Toxicology Practice Pulse

Campus harm reduction breakthrough: UTEP Student Union installs El Paso's first anonymous naloxone vending machine, dispensing free 2-dose Narcan...

Tox Pearl: Methamphetamine in maternal breast milk caused fatal toxicity in 15-month-old infant.

• Infant found purple, apneic; deceased long before...

Bedside tox pearl: Tramadol, long seen as lower risk, triggers seizure risk via dual brain action—often missed in pain pill overdoses.
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Key public-health win for opioid tox:

• Face to Face's mobile outreach/kiosks drove 66% of 2024 reversals with 44% of county naloxone.
• Targets...

Synthetic Opioid Alerts

• 🔥 Cychlorphine Overdoses in Pennsylvania: Mifflin County Coroner warns of cychlorphine, a synthetic opioid up to 10...

New community access model combats synthetic opioid overdoses with free 24/7 naloxone boxes at fire stations (e.g., Station 1 at 201 Orr St.,...

Emerging threat in PA overdoses—key clinical pearls:

• Potency: Up to 10x stronger than fentanyl; adulterated in heroin, cocaine, fake pills, meth
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Multi-pronged local success: Santa Barbara saw 40% fewer OD deaths (189 vs. expected 316, 2023-2025), driven by Narcan distribution, MAT (35% jail...

Ped ED tox pearl: Heighten vigilance for synthetic opioid OD in kids from disguised fentanyl pills resembling children's vitamins/candy.

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Pivotal Lancet case report linking maternal codeine to infant opioid overdoses faces retraction demands, casting uncertainty over breastfeeding safety guidelines.

Key webinar takeaways for opioid overdose prevention:

• Partner prevention providers and pharmacists to co-dispense naloxone, lock boxes, and disposal...

Envenomation Safety Warning

• 🔥 Cyclist Death Prompts U.S. Alert: U.S. issued warning after 25-year-old cyclist Julian Enrique Hernandez died...

Forensic tox pearl for heavy metal consults:

• Triple homicide via thallium sulfate, with microscopic postmortem findings
• Confirmed thallium poisoning: postmortem plasma 10 mcg/mL
• Urine thallium also measured
  Watch for these levels in suspected cases.

Key tox pearl from tragedy: 25yo fell on rattlesnake during CA mountain biking, died weeks later despite hospital care—cause listed as animal...

Gastric lavage rarely used now due to lack of evidence and complications, down from standard care.

• Case evidence: Successful prehospital use in...

Fatal Snakebites

• 🔥 SoCal Rattlesnake Death: 25-year-old Julian Hernandez died after a February rattlesnake bite on an Irvine hiking trail,...

Key clinical reminder from Irvine hiking death:

• Species/regional differences: Southern Pacific rattlesnakes show varied venom toxicity.
• High venom...

• Presenter: Conner McDonald, MD, Clinical Assistant Professor, Emergency Medicine, University of Iowa
• Event: MGMC Physician Grand Rounds on...

Station uniforms expose firefighters to PFAS, flame retardants, heavy metals—even on non-firefighting shifts.

Key risks:

• Contaminants persist in...

Key tox pearl: Add Dandora slum residence, informal e-waste recycling (e.g., burning wires for copper), or waste picking to pediatric heavy metal...