On-Demand Total Tox Course - Substance Use & Emergency Preparedness
Recorded On: 11/11/2022
- Registration Closed
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:
- Describe opioid use disorder
- Explain how to initiate treatment for opioid use disorders
- Highlight harm reduction efforts that can reduce the adverse consequences of opioid use.
- Review misuse, abuse, & criteria for diagnosing opioid use disorder
- Identify psychosocial treatments for opioid use disorder
- Describe the medication-assisted treatments for Buprenorphine, Methadone, and Naltrexone.
- Recognize the symptoms of cannabis toxicity
- Describe the treatment approach to cannabis toxicity
- Identify toxicology tests available in the ED
- Discuss which tests should be requested in specific situations
- Describe how test ordering changes treatment outcome
- Describe the clinical presentation of pulmonary irritants
- Discuss the role of water solubility in the clinical presentation of pulmonary irritants
- Identify the primary treatment for simple asphyxiant exposure
- Present a rationale for observation and/or hospital admission following respiratory irritant exposure
- Understand the differences between simple asphyxiants and chemical asphyxiants
- Indicate the sources and uses of chemical asphyxiants, understand their basic mechanisms of toxicity, and describe their clinical presentations
- Understand therapies used to treat asphyxiant poisoning
- Know the common sources of Carbon Monoxide poisoning
- Discuss the pharmacokinetics and pathophysiciology of Carbon Monoxide Poisoning
- Learn about novel treatments for Carbon Monoxide poisoning, including Hyperbaric options
- Discuss the diagnosis and management of radiation casualties and radiation mass casualty events
- Identify different types of radiation
- Describe the consequences of exposure to radiation
- List specific organophosphate insecticides and chemical weapon nerve agents
- Discuss management options for patients with organophosphate insecticide or nerve agent toxicity
- Recognize cholinergic toxidrome
- Discuss the diagnosis and management of casualties resulting from terrorism and mass casualty events
- Discuss the history of bioterrorism as a tool for warfare
- 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!
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.
Moderator: 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
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.
Interested in becoming an ACMT Member? Contact our Membership Manager 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: 2/1/2024
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 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.
- 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.
- 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.
- Complete Event Survey. If Learners have purchased CE, they will be required to complete this survey in order to receive their CE.
- 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.
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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!
Refunds and Cancellations
For questions regarding our refund and cancellation policy, please email us at events@acmt.net.