of Black Widow envenomation and management options. He will also discuss management options for pit viper envenomations.
The Toxic Yard | 28 min
Fiona Garlich Horner, MD Head of Toxicology & Assistant Professor of Clinical Emergency Medicine, LAC+USC Medical Center & University of Southern California Keck School of Medicine, Los Angeles, CA
Dr. Garlich Horner will examine different classes of plant derived toxins and their effects on humans and identify hazards of different mushrooms and clinical toxidromes associated with mushrooms.
The Toxic House | 29 min
Ashley Haynes, MD, FACEP Medical Director, Addiction Toxicology of Kansas, Wichita, KS
Dr. Haynes will discuss common household exposures and their implications and review the toxicity of common household cleaners and toys.
The Toxic Cabinet | 26 min
Stephen Wood, MS, ACNP-BC, FEWM Acute Care Nurse Practitioner & Director of Advanced Practice Providers, St. Elizabeth’s Medical Center, Brighton, MA
Nurse Practitioner Wood will review toxicity of essential oils and examine the risks associated with the use of dietary supplements.
The Toxic Garage | 34 min
Andrew King, MD Associate Professor in the Department of Emergency Medicine & Medical Director, Wayne State University School of Medicine & Michigan Poison and Drug Information Center, Detroit, MI
Dr. King will discuss common toxins and exposures of chemicals commonly found in the garage. He will also review toxicity and management of chemicals and other substances commonly found in the garage.
Case Panel - The Hot Patient | 60 min
Several speakers from previous lectures will return to review clinical cases.
Case Panel - The Unknown Tox Patient | 29 min
Several speakers from previous lectures will return to review clinical cases.
POST-TEST | 15 min
Retake the same 12 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.
Nena Bowman, PharmD, DABAT
Director of Vaccine Operations
Vaccine Preventable Diseases and Immunization Program, Tennessee Department of Health
Nena Bowman received her Bachelor of Science in Biochemistry at Middle Tennessee State University in 2010 and her Doctorate of Pharmacy at Lipscomb University College of Pharmacy in 2014. Bowman completed a specialty fellowship in Toxicology with the Utah Poison Control Center at the University of Utah in Salt Lake City, Utah in 2016. She is board certified as a clinical toxicologist, Diplomate of the American Board of Applied Toxicology (DABAT). Dr. Bowman currently practices at the Tennessee Department of Health as the Director of Vaccine Operations and a Toxicologist Consult for the Emergency Preparedness Program. Bowman works closely with providers across the state to ensure proper utilization of federal vaccine program funds, and equal access to all ACIP recommended vaccines for underserved children and adults. She also teaches at Lipscomb University College of Pharmacy as an adjunct professor in toxicology and emergency preparedness curriculum. She is an Advanced Hazmat Life Support (AHLS) Provider and Instructor, and she is the immediate past president of the Nashville Area Pharmacists Association. She enjoys working in public health to educate providers, consulting on difficult toxicology situations, and problem solving to navigate unprecedented events and challenges.
Andrea Carlson, MD
Emergency Medicine Physician
Advocate Christ Medical Center
Dr. Andrea Carlson is an attending physician in Emergency Medicine at Advocate Christ Medical Center in Oak Lawn, IL, where she has served the patients of Chicago's South Side for 25 years. She is also the Director of Medical Toxicology, and the Associate Program Director of the Advocate Christ Emergency Medicine Residency. Her primary academic interests lie in toxicology education and critical care toxicology.
Shaun D. Carstairs, MD, FACMT
Medical Toxicologist
98point6
Dr. Carstairs earned his undergraduate degree from the California Institute of Technology in Pasadena, CA and received his medical degree from the Uniformed Services University of the Health Sciences (USU), the nation's military medical school. He completed a residency in emergency medicine at the Naval Medical Center in San Diego and a fellowship in medical toxicology at the University of California, San Diego. He served more than 25 years on active duty in the U.S. Navy, which included a combat deployment to Iraq and shipboard deployment as the leader of a mobile trauma team for the Navy’s Pacific Fleet. He retired from the Navy as a Captain in 2019. He currently serves as a faculty member in the Department of Emergency Medicine & Division of Medical Toxicology at the University of California, San Diego (UCSD). In addition to his role at UCSD, he holds an appointment as Professor of Military & Emergency Medicine at USU.
Bram Dolcourt, MD
Clinical Assistant Professor Department of Emergency Medicine
Wayne State University
Bram Dolcourt is Assistant Professor of Emergency Medicine at Wayne State University and serves as Associate Residency Director for Emergency Medicine at Sinai Grace Hospital in Detroit. Dr. Dolcourt is a Clinical Consultant to the Michigan Poison and Drug Information Center. Dr Dolcourt complete Medical School at New York Medical College and residency at Henry Ford Hospital. Dr. Dolcourt then went on to complete fellowship in Medical Toxicology at the Children’s Hospital of Michigan. Dr. Dolcourt’s interests include inpatient addiction medicine and heavy metal exposures.
Ashley Haynes, MD, FACEP
Medical Toxicologist, Addiction Medicine Specialist
Veterans Health Administration
Dr. Haynes completed training in a combined emergency medicine-internal medicine program in 2014, and a toxicology fellowship at UTSW in 2016. She has been treating substance use disorders as part of her practice since that time and is board certified in addition medicine. She currently works for the VA at the Robert J Dole Veterans Medical Center in Wichita, KS, treating patients in a residential treatment center, as well as clinic, and performing bedside consults.
Fiona Garlich Horner, MD
Head of Toxicology & Assistant Professor of Clinical Emergency Medicine
LAC+USC Medical Center & University of Southern California Keck School of Medicine
Dr Fiona Garlich Horner is the Head of Medical Toxicology at Los Angeles County + University of Southern California (LAC+USC) Medical Center, and an Assistant Professor of Clinical Emergency Medicine at the University of Southern California Keck School of Medicine. She is a graduate of Oregon Health Sciences University School of Medicine in Portland, Oregon, and completed her residency in Emergency Medicine at Hennepin County Medical Center in Minneapolis, Minnesota. After completing a fellowship in Medical Toxicology at New York University and the New York City Poison Control Center, she served as an attending emergency physician and medical toxicologist with the Poison and Drug Information Service (PADIS) in Calgary, Alberta, Canada.
Dr. Garlich is now an attending emergency physician and medical toxicologist at LAC+USC Medical Center in Los Angeles, California, one of the largest and busiest public hospitals in the United States. She is the director of the inpatient toxicology consultation service and the resident toxicology rotation, as well as the chair of the hospital’s medication safety committee. Her primary academic interests lie in toxicology education and advancing the care of vulnerable and incarcerated populations.
B. Zane Horowitz, MD, FACMT
Associate Medical Director
Oregon Poison Center
Dr. B. Zane Horowitz served as the medical director of the Oregon-Alaska-Guam Poison Center for 22 years. He also served as the medical director for the Utah Poison Control Center for 7 of those years. He currently continues to teach at Oregon Health and Science University in medical toxicology, and has authored over 90 publications.
Andrew King, MD
Associate Professor in the Department of Emergency Medicine & Medical Director
Wayne State University School of Medicine & Michigan Poison and Drug Information Center
Dr. King is an Emergency medicine physician, Medical Toxicologist and Addiction Medicine specialist at the Detroit Medical Center and Wayne State University. He works as an emergency physician at Sinai Grace and Detroit Receiving Hospitals. He additionally works at the Tolan Park Research Center where he sees patients with substance use disorders. He is the interim director of the Michigan Poison and Drug Information Center and the Fellowship Director of the Medical Toxicology Fellowship. He is excited to be an organizer and presenter at the Total Tox Course!
Jerrold Blair Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM
Adjunct Clinical Professor Division of Environmental and Occupational Health Sciences & Professor of Medicine
University of Illinois Chicago and Rosalind Franklin University of Medicine & Science
I am a currently Adjunct Clinical Professor on the Division of Environmental and Occupational Health Sciences and the Occupational and Environmental Medicine Service of UI Health at the University of Illinois at Chicago and Professor of Medicine at Rosalind Franklin University of Medicine & Science in North Chicago, Ill.
In 1980, I received my medical degree from the Chicago Medical School. I then completed a combined residency in Internal Medicine and Emergency Medicine at Northwestern University (1984) followed by a three-year preceptorship/fellowship training in Medical Toxicology at Cook County Hospital and University of Illinois Hospital in Chicago, Illinois. I am Board Certified in Internal Medicine, Emergency Medicine, Medical Toxicology and Addiction Medicine.
I served as the Associate Director of the Emergency Department at Rush Presbyterian-St. Luke’s Medical Center in Chicago from 1998-2001. During this time, I was also the Medical Director of the Rush Poison Control Center and served as Medical Director of the United States Drug Testing Laboratory (from 1991 -1996). I was also the Medical Director of PROSAR (located in St. Paul, MN); a national call center devoted to industrial exposures and product safety issues, up until December 2013.
I have presented over 200 research abstracts at national meetings (primarily to the North American Congress of Clinical Toxicology) and have published over 200 articles in peer-reviewed medical journals. I am the co-editor of the Poisoning and Toxicology Handbook (now in its fourth edition), published by CRC Press, and the American Medical Association Handbook of First Aid and Emergency Care, and published by Random House (New York). I am also the co-editor with Dr. Robin McFee for the Toxico-terrorism book (McGraw Hill) and the Handbook of Nuclear, Biological and Chemical Agent Exposure (CRC Press) both published in 2007. I was also the co-editor of the American Medical Association Complete Medical Encyclopedia, published by Random House in 2003. I am presently the Editor-in-Chief of the primary care journal, Disease-a-Month, published by Elsevier. I was on the Illinois State Board of Health from 2016 – 2019.
Michael Levine, MD, FACMT
Co-Division Chief of Medical Toxicology
University of California, Los Angeles
Michael Levine is a Los Angeles native, who completed his emergency medicine residency at the Harvard Affiliated Emergency Medicine program, based out of Brigham and Women’s Hospital and Massachusetts General Hospital. After residency, he completed his medical toxicology fellowship at Banner Good Samaritan Medical Center in Phoenix, AZ. After staying as faculty for a year in Phoenix, he moved back to Los Angeles, where he joined the faculty at USC. He is currently the division chief of medical toxicology. He is actively involved in patient care, research, and serves on numerous hospital and university committees. He is an active member of American College of Emergency Physicians, the American College of Medical Toxicology, and is a member of the Toxicology Investigator's Consortium.
Anthony Pizon, MD, FACMT
Chief of Medical Toxicology Division, Professor of Emergency Medicine
University of Pittsburgh
Dr. Anthony (Tony) Pizon received his medical degree from the University of Toledo School of Medicine in 2001. He then completed his Emergency Medicine Residency at the University of Pittsburgh Medical Center in 2004 and his Medical Toxicology Fellowship at Banner Good Samaritan Medical Center in Phoenix, Arizona in 2006. Dr. Pizon is currently a Professor in the Department of Emergency Medicine, Division of Medical Toxicology at the University of Pittsburgh, School of Medicine. He serves as Chief of the Division of Medical Toxicology and Director of the Medical Toxicology Fellowship at UPMC. He is also Assistant Medical Director of both the Pittsburgh and West Virginia Poison Centers. Yet, most importantly, he is blessed with amazing wife, Caryn, and four wonderful children (Benjamin, Elizabeth, Gabriela, and Seraphina).
Evan Schwarz, MD, FACMT
Associate Professor of Emergency Medicine
University of California, Los Angeles
Dr. Schwarz attended medical school at the University of Texas Medical Branch in Galveston, Texas, before completing a residency in Emergency Medicine at the Washington University School of Medicine in Saint Louis, Missouri. After residency, he completed a fellowship in Medical Toxicology at the University of Texas Southwestern School of Medicine in Dallas, Texas, before returning to Missouri where he was an Advisory Dean and the Medical Toxicology Division Chief and Fellowship Director at Washington University. In 2023, he took a position in the Department of Emergency Medicine at the University of California Los Angeles. He is also a member of the Board of Directors for ACMT.
Donna Seger, MD, FAACT, FACMT
Professor Emeritus
Department of Medicine, Vanderbilt University Medical Center
Donna Seger, MD, retired in December 2021 after working for 33 years at Vanderbilt University Medical Center and the Tennessee Poison Center (TPC). Dr. Seger began her career at VUMC in 1988 in the Department of Emergency Medicine, becoming professor of Clinical Medicine and Emergency Medicine. She served as medical and executive director of the Tennessee Poison Center from 1990-2021. Seger received her undergraduate and medical degrees from University of North Dakota, Grand Forks. She completed her residency in emergency medicine and a fellowship in toxicology at the University of Cincinnati. Seger taught toxicology courses at Vanderbilt and developed consulting services and toxicology rotations for emergency medicine and pediatric residents and fellows and pediatric emergency medicine fellows. She was the first female president of the American Academy of Clinical Toxicology (AACT) and received its Career Achievement Award and Distinguished Service Award for her achievements in the field of toxicology. While retired from active clinical practice, she plans to remain active in the toxicology community.
Stephen Wood, MS, ACNP-BC, FEWM
Acute Care Nurse Practitioner & Director of Advanced Practice Providers
St. Elizabeth’s Medical Center
Stephen P. Wood is an acute care nurse practitioner and director of advanced practice providers in the division of pulmonary and critical care medicine at St. Elizabeth’s Medical Center. Prior to this he spent 11 years practicing as a nurse practitioner in emergency medicine. His roots are in EMS and he has over 30 years of field experience, including 10 as a flight paramedic. He is an instructor in the School of Nursing at Northeastern University in the graduate nursing program and is a graduate scholar of the Harvard Macy Institute program for Healthcare Educators. He is a former fellow in Bioethics at the Center for Bioethics at Harvard Medical School and a current visiting researcher at the Petrie-Flom Center at the Harvard Law School Petrie-Flom Center for Health Policy. He holds a Master of Science in Nursing as well as a Master of Science in Toxicology. He is the Director of Field Operations for World Extreme Medicine USA and host of the WEM podcast.
Registration Rates
Registration includes:
- 90-day access to all course content
- Access to the Speaker slides
- 8.0 Continuing Education Certificate. Available credits: Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners.
Member Rates
Member Tier I: Full, Affiliate, International, Emeritus
$200
Member Tier II: Fellows
$200
Member Tier III: Residents, International - Developing Country
$125
Member IV: Medical Students
$75Non-Member Rates
Non-member Tier I: Physicians, Pharmacists, Lawyers, "Other"
$225
Non-member Tier II: Fellows, SPIs, Nurses, etc.
$225
Non-member Tier III: Educators & Emergency Responders
$150
Non-member IV: Residents & Students
$100
ACMT Membership
ACMT Members receive a discounted rate. Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership
Package Rates
Sign up for the full ACMT Total Tox Course and save $100!
Refunds and Cancellations
For information on ACMT's Cancellation and refund policy, click here.
Questions?
For any questions, please email us at events@acmt.net.
Instructions
Once you have completed your registration:
- Click on the Contents tab. This is where you will be able to see all lectures and required content for this course.
- Complete the Pre-Test. You are not required to pass the Pre-Test, this is to test your skills before you begin the on-demand course.
- Watch all lectures and case panels. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.
- Complete the Post-Test. These questions are based on content from the lectures to gauge your comprehension of the lectures. It requires a 80% to pass.
- Complete the CE Survey. These questions are required to claim your CE certificate.
- Claim your CE certificate. Once you have claimed your CE credit, you will not be able to change your CE certificate.
Full credit can only be claimed after completion of all required components.
Hardware/Software Requirements
Computer or Other Internet-Enabled Device; Internet Connection; Browser.
Materials
None.
Prerequisites
None.
Format
This is a self-guided course with CME, CNE, CPE, AAPA CME, and AANP CE.
Need Assistance or Have Questions?
For assistance logging in, accessing content, purchasing or completing Continuing Education credits, or for other questions, please contact us at events@acmt.net or visit our FAQ page.
If you are in need of accessible learning accommodations, please contact events@acmt.net for additional assistance.
Continuing Education
ACMT Total Tox Course – Non-Pharmaceuticals
On-Demand Course
Release Date: December 6, 2024
Expiration Date: December 6, 2025CE credit provided by AKH Inc., Advancing Knowledge in Healthcare.
Criteria for Success
To obtain a certificate of completion, a score of 70% or better on the post-test is required. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your certificate. You must participate in the entire activity to receive credit. There is no fee to participate in this activity. If you have questions about this activity, please contact AKH Inc. at events@acmt.net.Please claim your credit by December 6, 2025
If you have questions about this CE activity, please contact AKH Inc at bethany@akhcme.com
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Nurses
Credit being awarded: 8.0 ANCC contact hours.Nurse Practitioners
This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803. This activity is approved for 8.0 contact hour(s) (which includes 8.0 hour(s) of pharmacology).
Physician Associate
AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 8.0 AAPA Category 1 CME credits. Approval is valid until 12/6/2025.
PAs should only claim credit commensurate with the extent of their participation.
Pharmacists
AKH Inc., Advancing Knowledge in Healthcare designates this continuing education activity for 8.0 contact hour
Commercial Support
This activity is supported from an independent medical education grant from BTG international lnc.,Disclosures
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with ineligible companies whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participants misunderstanding of the content. If you would like to opt out from future communications from AKH please send an email to optout@akhcme.com with your information with "Opt Out" in the subject line.