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Electives - Emergency Medicine

Medical Toxicology - Wilderness Medicine

(Does not count towards 12-week limit of clinical EM)

Elective Number: 1305 (Lottery)

Rotation Supervisor: Dr. Christopher Holstege

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

Duration: Maximum 4 weeks, Minimum 2 weeks

Available: All rotations

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

Time to Report: 8:30 am

Place to Report: Blue Ridge Poison Center,1222 JPA, 4th floor, Poison Center Suite

Typical day: 8:30 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: 5

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.

Learning Objectives:

1. Students will learn to diagnose various toxic syndromes (anticholinergic, sympathomimetic, opioid, cholinergic, and withdrawal states).

2. Students 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).

3. Students 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. 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:

Gen Management

Acetaminophen

Salicylate

Iron

Theophylline

Hypoglycemics

Digitalis

Antihypertensives

Antidepressants

Opiods

Toxic Alcohols

Cocaine

Amphet/Metcath

Plants

Mushrooms

Vitamins

Caffeine

Anticonvulsants

Antihistimines

Anticoagulants

Antuberculosis

Antimalarial

Ergotamines

Antimicrobials

Neuroleptics

Drug Withdraw

Botulism

Tox Lab

Neurotansmitters

Antidotes

Mothballs

Rodenticides

Herbicides

Caustics/Batteries

Marine Animals

Food Poisoning

Herbal Medicine

Nicotine

Arsenic

Mercury

NMS/SS/MH

Sedative-Hypnotic

PCP

Hallucinogens

Marijuana

Hydocarbons

Snakes

Smoke Inhalation

Insecticides/Nerve

Lead

INH

NSAIDS

Strichnine

Antidotes

Hazmat

Lithium

Teratology

Inhalents

Cases

Murder

Cold Injury Heat Illness Lightning injuries Wilderness trauma Wilderness survival
Search & rescue Tick-borne disease Parasites Dysbarism High altitude illness