Electives - Emergency Medicine

Medical Toxicology - Wilderness Medicine

Elective Number: 1305 (arranged)

Rotation Supervisor: Dr. Christopher Holstege

Designated signer: Heather Collier, Blue Ridge Poison Center, Towers Building (1222 JPA) 4th floor

Evaluation should be given to: Attending on service

Duration: Rotations 2 - 12 - Class of 2008; 1, 3 - 13 - Class of 2009

Maximum 4 weeks, Minimum 2 weeks

A pager is required and will be provided by the department.

Time to Report: 9:00 am

Place to Report: Blue Ridge Poison Center, Tower Building (1222 JPA) 4th floor

Typical day: 9:00 am - 5:00 pm

Attendance: Attendance at elective activities is mandatory.

• Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
• Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
  • Specific days missed must be approved by the Attending on Service.

Number of students per rotation: 3

Course Description: Medical Toxicology focuses on the care of the patient poisoned by toxins either intentionally or accidentally. Wilderness Medicine focuses on the care of patients in remote environments. This course will include evaluation of inpatient consults, outpatient clinic patients, and poison center calls. The Medical Toxicology consult service is involved in the management of nearly all poisoned patients admitted to the University of Virginia. Rotating medical students will be actively involved in the initial management and treatment of these patients. They will learn to diagnose various toxic syndromes (anticholinergic, sympathomimetic, opioid, cholinergic, and withdrawal states). They will also learn how to manage specific poisonings. These will include prescription drugs, over-the-counter drugs, herbal products, drugs of abuse, natural toxins, occupational chemicals, chemical warfare agents and household products (see appendix 1). Rotators will also learn how to managements patients in remote wilderness regions. Wilderness medicine topics will be addressed. Outings to Wintergreen will be arranged for Wilderness Medicine training. Rotators will receive a packet at the start of the rotation that includes articles relating to daily lectures. The students will also be involved in accessing patients in the outpatient toxicology clinic that meets twice a month and the management of patients undergoing hyperbaric oxygen treatment. In addition, inpatient cases followed by the Blue Ridge Poison Center will be reviewed daily. The Blue Ridge Poison Center manages a region encompassing 2.8 million people and receives approximately 24,000 calls each year pertaining to human poisonings. It is the intention of this rotation to provide a strong foundation of knowledge pertaining to the diagnosis and management of acute and chronic poisoning and to provide a basic overview of wilderness medicine.

Appendix 1: