Sun Tzu and the Art of Focusing in Medical Toxicology

November 7, 2014, 6:28 pm

PocketSunTzuThe philosophy expressed in Sun Tzu’s classic The Art of War has been applied to everything from military strategy to business management. But what does it have to teach practitioners of emergency medicine and medical toxicology? In my current column for Emergency Medicine News I discuss a very important lesson from the book that will completely change the way you …

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There is no real evidence on treating calcium channel blocker overdose

November 6, 2014, 8:06 pm


Treatment of calcium channel blocker poisoning: A systematic review. St-Onge M et al. Clin Toxicol 2014 Nov;52:926-944.


This systematic review is massive, thorough, intimidating, and all but unreadable.

As a prelude to establishing a clinical guideline for treatment of calcium channel blocker (CCB) overdose, the 14 Canadian authors systematically searched and evaluated relevant literature. They initially identified 15,577(!) citations, …

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Use of alkyl nitrite “poppers” can cause permanent visual impairment

November 5, 2014, 9:54 am


Some poppers are sold as “Leather Cleaner” or “Acetone-free nail polish remover”


Poppers maculopathy. Gruener AM et al. Lancet 2014;384:1606

Full Text

This case report describes a 30-year-old man who developed central visual impairment after using alkyl nitrite “poppers” as a sexual aid.

Eye exam revealed diminished visual acuity bilaterally, yellow foveal spots and damage to the …

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Position statement on bystander naloxone

November 4, 2014, 8:31 pm

Intranasal naloxone★★★★☆

Position Statement: Expanding access to naloxone in the United States. Doyon S et al Clin Toxicol 2014 Oct 15 [Epub ahead of print]


This position statement was endorsed by the American Academy of Clinical Toxicology, the American College of Medical Toxicology, and the American Association of Poison control Centers.

The authors start off by noting the marked increase in …

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Saturday with SMACC: Motorbike Mayhem

November 1, 2014, 3:34 pm

Screen Shot 2014-11-01 at 2.48.59 PM

The lecture by John Hinds (@DocJohnHinds) last March at SMACC Gold in Brisbane was one of the most fascinating and unusual presentations I’ve ever seen at a medical conference. Hinds, a consultant anesthesiologist and intensivist at Craigavon Area Hospital in Northern Ireland, is also a motor bike racing enthusiast. His riveting account of the types of injuries that …

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Tox Tunes #89: Strange Brew (Cream)

October 26, 2014, 4:28 pm


“Strange brew — killin’ what’s inside of you”


It always seemed to me that the subtext of this song was about drugs, although the lyrics don’t explicitly reference psychedelics or any other recreational pharmaceuticals.

The song, found on Cream’s second album Disraeli Gears, is a reworking of Buddy Guy’s and Junior Wells’ version of an early blues …

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Saturday with SMACC: Evidence-Based Education — What Works

October 11, 2014, 12:18 pm

Victoria Brazil Evidence-Based Education — What Works– from Social Media and Critical Care on Vimeo.

From SMACC Gold: Victoria Brazil asks what educational modalities and interventions are effective in medical education, what does “effectiveness” really mean and how do we measure it. Here are links to some of the studies and resources she mentions:

The Great Dr. Fox Lecture:

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More than you ever wanted to know about synthetic cannabinoids

October 9, 2014, 1:08 pm


Synthetic cannabinoids: Epidemiology, pharmacodynamics, and clinical implications. Castaneto MS et al.  Drug Alcohol Depend 2014 Aug 18 [Epub ahead of print]


This article is not really readable, but I’m not sure it was meant to be read. Rather, it’s a reference paper with (by my count) 228 citations through the year 2014. It will be invaluable for anyone surveying …

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TPR Podcast Episode #6: I’m tripping and I can’t get down

October 6, 2014, 11:52 pm

Although summer is over and the polar vortex is knocking at the door, in this episode of the TPR podcast we look back at massive summer music festivals and the drugs which can be encountered among attendees. Theresa Kim, Leon Gussow, and guest discussant Dr.Tim Erickson cover agents such as synthetic cathinones ("bath salts"), piperazine compounds, GHB, methoxetamine, and "N-bomb."

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