[toxnews] Toxicology Case Conference for September 29, 2022 (1:30-3:30 PM)

[Christine Stork]

Upstate NY Poison Center

Toxicology Case Conference

September 29, 2022

Time: 1330-1530
Location
JH 5th Floor


Zoom:

https://urldefense.com/v3/__https://upstate.zoom.us/j/94022814635?pwd=ZXdZOFN3OFMrN1FjWlhOTGRid3YyUT09__;!!GobTDDpD7A!I_eqU06MPbV8HhZA6Tilb3IO_oXORufBE3_UIvG52lploTql3bXkGbq0DlXI9ezuksTNBrNL1JVryTXYAmC2IXwO$  

password: caseconf
Leader
Michael Keenan, MD and Christine Stork, PharmD

Case Presentation

  1.  Patient is a 34 year old female who presents after an overdose of a product she bought online. She has a yellow discoloration to her fingers. She is agitated, tachycardic (160s) and hyperthermic (100.4oF).
     *   What could this be?
     *   Management approach?
  2.  Patient is a 37 year old Male who presented intoxicated. He states he had been drinking alcohol mixed with a product at work (works as a lawn keeper at a golf course). HR on arrival in the 150s. Temp 102oF. BP 92/63. Lactate 10.7.
     *   What could this be?
     *   Management approach?
  3.  Pt is a 92 year old Male who presented for routine lab work and was found to have digoxin level of 6.2. Cr is elevated at 1.81. He was otherwise asymptomatic. He was admitted and levels were trended. Digoxin decreased to 4.7, but then increased to 5.9. Cr has improved to 1.35. PCC is called at this point
     *   What is going on?

Journal Club - Syracuse rotators, please read all articles and please let the fellow know who will briefly present each article.
1. Emily K. Kershner, Natasha Tobarran, Andrew Chambers, Brandon K.
Wills & Kirk L. Cumpston (2022): Retained bullets and lead toxicity: a systematic review, Clinical

Toxicology, DOI: 10.1080/15563650.2022.2116336

2. Duburcq T, Goutay J, Preau S, Mugnier A, Rousse N, Moussa MD, Vincentelli A, Cuny J, Parmentier-Decrucq E, Poissy J. Venoarterial Extracorporeal Membrane Oxygenation in Severe Drug Intoxication: A Retrospective Comparison of Survivors and Nonsurvivors. ASAIO J. 2022 Jul 1;68(7):907-913. doi: 10.1097/MAT.0000000000001583. Epub 2022 Sep 20. PMID: 34560717.

3. Vandroux D, Aujoulat T, Gaüzère BA, Puech B, Guihard B, Martinet O. Predicting factors for the need of extracorporeal membrane oxygenation for suicide attempts by cardiac medication: a single-center cohort study. World J Emerg Med. 2022;13(4):283-289. doi: 10.5847/wjem.j.1920-8642.2022.070. PMID: 35837565; PMCID: PMC9233975.


Christine M. Stork, BSPharm, PharmD, MPH, DABAT, FAACT
Professor, Department of Emergency Medicine
Clinical Director, Upstate NY Poison Center
Upstate Medical University
Syracuse, NY

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