Learning toxicology

[Perrotfish]

How did you guys learn toxicology during residency? Did you think a tox rotation significantly improved your ability to interpret routine ingestions that walk into your ED? Is there a specific book that you think is really worth reading through? A particular reference that you think is particularly strong? This is one of the areas of medicine where I can honestly say I know next to nothing. Considering that, and considering I want to be goot at tox, what should I do?

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[Rendar5]

just learn your toxidromes honestly. critical care segment of emrap is paid for separately unfortunately, but it had one of the best ingestion critical care lectures from about a year and a half ago that I ever heard. Emrap itself did have a decent 2 lecture series on a few important toxidromes awhile ago, and that shouldn't cost you anything to access if you're a resident.

 

[Tiger26]

Agree--toxidromes plus 1-800-222-1222 (call them on every ingestion so they get funding and you can learn from the Tox guy/gal on call)

 

[Apollyon]

Agree--toxidromes plus 1-800-222-1222 (call them on every ingestion so they get funding and you can learn from the Tox guy/gal on call)

I didn't know that - that getting calls helped them get funding. When I was in HI, my calls went to Denver.

However, I have never actually spoken with the toxicologist on call, save once (as he had worked with one of my attendings when the tox guy was a fellow). I did, though, as posted in a certain thread, and also in this subforum, find out that South Carolina indeed has a "state mycologist", and he was quickly available on a Sunday evening.

 

[Daiphon]

Agree--toxidromes plus 1-800-222-1222 (call them on every ingestion so they get funding and you can learn from the Tox guy/gal on call)

Yep. Calls get logged, and total numbers help determine funding.

Denver covers several states (incl HI).

As for a good book, I was a fan of Erickson/Ling "Toxicology Secrets," but it's out of print... your library probably has a copy.

Best way, though, is to see tox patients... and not just the obvious ones. AMS with fever in a NH resident could be ASA poisoning... amongst others.

Cheers!
-d

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[Perrotfish]

Best way, though, is to see tox patients... and not just the obvious ones. AMS with fever in a NH resident could be ASA poisoning... amongst others.

So where can I see a lot tox patients in a row? Do the guys that run poison control take rotators? It there a massive hospital system outhere than has an inpatient toxicologist who rounds in the ED? I've done a few months in the ED and I feel like Tox patients (other than the obvious street drugs stuff) are rare enough that I'll never get a good handle on it by just waiting for one to randomly get assigned to me. I know my residency does NOT have a toxicology rotation, but I think they'd let me leave the area for one if I asked very nicely.

 

[Daiphon]

So where can I see a lot tox patients in a row? Do the guys that run poison control take rotators? It there a massive hospital system outhere than has an inpatient toxicologist who rounds in the ED? I've done a few months in the ED and I feel like Tox patients (other than the obvious street drugs stuff) are rare enough that I'll never get a good handle on it by just waiting for one to randomly get assigned to me. I know my residency does NOT have a toxicology rotation, but I think they'd let me leave the area for one if I asked very nicely.

Your best bet is probably to do an elective with a fellowship program, as they typically have resident rotations and focus entirely on tox.

Some are more PCC-based, others more bedside; but all have some of both.

I don't know what program you're training in, but here's a list of all the fellowships. Pick a few that are close by or in a nice place to visit & either cold-call or have your PD make some calls to alumni/friends/other PD's.

http://acmt.net/resources_training.html

Cheers!
-d

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[deuist]

So where can I see a lot tox patients in a row?

Do a tox rotation at New York Poison Control. Best month in residency.