ACMT Toxicology Visual Pearl: The Heart Won’t Go On and On
Which cardiotoxic plant is shown?
- Lily of the valley
- Moonflower
- Morning glory
- Water hemlock
- White snakeroot
Which cardiotoxic plant is shown?
The venom from this pictured snail shares a primary mechanism of action with what other deadly toxin?
Using Foley bag tubing
The tube from a standard Foley bag, available in all emergency departments, contains a Luer lock near the tapered nozzle. This unique connector setup allows you to instill warm fluids into the thoracic space with minimal spillage.
Read other Tricks of the Trade posts.
During the COVID-19 pandemic, a few of us interested in climate change science met through the Society for Academic Emergency Medicine (SAEM), and our group slowly expanded with the virtual world. We discussed the ever-growing number of climate publications and scholarship opportunities available. Some of us did research, education, or policy work, and all of us practiced clinically.
We discussed how climate-related impacts negatively affected our patients, and brainstormed how we could tackle the problem now. For us in Rhode Island, Pennsylvania, Wisconsin, Colorado, and California, the climate crisis was pathology and interrupted treatment regimens, but also an opportunity to transform current care systems. At all of our hospitals, patients were brought in by ambulance with empty inhalers and non-functioning medical devices after losing electrical power. Monitors beeped from abnormal vital signs of patients impacted by extreme heat, inland and coastal flooding, or wildfires. We recognized the dangers related to place of residence and structural drivers that exacerbated existing health disparities. We agreed that open access education was the next step to action and striving for justice across our nation together.
More and more colleagues asked us where they could begin their own climate and emergency medicine journeys. We used our varied local and global experiences to curate content that could be used for journal clubs, medical simulation, quality improvement projects, grant applications, and other educational tracks or electives. Our goal was to provide a starting place for individuals who may not have dedicated faculty at their institutions.
We are proud to announce a comprehensive 10-module curriculum on Climate Change and Emergency Medicine (EM) worth 56 hours of ALiEMU learning credits. Each module encompasses a broad range of reading materials and is followed by a brief quiz on ALiEMU. All of this is available for free. Get learning now.
We hope the material reminds all of us of what actions are needed yet: authentic partnerships, clear communication of the robust evidence that we know, inclusivity, and leadership. Like emergency medicine, climate change and health work is truly life-long learning. Yet, knowledge is only as good as its use. We look forward to years of innovative solutions that move beyond dialogue and meaningfully address some of the greatest barriers to well-being for our patients and global community.
A 29-year-old female presented to the emergency department for a rash on her right calf. 5 days prior, at her home in Alabama, the patient developed pain and swelling of her right calf following a spider bite while putting on her pants. The patient felt a “burning pain” and found a spider which she then killed. She went to a hospital and received cephalexin, trimethoprim/sulfamethoxazole, and oxycodone. Despite taking these medications she continued having aching pain rated 10/10 in her right calf along with generalized pruritus. The patient stated that the bite evolved from an initial generalized redness into a blue/black lesion with blistering and extensive redness along her leg and torso. She denied fever, chills, lightheadedness, abdominal pain, nausea, vomiting, and hematuria.
A 62-year-old male presented thirty minutes after being bitten by a snake in his garden. He stated that he thinks his finger was bitten twice. The patient presented with pain and swelling of his right hand and forearm.
A 14 year old girl presenting from Mexicali with altered mental status. Her mother reports a rash about a week ago following a tick bite. She had been going to school until 4 days ago when she became very fatigued with associated vomiting, diarrhea, tactile fevers, and headache. She subsequently collapsed at home today and was difficult to arouse which prompted EMS activation. Her mother denies any prior complaint of neck stiffness, shortness of breath, cough, hematemesis, or hematochezia.