Excellent lectures giving introduction to medical toxicology

http://www.youtube.com/watch?v=RTKj-hgFhE0 At Academic Life in Emergency Medicine, Dr. Rahul Patwari has posted a very good series of whiteboard lectures that can serve as a basic introduction to medical toxicology for rotating medical students or interns. The four lectures — about 10 minutes each — cover general supportive management, toxidromes, laboratory testing, and gastrointestinal decontamination. I especially appreciated Dr. Patwari’s uncompromising approach to gastric lavage: “We don’t do that anymore”. The entire lecture series is full of common sense advice. There are some areas in which I’d add to Dr. Patwari’s points. As noted in some of the comments to the series, many toxicologists are now using a starting dose of naloxone lower than that used in the past to manage possible opioid overdose. Dr. Patwari recommends 0.4 mg; some recommendations go as low as 0.04 mg. The lecture also might have mentioned administration of nebulized naloxone by inhalation, or even not using naloxone at all unless absolutely necessary. Also, in the discussion of the Rumack-Matthew nomogram in acetaminophen overdose, a more careful distinction could have been made between acute ingestion (generally within 8 hours, with the time of ingestion being when last taken) — in which the nomogram can be applied, and chronic ingestion where it can not be used.  
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical academic life in emergency medicine decontamination patwari toxicology toxidromes Source Type: news