Toxicology

The ToxCard series covers metal phosphides.

The ToxCard series is back with kratom.

When can a urine drug screen assist in the ED?

What do you need to know about shellfish poisoning?

This week’s ToxCard covers thyroid hormone overdose!

A 40-year-old female with history of depression is brought in by EMS for agitation. On arrival she is confused and diaphoretic. Vitals include temperature of 40°C, BP 150/80, HR 120, and RR 28. Exam is remarkable for muscle rigidity, hyperreflexia, and clonus of the lower extremities. What is the next step in your evaluation and treatment?

How does anthrax present? What is the evaluation and treatment?

How does the presentation and management of toxidromes associated with Scombroid, Ciguatera, and Pufferfish poisoning differ?

A 42-year-old female with a past medical history of iron deficiency anemia presents to the ED with a peritonsillar abscess. You give 2 benzocaine sprays and successfully aspirate the abscess. As she is waiting for her discharge paperwork, the nurse alerts you that her oxygen saturation is now in the mid-80s. Repeat vitals in the room are as follows: BP 102/78, HR 102, O2 85%, RR 24. She has perioral cyanosis that was not seen on your initial exam. What is the diagnosis and best next step?

Paraquat is a herbicide that is rapidly absorbed and undergoes redox-cycling with generation of ROS causing cellular dysfunction and death. Tolerate hypoxia and avoid oxygen as it can promote oxidative stress and causes further tissue damage.