On-Demand Total Tox Course - Full Course Package

On-Demand Total Tox Course - Full Course Package

  • Register
    • Non-member - Tier I - $650
    • Non-member - Tier II - $650
    • Non-member - Tier III - $650
    • Non-member - Tier IV - $650
    • Member - Tier I - $500
    • Member - Tier II - $500
    • Member - Tier III - $500
    • Member - Tier IV - $500


This Course is recommended by:

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Overview

The ACMT Total Tox Course is a comprehensive review of the scope of emergency toxicology and includes cutting-edge interventions and management options for poisoned patients. 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 three sections are: 

  • Pharmaceuticals

  • Substance Abuse & Emergency Preparedness

  • Non-Pharmaceuticals

Target Audience:

Professionals who would be interested in this course include: Physicians, Pharmacists, Advanced Practice Nurses, Nurses, Physician Assistants, Medics, EMTs, SPIs, Laboratorians, Poison Center Educators, First Responders, Operational or Tactical Specialists, Residents and Students.


Course Objectives:

  • Develop an evidence-based approach to evaluation, diagnosis, and treatment of acutely poisoned patients.

  • Discuss cutting-edge management options, including new antidote therapies and advanced treatment modalities for critically ill poisoned patients.

  • Understand emerging trends in drugs of abuse and new approaches to the management of patients with substance use disorders.

  • Review chemical and radiological threats and approaches to CBRN victim initial management and stabilization.

Length of Course: 19h 40m 

  • Contains 16 Component(s) Recorded On: 11/18/2022

    Non-Pharmaceuticals Section

    This Course is recommended by:

    image

    Overview

    The ACMT Total Tox Course is a comprehensive review of the scope of emergency toxicology and includes cutting-edge interventions and management options for poisoned patients. Prominent experts in medical toxicology and emergency medicine have lead the creation of this course. This on-demand course consists of three sections: Pharmaceuticals, Substance Use & Emergency Preparedness, and Non-Pharmaceuticals. 

    The lectures in this section will focus on Non-Pharmaceuticals. With approximately 6.75 hours of on-demand Continuing Educational content, there are eleven lectures and one case panel in this section.

    Target Audience: Physicians, Pharmacists, Advanced Practice Nurses, Nurses, Physician Assistants, Medics, EMTs, SPIs, Laboratorians, Poison Center Educators, First Responders, Operational or Tactical Specialists, Residents and Students 

    Learning Objectives

    1. Describe the history and pharmacology of local anesthetics.
    2. Discuss the unique characteristics and common clinical use for each prototypical local anesthetic
    3. Assess the most commonly caused several complications of local anesthetics
    4. Identify general thermoregulatory principles
    5. Review the following hyperthermic syndromes & discuss treatment options: Serotonin Syndrome, Neuroleptic Malignant Syndrome, and Malignant Hyperthermia
    6. Discuss the common agents causing Methemoglobinemia
    7. Identify Methemoglobinemia mechanisms of toxicity
    8. Describe best practices in clinical management of Methemoglobinemia
    9. Review the signs and symptoms of lead toxicity
    10. Contrast the toxicity caused by different forms of mercury
    11. Discuss the role of chelation in heavy metal toxicity
    12. Identify the prevalence of ethanol AUD in patients presenting to the Emergency Department
    13. Discuss the genetic vs. environmental factors for ethanol AUD
    14. Assess the most critical laboratory tests for symptomatic patients who have suspected ethanol intoxication
    15. Describe toxicity & time course of methanol (MeOH) and ethylene glycol (EthGly) exposures
    16. Identify 2 stand-in tests for MeOH and EthGly, noting limitations
    17. Present a rationale for treatment with ethanol, fomepizole, and/or hemodialysis
    18. Recognize alcohol withdrawal symptoms
    19. Ensure appropriate treatment so that complications are prevented
    20. Describe the principles of detoxification
    21. Identify various toxic envenomations
    22. Describe the characterization of Black Widow envenomation and management options
    23. Describe management options for pit viper envenomations
    24. Highlight several different classes of plant derived toxins and their effects on humans
    25. Identify hazards of different mushrooms and clinical toxidromes associated with mushrooms
    26. Describe three risks associated with the use of dietary supplements
    27. Review toxicity of essential oils
    28. Discuss common household exposures and their implications
    29. Review toxicity of common household cleaners and toys

    If you are interested in the other sections of this course, check out the links below!

    Pharmaceuticals Section  Substance Use & Emergency Prepardness Section

    Total Tox - Non-Pharmaceuticals Syllabus


    PRE-TEST
    11 multiple-choice questions to ascertain your baseline knowledge on the topic.


    Hospital Hazards #1: Anesthetic Toxicity & Malignant Hyperthermia | 24m

    Dr. Shaun Carstairs, Professor of Emergency Medicine at the University of California, San Diego (UCSD), describes the history and pharmacology of local anesthetics, and discusses the unique characteristics and common clinical use for each prototypical local anesthetic. During his lecture he assesses the most commonly caused complications of local anesthetics and identifies their general thermoregulatory principles. He reviews the following hyperthermic syndromes and discuss treatment options for: Serotonin Syndrome, Neuroleptic Malignant Syndrome, and Malignant Hyperthermia.


    Hospital Hazards #2: Methemoglobinemia | 27m

    Emergency Medicine Physician at Advocate Christ Medical Center, Dr. Andrea Carlson, discusses the common agents causing Methemoglobinemia, identifies its mechanisms of toxicity, and describes best practices in clinical management of the condition.


    Heavy Metals In the ED: Lead, Arsenic & Mercury | 28m

    Dr. Evan Schwarz, Associate Professor of Emergency Medicine at Washington University School of Medicine, reviews the signs and symptoms of lead toxicity, contrasts the toxicity caused by different forms of mercury, and discusses the role of chelation in heavy metal toxicity.


    Ethanol Intoxication: Too Much Of a Good Thing | 37m

    Chief of the Medical Toxicology Division and Professor of Emergency Medicine at the University of Pittsburgh, Dr. Tony Pizon, identifies the prevalence of ethanol AUD in patients presenting to the Emergency Department. He discusses the genetic vs. environmental factors for ethanol AUD and gives an assessment of the most critical laboratory tests for symptomatic patients who have suspected ethanol intoxication.


    When It's Not Ethanol: Demystifying Toxic Alcohols | 42m

    Dr. Bram Dolcourt, Clinical Assistant Professor of Emergency Medicine at Wayne State University, describes the toxicity and time course of methanol (MeOH) and ethylene glycol (EthGly) exposures. He identify 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 | 26m

    Dr. Jerrold Leikin, Adjunct Clinical Professor in 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, describes alcohol withdrawal symptoms, advises on appropriate treatment so that complications are prevented, and identifies the principles of detoxification.


    Don't Touch That! Marine, Arthropod & Reptile Envenomations | 38m

    Dr. Michael Levine, Associate Professor of Emergency Medicine at the University of California, Los Angeles, identifies various toxic envenomations, describes the characterization of Black Widow envenomation and management options, and describes management options for pit viper envenomations.


    The Toxic Yard: Plants and Mushrooms | 30m

    Dr. Fiona Garlic Horner, Head of Medical Toxicology at Los Angeles County + University of Southern California (LAC+USC) Medical Center, highlights several different classes of plant derived toxins and their effects on humans. During her lecture, she identifies the hazards of different mushrooms and theclinical toxidromes associated with mushrooms.


    The Toxic Cabinet: Nutritional Supplements, Essential Oils, and Diet Drugs | 26m

    Director of Advanced Practice Providers at St. Elizabeth's Medical Center, Acute Care Nurse Practitioner Stephen Wood, describes three risks associated with the use of dietary supplements and reviews toxicity of essential oils.


    The Toxic Garage: Hydrocarbons and Pesticides | 34m

    Associate Professor in the Department of Emergency Medicine & Medical Director at Wayne State University School of Medicine & Michigan Poison and Drug Information Center, Dr. Andrew King, discusses common toxins and exposures of chemicals commonly found in household garages, as well as reviews their toxicity and management.


    The Toxic House: Cleaning Chemicals and Toys | 30m

    Dr. Ashley Haynes, Medical Director at Direction Toxicology of Kansas, discusses common household exposures and their implications, and reviews toxicity of common household cleaners and toys.


    Case Review and Roundtable Discussion on Novel Treatments for the Crashing Patient & the Hot Patient | 41m

    This case study was designed to spark conversation between a group of experts and attendees on the topic of drugs of addiction. It was recorded during a live virtual Total Tox Course on November 18, 2022. Learners will learn from the discourse and interaction on clinical cases presented. The Speakers for this discussion: Andrea Carlson, MD; Shaun Carstairs, MD, FACMT; Howard McKinney, PharmD, DABAT, FAACT; and Andrew King, MD (moderator).


    POST-TEST
    Retake the same 11 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.


    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, Inc.

    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.

    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.

    Ashley Haynes, MD, FACEP

    Medical Director

    Addiction Toxicology of Kansas

    Dr. Ashley Haynes completed her medical training at the University of Kansas, followed by a combined emergency-internal medicine training program at East Carolina University.  She completed a toxicology fellowship at University of Texas Southwestern in 2016, remaining as faculty for a few years after while engaging in a faculty development project in addiction medicine.  She moved to Kansas in 2019 and now provides bedside toxicology and addiction medicine consultations at Ascension Via Christi hospitals in Wichita and periodically provides on-call support for the Kansas Poison Control Center.  Additionally, she is a program physician for an outpatient addiction treatment center, and provides medication assisted therapy services to an inpatient residential treatment facility.

    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

    Associate Professor of Emergency Medicine

    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.

    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.

    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

    Washington University School of Medicine

    Dr. Schwarz attended medical school at the University of Texas Medical Branch in Galveston, Texas before completing a residency in Emergency Medicine at 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 is an Associate Professor of Emergency Medicine and the Medical Toxicology Section Chief. He is also involved at the medical school as one of 3 Advisory Deans in the Office of Student Affairs and has been on the Board of Directors for the Missouri College of Emergency Physicians since 2012 and is a member of the Board of Directors for ACMT.

    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


         ACMT Member 


         $200

         Non-member


         $250


    Registration includes: 

    • 90-day access to the course from date of purchase
    • Access to all lectures and slides in the Non-Pharmaceuticals section of the Total Tox Course
    • Pre/Post Test
    • Downloadable Certificate of Completion

    If you would like continuing education credits for your participation, they are available for an additional fee. 

    Purchase CE

    Interested in becoming an ACMT Member? Contact our Membership Manager, Jenn Dorsey, at membership@acmt.net. Learn more at: www.acmt.net/membership


    Available Discounts

    If you are a member of one of the following organizations, you may be eligible for a registration discount. Please reach out to us at events@acmt.net for a discount code:

    • American Academy of Emergency Medicine (AAEM)
    • America's Poison Center (APC)
    • Association of Healthcare Emergency Preparedness Professionals (AHEPP)
    • American College of Emergency Physicians (ACEP)

    Refunds and Cancellations

    For questions regarding our refund and cancellation policy, please email us at events@acmt.net.


    Package Options - Discounted Rates!

    ACMT offers a discounted rate for purchase of all three sections of the Total Tox Course as well as CE purchases for all three sections. Please use the links below if you are interested in these potential savings!

    Total Tox Course Package: Save $100    CE Package: Save $25   

    Last day to Register: 9/4/2023

    Instructions

    Once you have completed your registration:

    1. Click on the Contents tab. This is where you will be able to see all lectures and required content for this course.
    2. Complete Pre-Test. This test is purely to assess your baseline knowledge of the topic. You will take the same test again at the end of the course and compare your scores to assess your learning.
    3. Watch all lectures and case discussion. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.
    4. Complete Post-Test. Learners will have unlimited attempts and the test requires seven points to pass. Compare your post-test to your pre-test to assess your learning.
    5. Complete Event Survey. If Learners have purchased CE, they will be required to complete this survey in order to receive their CE.
    6. Download Certificate of Completion. This certificate is not a record for Continuing Education, this is a record of your completion of this section only. You will be able to download the certificate until your course registrations expires.

    If you have purchased CE: Learners will need to navigate to their separately purchased CE to complete the final steps to obtain their CE certificate.


    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

    Continuing Education credits are available for an additional fee. Available CE credits include: Continuing Medical Education (CME), Continuing Pharmacy Education (CPE), and Continuing Nursing Education (CNE).

    The Non-Pharmaceuticals Section contains a maximum of 6.75 CE credits.

    Purchase CE for Non-Pharmaceuticals Section

    ACMT also offers a discounted package rate for purchase of CE for all three sections. Please use the link below if you are interested in these potential savings!

    CE Package: Save $25   

    Refunds and Cancellations

    For questions regarding our refund and cancellation policy, please email us at events@acmt.net.

  • Contains 16 Component(s) Recorded On: 11/11/2022

    Substance Use & Emergency Preparedness Section

    This Course is recommended by:

    image

    Overview

    The ACMT Total Tox Course is a comprehensive review of the scope of emergency toxicology and includes cutting-edge interventions and management options for poisoned patients. Prominent experts in medical toxicology and emergency medicine have lead the creation of this course. This on-demand course consists of three sections: Pharmaceuticals, Substance Use & Emergency Preparedness, and Non-Pharmaceuticals. 

    The lectures in this section will focus on Substance Use & Emergency Preparedness. With approximately 6 hours of on-demand Continuing Educational content, there are eleven lectures and one case panel in this section.

    Target Audience: Physicians, Pharmacists, Advanced Practice Nurses, Nurses, Physician Assistants, Medics, EMTs, SPIs, Laboratorians, Poison Center Educators, First Responders, Operational or Tactical Specialists, Residents and Students 

    Learning Objectives

    At the end of the Substance Use & Emergency Preparedness section, learners should be able to:

    1. Describe opioid use disorder
    2. Explain how to initiate treatment for opioid use disorders
    3. Highlight harm reduction efforts that can reduce the adverse consequences of opioid use.
    4. Review misuse, abuse, & criteria for diagnosing opioid use disorder
    5. Identify psychosocial treatments for opioid use disorder
    6. Describe the medication-assisted treatments for Buprenorphine, Methadone, and Naltrexone.
    7. Recognize the symptoms of cannabis toxicity
    8. Describe the treatment approach to cannabis toxicity
    9. Identify toxicology tests available in the ED
    10. Discuss which tests should be requested in specific situations
    11. Describe how test ordering changes treatment outcome
    12. Describe the clinical presentation of pulmonary irritants
    13. Discuss the role of water solubility in the clinical presentation of pulmonary irritants
    14. Identify the primary treatment for simple asphyxiant exposure
    15. Present a rationale for observation and/or hospital admission following respiratory irritant exposure
    16. Understand the differences between simple asphyxiants and chemical asphyxiants
    17. Indicate the sources and uses of chemical asphyxiants, understand their basic mechanisms of toxicity, and describe their clinical presentations
    18. Understand therapies used to treat asphyxiant poisoning
    19. Know the common sources of Carbon Monoxide poisoning
    20. Discuss the pharmacokinetics and pathophysiciology of Carbon Monoxide Poisoning
    21. Learn about novel treatments for Carbon Monoxide poisoning, including Hyperbaric options
    22. Discuss the diagnosis and management of radiation casualties and radiation mass casualty events
    23. Identify different types of radiation
    24. Describe the consequences of exposure to radiation
    25. List specific organophosphate insecticides and chemical weapon nerve agents
    26. Discuss management options for patients with organophosphate insecticide or nerve agent toxicity
    27. Recognize cholinergic toxidrome
    28. Discuss the diagnosis and management of casualties resulting from terrorism and mass casualty events
    29. Discuss the history of bioterrorism as a tool for warfare
    30. Enumerate and identify the agents used in bioterrorist events

    If you are interested in the other sections of this course, check out the links below!

    Pharmaceuticals Section  Non-Pharmacecuticals Section

    Total Tox - Substance Use & Emergency Preparedness Syllabus


    PRE-TEST
    11 multiple-choice questions to ascertain your baseline knowledge on the topic.


    Chasing the Dragon: The New Dangers of Opioid Addiction | 42m

    Chair of Emergency Medicine at Rutgers New Jersey Medical School, Dr. Lewis Nelson, describes opioid use disorder and explains how to initiate treatment. He also highlights harm reduction efforts that can reduce adverse consequences of opioid use.


    Taming the Dragon: Management Options for Opioid Use Disorder | 33m

    Dr. Rachel Wightman, Assistant Professor of Emergency Medicine at the Warren Alpert Medical School of Brown University, reviews misuse, abuse, and criteria for diagnosing opioid use disorder. She also identifies psychosocial treatments for opioid use disorder and describes the medication-assisted treatments for Buprenorphine, Methadone, and Naltrexone.


    Cannabis & Cannabinoid Toxicity | 22m

    Medical Director & Emergency Medicine Physician at Northern New England Poison Center & Maine Medical Center, Dr. Mark Neavyn, identifies the symptoms of cannabis toxicity and describes treatment approaches.


    What’s New in Your Neighborhood: Novel Psychoactive Substances | 18m

    Dr. Stephanie Weiss, Staff Research Physician serving the Translational Addiction Medicine Branch of the National Institute on Drug Abuse’s Intramural Research Program, discusses the epidemiology of new fentalogues and explains how to initiate treatment for fentanyl-related overdose.


    Drug Screen Pitfalls | 36m

    ACMT Executive Director Dr. Paul Wax identifies toxicology tests typically available in Emergency Departments. During his lecture he also discusses which tests should be requested in specific situations and describes how test ordering changes treatment outcome.


    Case Review and Roundtable Discussion on Drugs of Addiction | 26m

    This case study was designed to spark conversation between a group of experts and attendees on the topic of drugs of addiction. It was recorded during a live virtual Total Tox Course on November 11, 2022. Learners will learn from the discourse and interaction on clinical cases presented. The Speakers for this discussion: Mark Neavyn, MD, FACMT; Stephanie Weiss, MD, PhD; Rachel Wightman, MD, FACMT; Howard McKinney, PharmD, DABAT, FAACT (moderator).


    I Can't Breathe! Pulmonary Irritants & Simple Asphyxiants | 39m

    Associate Medical Director of the Connecticut Poison Control Center and Former ACMT President, Dr. Chuck McKay, describes the clinical presentation of pulmonary irritants, discusses the role of water solubility in the clinical presentation of pulmonary irritants, and identifies the primary treatment for simple asphyxiant exposure. During his lecture he also presents a rationale for observation and/or hospital admission following respiratory irritant exposure.


    Chemical Suicide & Mitochondrial Asphyxiants | 35m

    ACMT Executive Director Dr. Paul Wax identifies the differences between simple asphyxiants and chemical asphyxiants and indicates the sources and uses of chemical asphyxiants. The goal of this lecture is to teach learners about the basic mechanisms of toxicity and their clinical presentations. Learners will also learn about therapies used to treat asphyxiant poisoning.


    Carbon Monoxide Poisoning: High Flow Oxygen or the Hyperbaric Chamber? | 27m

    Medical Director at the National Capital Poison Center and Emergency Medicine Physician at MedStar Georgetown University Hospital, Dr. Kelly Johnson-Arbor, discusses the pharmacokinetics and pathophysiciology of Carbon Monoxide Poisoning. By the end of her lecture, learners will know the common sources of Carbon Monoxide poisoning and learn about novel treatments for Carbon Monoxide poisoning, including Hyperbaric options.


    Disaster Preparedness #1: Radiation Events | 32m

    Lt Col Joseph Maddry, Deputy Commander of the US Army Institute of Surgical Research, discusses the diagnosis and management of radiation casualties and radiation mass casualty events. During his lecture he also identifies different types of radiation and describes the consequences of exposure to radiation.


    Disaster Preparedness #2: Organophosphates & Nerve Agents | 27m

    Emergency Physician and Medical Toxicologist, Dr. Christina Hantsch, lists specific organophosphate insecticides and chemical weapon nerve agents and discusses management options for patients with organophosphate insecticide or nerve agent toxicity. By the end of this lecture, learners should be able to recognize cholinergic toxidrome.


    Disaster Preparedness #3: Other Chemical & Biologic Terrorism | 37m

    Dr. Aaron Frey, WellSpan Health at York Hospital Medical Toxicologist, discusses the diagnosis and management of casualties resulting from terrorism and mass casualty events. During his lecture, he also discusses the history of bioterrorism as a tool for warfare and identifies the agents used in bioterrorist events.


    POST-TEST
    Retake the same 11 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 clinical instructor of emergency medicine and medical toxicology at the University of Virginia Health System.

    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.

    Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT

    Medical Director

    National Capital Poison Center & MedStar Georgetown University Hospital

    Dr. Kelly Johnson-Arbor is a physician who 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. She
    currently serves as the co-medical director of National Capital Poison Center and the medical
    director of hyperbaric medicine at MedStar Georgetown University Hospital. 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. 
    Dr. Johnson-Arbor has been in practice as a medical toxicology physician for more than 15
    years. She has extensive experience in the diagnosis, treatment, and prevention of various
    types of toxic exposures affecting both adults and children. She has served as a toxicology
    consultant for multiple Poison Control Centers in the United States, and currently treats
    toxicology patients at MedStar Georgetown University Hospital. She has a special interest in the
    management of heavy metal toxicity and carbon monoxide poisoning.
    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 to the public as
    well as medical professionals.

    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, FACEP

    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, medication-assisted therapy in the ED, human poisoning, 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 incoming 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


         ACMT Member 


         $200

         Non-member


         $250


    Registration includes: 

    • 90-day access to the course from date of purchase

    • Access to all lectures and slides in the Substance Use and Emergency Preparedness section of the Total Tox Course

    • Pre/Post Test

    • Downloadable Certificate of Completion

    If you would like continuing education credits for your participation, they are available for an additional fee. 

    Purchase CE

    Interested in becoming an ACMT Member? Contact our Membership Manager, Jenn Dorsey, at membership@acmt.net. Learn more at: www.acmt.net/membership


    Available Discounts

    If you are a member of one of the following organizations, you may be eligible for a registration discount. Please reach out to us at events@acmt.net for a discount code:

    • American Academy of Emergency Medicine (AAEM)

    • America's Poison Center (APC)

    • Association of Healthcare Emergency Preparedness Professionals (AHEPP)

    • American College of Emergency Physicians (ACEP)

    Refunds and Cancellations

    For questions regarding our refund and cancellation policy, please email us at events@acmt.net.


    Package Options - Discounted Rates!

    ACMT offers a discounted rate for purchase of all three sections of the Total Tox Course as well as CE purchases for all three sections. Please use the links below if you are interested in these potential savings!

    Total Tox Course Package: Save $100    CE Package: Save $25   

    Last day to Register: 9/4/2023

    Instructions

    Once you have completed your registration:

    1. Click on the Contents tab. This is where you will be able to see all lectures and required content for this course.
    2. Complete Pre-Test. This test is purely to assess your baseline knowledge of the topic. You will take the same test again at the end of the course and compare your scores to assess your learning.
    3. Watch all lectures and case discussion. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.
    4. Complete Post-Test. Learners will have unlimited attempts and the test requires seven points to pass. Compare your post-test to your pre-test to assess your learning.
    5. Complete Event Survey. If Learners have purchased CE, they will be required to complete this survey in order to receive their CE.
    6. Download Certificate of Completion. This certificate is not a record for Continuing Education, this is a record of your completion of this section only. You will be able to download the certificate until your course registrations expires.

    If you have purchased CE: Learners will need to navigate to their separately purchased CE to complete the final steps to obtain their CE certificate.


    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

    Continuing Education credits are available for an additional fee. Available CE credits include: Continuing Medical Education (CME), Continuing Pharmacy Education (CPE), and Continuing Nursing Education (CNE).

    The Substance Use and Emergency Preparedness Section contains a maximum of 6.0 CE credits.

    Purchase CE for Substance Use & Emergency Preparedness Section

    ACMT also offers a discounted package rate for purchase of CE for all three sections. Please use the link below if you are interested in these potential savings!

    CE Package: Save $25   

    Refunds and Cancellations

    For questions regarding our refund and cancellation policy, please email us at events@acmt.net.

  • Contains 17 Component(s) Recorded On: 11/04/2022

    Pharmaceuticals Section

    This Course is recommended by:

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     Overview

    The ACMT Total Tox Course is a comprehensive review of the scope of emergency toxicology and includes cutting-edge interventions and management options for poisoned patients. Prominent experts in medical toxicology and emergency medicine have lead the creation of this course. This on-demand course consists of three sections: Pharmaceuticals, Substance Use & Emergency Preparedness, and Non-Pharmaceuticals. 

    The lectures in this section will focus on Pharmaceuticals. With approximately 6 hours of on-demand Continuing Educational content, there are twelve lectures and one case panel in this section.

    Target Audience: Physicians, Pharmacists, Advanced Practice Nurses, Nurses, Physician Assistants, Medics, EMTs, SPIs, Laboratorians, Poison Center Educators, First Responders, Operational or Tactical Specialists, Residents and Students 

    Learning Objectives

    At the end of the Pharmaceuticals section, learners should be able to:

    1. Identify the most common interventions performed in acute poisoning
    2. Know how to examine a poisoned patient and identify what to look for in common poisonings
    3. Learn different treatment options for common toxidromes
    4. Discuss acetaminophen ingestions
    5. Know which patients require treatment
    6. Learn about novel treatments for acetaminophen-related poisoning.
    7. Describe the treatment of NSAID poisoning
    8. Discuss the pathophysiology of salicylate poisoning
    9. Differentiate between treatment for NSAID and salicylate poisoning
    10. Identify major antihistamines used to treat breathing problems
    11. Describe the action of antitussive medications
    12. Describe the pharmacology of antihistaminics with emphasis on clinical uses, adverse drug reactions and interactions
    13. Explain the pharmacologic, toxicity, and treatment differences between Tricyclic Antidepressants and Antipsychotics
    14. Discuss "typical" vs. "atypical" antipsychotics
    15. Describe the overlapping features of  Serotonin Syndrome, Anticholinergic Syndrome, and NMS produced by TCAs and Antipsychotics
    16. Identify unique concerns of specific antidepressants in overdose
    17. Discuss drug discontinuation syndrome as it applies to SSRIs & atypical antidepressants
    18. Compare differences in acute vs. chronic lithium toxicity
    19. Discuss mechanisms of toxicity, clinical manifestations, and update on optimal therapy for beta-adrenergic blocking drugs and calcium channel antagonists drugs
    20. Discuss treatment options focusing on high-dose insulin vs vasopressor controversy
    21. Discuss how the optimal management of drug-induced dysrhythmias differs from AHA ACLS algorithms
    22. Discuss optimal treatment of drug-induced dysrhythmias
    23. Review the mechanism of action, indications, contraindications, adverse reactions, and common drug interactions of warfarin.
    24. Identify appropriate uses of reversal agents for common anticoagulants
    25. Review the latest data in NOAC trials
    26. Recognize management issues with overdose of endocrine drugs
    27. Recognize endocrine function impact of ‘non-endocrine’ medications
    28. Be aware of endocrine clues and mimics
    29. Know the toxicity of common anticonvulsants
    30. Identify which laboratory testing is required for toxicity from anticonvulsant agents
    31. Identify treatment options for anticonvulsant toxicity
    32. Discuss the mechanism of action of the 5 major classes of antimicrobials
    33. Assess the likelihood of a cross-reaction between penicillin and cephalosporin
    34. Describe potential toxicities of commonly prescribed antimicrobial treatments

    If you are interested in the other sections of this course, check out the links below!

    Substance Use & Emergency Preparedness Section  Non-Pharmacecuticals Section

    Total Tox - Pharmaceuticals Syllabus


    PRE-TEST
    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 | 43m

    Dr. Ann Arens, Emergency Medicine physician at Hennepin Healthcare in Minneapolis, identifies the most common interventions performed in acute poisoning. After watching this lecture, learners will know how to examine a poisoned patient and identify what to look for in common poisonings. They will also learn different treatment options for common toxidromes.


    Over-the-Counter Poisons #1: Acetaminophen | 28m

    Cook County Health & NorthShote University HealthSystem Medical Toxicologist and Emergency Medicine Physician, Dr. Neeraj Chhabra, discusses acetaminophen ingestions. Learners will know which patients require treatment. They will also learn about novel treatments for acetaminophen-related poisoning.


    Over-the-Counter Poisons #2: NSAIDS and ASA | 41m

    Clinical Associate Professor of Pharmacology at the University of Illinois Chicago, Dr. Renee Petzel Gimbar, describes the treatment of NSAID poisoning. During her lecture, she also discusses the pathophysiology of salicylate poisoning and differentiates between treatment for NSAID and salicylate poisoning.


    Case Review & Roundtable Discussion on Complex Acetaminophen Cases | 20m

    This case study was designed to spark conversation between a group of experts and attendees on the topic of acetaminophen. It was recorded to a live virtual Total Tox Course recorded on November 4, 2022. Learners will learn from the discourse and interaction on clinical cases presented. The Speakers for this discussion: Neeraj Chhabra, MD, MSCR; Renee Petzel Gimbar, PharmD; Christina Hantsch, MD, FACEP, FACMT, FAACT; Michelle Hieger, DO (moderator).


    Over-the-Counter Poisons #3: Antihistamines & Antitussives | 28m

    Dr. Michelle Hieger, Emergency Physician and Medical Toxicologist at WellSpan York Hospital, identifies major antihistamines used to treat breathing problems. Her lecture also describes the action of antitussive medications and the pharmacology of antihistaminics with emphasis on clinical uses, adverse drug reactions, and interactions.


    The Ins and Outs of Ups and Downs #1: Tricyclic Antidepressants & Antipsychotics  | 49m

    Emergency Medicine Physician and Director of Consultation-Liaison Psychiatry services for the Queen Elizabeth Hospital in Charlottetown, Prince Edward Island, Dr. J.J. Rasimas, explains the pharmacologic, toxicity, and treatment differences between Tricyclic Antidepressants and Antipsychotics. During his lecture he also 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  | 32m

    Director of Addiction & Toxicology Program & Emergency Care Physician at Abbott Northwestern Hospital & Emergency Care Consultants, Dr. Katherine Katzung, identifies unique concerns of specific antidepressants in overdose. Her lecture also discusses drug discontinuation syndrome as it applies to SSRIs & atypical antidepressants and compares differences in acute vs. chronic lithium toxicity.


    Beta Blockers and Calcium Channel Blockers: When the Antagonists Become Antagonistic | 30m

    Dr. William "Russ" Kerns, Emeritus Professor of Emergency Medicine at Carolinas Medical Center, discusses mechanisms of toxicity, clinical manifestations, and provides updates on optimal therapy for beta-adrenergic blocking drugs and calcium channel antagonists drugs. He also discusses treatment options focusing on high-dose insulin vs vasopressor controversy.


    Drug-Induced Dysrhythmias: When You Can't Control the Rhythm | 27m

    Dr. William "Russ" Kerns, Emeritus Professor of Emergency Medicine at Carolinas Medical Center, discusses how the optimal management of drug-induced dysrhythmias differs from AHA ACLS algorithms and compares optimal treatments of drug-induced dysrhythmias.


    Anticoagulants and Antithrombotics: When You Can't Control the Bleeding | 39m

    Emergency Medicine Physician and Associate Medical Director at Hennepin HealthCare and Minnesota Poison Control System, Dr. Travis Olives, reviews the mechanism of action, indications, contraindications, adverse reactions, and common drug interactions of warfarin. During his lecture he also identifies appropriate uses of reversal agents for common anticoagulants and reviews the latest data in NOAC trials.


    Out of Balance: Toxicity of Endocrine Agents | 25m

    Dr. Mary Billington, Assistant Professor and Director of Medical Toxicology at the University of Texas Health Science Center at Houston discusses management issues with overdose of endocrine drugs. During this lecture she also reviews the endocrine function impact of ‘non-endocrine’ medications and so that learners are aware of endocrine clues and mimics.


    Anticonvulsants: When the Level Makes You Unsteady | 28m

    Dr. Daniel Sessions, Medical Toxicologist at Ochsner Medical Center in New Orleans, reviews the toxicity of common anticonvulsants. During his lecture he identifies which laboratory testing is required for toxicity from anticonvulsant agents and also identifies treatment options for anticonvulsant toxicity.


    Antimicrobials & Antivirals: When the Cure Becomes Toxic | 35m

    Emergency Medicine Attending Physician and Professor Of Emergency Medicine at MedStar Washington Hospital Center & Georgetown University Hospital, Dr. Maryann Amirshahi, discusses the mechanism of action of the 5 major classes of antimicrobials. After watching this lecture, learners should be able to assess the likelihood of a cross-reaction between penicillin and cephalosporin and describe potential toxicities of commonly prescribed antimicrobial treatments.


    POST-TEST
    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 and Professor Of Emergency Medicine

    MedStar Washington Hospital Center & Georgetown University Hospital

    Maryann Amirshahi completed her Bachelors in Pharmacy and PharmD degrees at the University of the Sciences in Philadelphia, followed by medical school at Temple University. She completed her emergency medicine residency at the Hospital of the University of Pennsylvania, medical toxicology fellowship at the George Washington University/National Capital Poison Center, and clinical pharmacology fellowship at Children’s National Medical Center. She also received an MPH from the George Washington University focusing on environmental and occupational health. She completed her PhD at Erasmus University, with a focus on pharmacology and public health. She is board certified in emergency medicine, medical toxicology, addiction medicine, and clinical pharmacology. She is also a registered pharmacist with over a decade of practice experience and is a Board Certified Pharmacotherapy Specialist. She is a Professor of Emergency Medicine at the Georgetown University School of Medicine in Washington, DC.

     

    Maryann practices clinically at MedStar Washington Hospital Center, where she not only treats poisoned patients on a daily basis, but also plays a major role in bringing addiction care to the emergency department setting. She also is active at the health system level with roles in medication safety, opioid stewardship, and resident education. Nationally she has served on the Board of Directors for the American College of Medical Toxicology and the American Board of Clinical Pharmacology. Maryann is a medical toxicologist at the National Capital Poison Center and also serves as a toxicology consultant for the Mid-Atlantic Center for Children’s Health and the Environment.

    Ann Arens, MD

    Associate Professor of Emergency Medicine

    University of Minnesota

    Dr. Arens is an Emergency Medicine physician at Hennepin Healthcare in Minneapolis, MN as well as an Associate Professor of Emergency Medicine at the University of Minnesota. She is also a practicing medical toxicologist at Hennepin Healthcare and an Associate Medical Director of the Minnesota Poison Control System. 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.

    Mary Billington, MD

    Assistant Professor and Director Of Medical Toxicology

    University of Texas Health Science Center at Houston (UTHealth Houston)

    Dr. Mary Billington is a board-certified Medical Toxicologist and Emergency Medicine physician. She completed both Emergency Medicine residency training and Medical Toxicology fellowship at Parkland Memorial Hospital/UT Southwestern in Dallas, TX. Dr. Billington initiated a Medical Toxicology service at Memorial Hermann Hospital in Houston, TX. She is very enthusiastic about medical and toxicologic education, and sincerely enjoys professional engagement in ACMT and ACEP. 

    Neeraj Chhabra, MD, MSCR

    Medical Toxicologist & Emergency Medicine Physician

    Cook County Health & NorthShore University HealthSystem

    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.

    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.

    Michelle Hieger, DO

    Emergency Physician and Medical Toxicologist

    WellSpan Health & VCU Health System

    I am a board-certified Medical Toxicologist 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 and Medical Toxicologist. I initiated the toxicology service at York Hospital. I am interested in treating the poisoned patients at bedside, and especially interested in the antidotal therapy with physostigmine 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.

    Travis D. Olives, MD, MPH, MEd, FACMT

    Emergency Medicine Physician & Associate Medical Director

    Hennepin HealthCare & Minnesota Poison Control System

    Travis Olives is a faculty emergency physician and medical toxicology at Hennepin Healthcare, and the associate medical director of the Minnesota Poison Control System. Dr. Olives also directs the combined residency in emergency medicine and internal medicine at Hennepin Healthcare. He holds active research interests in social determinants of health and disparities in poisoning diagnostic and therapeutic modalities, and he serves as the lead in Hennepin Healthcare's collaboration with both the Minnesota Department of Health in the Minnesota Drug Overdose and Substance Use Surveillance Activity, and with the American College of Medical Toxicology's FDA ACMT Covid-19 ToxIC Pharmacovigilance Project.

    J.J. Rasimas, MD, PhD, FAACT, FACLP, FACMT, FACPsych

    Professor of Psychiatry & Emergency Medicine

    University of Minnesota & Penn State College of Medicine

    Dr. Rasimas attended the University of Scranton and graduated summa cum laude with degrees in biochemistry, mathematics, and philosophy. He completed the Medical Scientist Training Program at Penn State University, earning a Ph.D. in chemical biology (2002) and M.D. (2003). Upon graduation from the Penn State College of Medicine, Dr. Rasimas matriculated to psychiatry residency training at the Mayo Clinic in Rochester, Minnesota. He was a clinical fellow at the NIMH, training in consultation-liaison psychiatry, bioethics, and clinical research. Dr. Rasimas has studied psychoanalytic psychotherapy at the Minnesota Psychoanalytic Society and Institute and the Washington School of Psychiatry. He served as a C-L psychiatrist for Milton S. Hershey Medical Center and remains an Associate Professor of Psychiatry and Emergency Medicine for the Penn State College of Medicine, there. He completed the critical care based medical toxicology fellowship at Penn State, obtained board certification in addiction medicine, and then returned to NIMH to join the Undiagnosed Diseases Program and the Intramural Research Program to oversee clinical trials in mood and anxiety disorders. He is also a Fellow of the Academy of Psychosomatic Medicine and a Laughlin Fellow with membership in the American College of Psychiatrists. Dr. Rasimas is a Professor at the University of Minnesota, 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. His current clinical position is the director of Consultation-Liaison Psychiatry services for the Queen Elizabeth Hospital in Charlottetown, Prince Edward Island.

    Daniel J. Sessions, MD

    Medical Toxicologist

    Ochsner Medical Center

    Dr. Sessions trained in Emergency Medicine at Brooke Army Medical Center in San Antonio. He completed a Medical Toxicology fellowship at The Rocky Mountain Poison & Drug Center at Denver Health. He practices Emergency Medicine, Medical Toxicology, and Addiction Medicine at Ochsner Medical Center in New Orleans LA. He is also faculty at the Minnesota Poison Center.

    Registration Rates


         ACMT Member 


         $200

         Non-member


         $250


    Registration includes: 

    • 90-day access to the course from date of purchase
    • Access to all lectures and slides in the Pharmaceuticals section of the Total Tox Course
    • Pre/Post Test
    • Downloadable Certificate of Completion

    If you would like continuing education credits for your participation, they are available for an additional fee. 

    Purchase CE

    Interested in becoming an ACMT Member? Contact our Membership Manager, Jenn Dorsey, at membership@acmt.net. Learn more at: www.acmt.net/membership


    Available Discounts

    If you are a member of one of the following organizations, you may be eligible for a registration discount. Please reach out to us at events@acmt.net for a discount code:

    • American Academy of Emergency Medicine (AAEM)
    • America's Poison Center (APC)
    • Association of Healthcare Emergency Preparedness Professionals (AHEPP)
    • American College of Emergency Physicians (ACEP)

    Refunds and Cancellations

    For questions regarding our refund and cancellation policy, please email us at events@acmt.net.


    Package Options - Discounted Rates!

    ACMT offers a discounted rate for purchase of all three sections of the Total Tox Course as well as CE purchases for all three sections. Please use the links below if you are interested in these potential savings!

    Total Tox Course Package: Save $100    CE Package: Save $25   

    Last day to Register: 9/4/2023

    Instructions

    Once you have completed your registration:

    1. Click on the Contents tab. This is where you will be able to see all lectures and required content for this course.

    2. Complete Pre-Test. This test is purely to assess your baseline knowledge of the topic. You will take the same test again at the end of the course and compare your scores to assess your learning.

    3. Watch all twelve lectures and case discussion. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.

    4. Complete Post-Test. Learners will have unlimited attempts and the test requires seven points to pass. Compare your post-test to your pre-test to assess your learning.

    5. Complete Event Survey. If Learners have purchased CE, they will be required to complete this survey in order to receive their CE.

    6. Download Certificate of Completion. This certificate is not a record for Continuing Education, this is a record of your completion of this section only. You will be able to download the certificate until your course registrations expires.

    If you have purchased CE: Learners will need to navigate to their separately purchased CE to complete the final steps to obtain their CE certificate.


    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

    Continuing Education credits are available for an additional fee. Available CE credits include: Continuing Medical Education (CME), Continuing Pharmacy Education (CPE), and Continuing Nursing Education (CNE).

    The Pharmaceuticals Section contains a maximum of 6.0 CE credits.

    Purchase CE for Pharmaceuticals Section

    ACMT also offers a discounted package rate for purchase of CE for all three sections. Please use the link below if you are interested in these potential savings!

    CE Package: Save $25   

    Refunds and Cancellations

    For questions regarding our refund and cancellation policy, please email us at events@acmt.net.

Registration Rates


     ACMT Member 


     $600

     Non-member


     $650


Registration includes: 

  • 90-day access to the course from date of purchase

  • Access to all lectures and slides in all three sections of the Total Tox Course (Pharmaceuticals, Substance Use & Emergency Preparedness, and Non-Pharmaceuticals)

  • 3 Pre/Post Tests

  • 3 Downloadable Certificates of Completion

If you would like continuing education credits for your participation, they are available for an additional fee:

Purchase CE

Interested in becoming an ACMT Member? Contact our Membership Manager, Jenn Dorsey, at membership@acmt.net. Learn more at: www.acmt.net/membership


Available Discounts

If you are a member of one of the following organizations, you may be eligible for a registration discount. Please reach out to us at events@acmt.net for a discount code:

  • American Academy of Emergency Medicine (AAEM)

  • America's Poison Center (APC)

  • Association of Healthcare Emergency Preparedness Professionals (AHEPP)

  • American College of Emergency Physicians (ACEP)

Refunds and Cancellations

For questions regarding our refund and cancellation policy, please email us at events@acmt.net.


Last day to Register: 9/4/2023

Instructions

Once you have completed your registration:

  1. Click on the Contents tab for whichever section you would like to start.

  2. Complete Pre-Test. This test is purely to assess your baseline knowledge of the topic. You will take the same test again at the end of the course and compare your scores to assess your learning.

  3. Watch all lectures and case discussion. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.

  4. Complete Post-Test. Learners will have unlimited attempts and the test requires seven points to pass. Compare your post-test to your pre-test to assess your learning.

  5. Complete Event Survey. If Learners have purchased CE, they will be required to complete this survey in order to receive their CE.

  6. Download Certificate of Completion. This certificate is not a record for Continuing Education, this is a record of your completion of this section only. You will be able to download the certificate until your course registrations expires.

  7. Begin the next section, following steps 2-6 until all sections are complete.


If you have purchased CE: Learners will need to navigate to their separately purchased CE to complete the final steps to obtain their CE certificate.


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

Continuing Education credits are available for an additional fee. Available CE credits include: Continuing Medical Education (CME), Continuing Pharmacy Education (CPE), and Continuing Nursing Education (CNE). Save $25 by purchasing CE for all 3 sections of the ACMT Total Tox Course at the same time!

The On-Demand Total Tox Course offers a maximum of 18.75 CE credits along the following breakdown:

  • 6.0 CE - Pharmaceuticals Sections

  • 6.0 CE - Substance Use & Emergency Preparedness Section

  • 6.75 CE - Non-Pharmaceuticals Section

Purchase CE Package   

Refunds and Cancellations

For questions regarding our refund and cancellation policy, please email us at events@acmt.net.