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Toxicology in Emergency Medicine

You'll be able to recognize toxidromes quickly and sequence decontamination, antidotes, and supportive care decisions in acute poisoning presentations.

What this track covers

This track covers evidence-based approaches to poisoning and overdose in the emergency setting, from initial toxidrome recognition through resuscitation and disposition. It spans common and high-acuity exposures, including analgesic, caustic, environmental, and pharmaceutical toxicity, with attention to when enhanced elimination or antidote therapy is indicated.

What you will practice

  • Distinguishing sympathomimetic, anticholinergic, cholinergic, opioid, and sedative-hypnotic toxidromes at the bedside
  • Sequencing initial stabilization and reversal decisions in a suspected opioid overdose
  • Applying a nomogram-based approach to acetaminophen exposure and timing of antidote therapy
  • Deciding when GI decontamination or endoscopy is appropriate after a caustic ingestion
  • Recognizing when hemodialysis, urinary alkalinization, or lipid emulsion therapy changes management

Simulator scenario

A patient presents unresponsive with pinpoint pupils and depressed respirations of unclear onset, requiring rapid toxidrome recognition and a stepwise reversal and monitoring plan.

Board question topics

  • Toxidrome pattern recognition
  • Acetaminophen toxicity and antidote timing
  • Caustic ingestion decision-making
  • Indications for enhanced elimination

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