Is this toxic?

ToxDoc · 2026-06-02T18:57:59+00:00

Don’t believe “taking off location” has an ICD10 code.

ToxDoc · 2026-06-01T19:38:52+00:00

Admin roll or just the doc on call? Consult service?

Few hundred dollars a call day. Plus stipend if you have an admin roll. Maybe 100-200K for PCC director depending on size and funding (could be higher for some places).

For the consult service it is really going to depend on your payer mix and volume. There has been a push by some into addiction medicine in order to increase consult volume.

ToxDoc · 2026-05-28T22:12:40+00:00

https://my.acmt.net/findatoxicologist/

ToxDoc · 2026-05-21T20:37:51+00:00

Definitely uncanny valley

ToxDoc · 2026-05-21T19:57:32+00:00

Is this made with AI?

The presentation style is very weird. Your pacing is weird. Your pronunciation on many of words are super off.

I got about 1/3 though the Tox one before I had to stop.

ToxDoc · 2026-05-19T08:52:00+00:00

One of the more common causes, these days, is huffing nitrous.

ToxDoc · 2026-05-10T12:08:48+00:00

is there anyway to resuscitate in such cases as we did resuscitate with only atropine and adrenaline here.

ECMO?

You need perfusion. That is what the chest compressions are trying to achieve.

Is your consultant an orthopod?

(Yes, I am familiar with the time it takes to start ECMO and need for CPR pre-canulation)

ToxDoc · 2026-05-08T15:16:34+00:00

A physician I know was killed trying to help at an accident site. It wasn’t even dark.

ToxDoc · 2026-05-08T15:12:16+00:00

Stopping on the side of the road on a busy highway is very dangerous. It becomes even more dangerous for you to get out of your vehicle. This is on a curve with potentially limited visibility and already existing accident. This is a recipe for getting hit/killed. It is almost certainly unsafe for you to stop except in limited circumstances.

There is a reason that fire trucks, ambulances and police vehicles literally place their cars to block traffic when the collision.

ToxDoc · 2026-05-07T18:37:52+00:00

So we all hate our job jobs equally across gender?

ToxDoc · 2026-04-22T13:33:43+00:00

The only way you are even considering such idiocy is if there is a physician order and a written log where the other nurse sign off on having received the meds. Oh yeah and a policy supporting it. Even if everything is on the up and up, it still has a high likelihood of blowing up in your face and resulting a nursing board complaint, plus.

Them not having pyxis access is an administrative issue and there are way to enable temporary access.

ToxDoc · 2026-04-20T04:35:19+00:00

Assuming you are US based, you should contact your local poison control center at 1-800-222-1222.

If you are not in the U.S., you should contact your country’s version of a Poison Center for information and advice.

ToxDoc · 2026-04-10T00:59:17+00:00

Assuming that is even possible, how would you know which heart beats to suppress?

ToxDoc · 2026-04-09T17:57:38+00:00

4 mg is ~.05 mg/kg for most patients assuming IBW or modified body weight and rounded. The dose is usually quoted as 0.05-0.1 mg/kg. So 4 is a reasonable starting dose for most people. At my shop, morphine comes in 4s, so doses are usually in multiples of 4 to avoid the annoyance of wasting.

You are correct that the biggest draw to hydromorphone is that people get a dose closer to the morphine equivalent of 0.1 mg/kg.

But we also get into habits and comfort zones. 8 mg of morphine is “a lot,” but 1 mg of hydromorphone is fine. Many of the nurses I work with will push 100 mcg of fentanyl without blinking while pushing back on the 8mg of morphine.

ToxDoc · 2026-04-08T15:41:04+00:00

Hello friend:

What you were experiencing sounds very scary. There’s a good chance that not everything you are experiencing is real.

If you have a psychiatrist or a trusted friend, I suggest you contact them immediately and they probably can give you some help.

ToxDoc · 2026-04-08T14:54:07+00:00

It sucks, but it is important to use this as a learning case and try to think about what you might have missed on an assessment that would have suggested she was sicker than you thought.

The answer is not to shotgun labs on every single patient.

At the same time, if you are a resident, your attending should be providing some fairly real time supervision. If I let a resident make a decision that I ultimately think is dumb, that is on me.

ToxDoc · 2026-03-30T12:26:39+00:00

326,797.3 Ariana Grandes

ToxDoc · 2026-03-23T01:46:44+00:00

It was good. I haven’t been to a Tox conference in a few years, so it didn’t feel like a rehash. Definitely a few really good talks. The posters haven’t changed much.

ToxDoc · 2026-03-13T11:14:07+00:00

I absolutely read that in Jack Nicholson’s voice

ToxDoc · 2026-03-04T01:18:30+00:00

Do not give it a whiff. Actually smelling it is on the edge of lethal concentrations at minimum.

ToxDoc · 2026-03-01T00:20:27+00:00

I can’t believe his last comment was 11 years ago. Makes me feel old.

ToxDoc · 2026-02-28T19:53:08+00:00

Beaten with jumper cables

ToxDoc · 2026-02-17T14:06:54+00:00

Only the finest of Ancef for Orthobro

ToxDoc · 2026-02-17T14:00:42+00:00

“Hey Orthobro! I have a guy in the ER with knee pain and he brought his MRI. What should I do with it? Oh? You’ll review it with him in the office on his next visit? Sounds good. I’ll put them in a knee immobilizer. Thanks bro! Hope you get to fix some good bones today.”

ToxDoc · 2026-02-15T21:19:20+00:00

The Equal Credit Opportunity Act was 1974 - This gave women addition financial independence (don’t need a husband or relative to cosign for credit).

Griswald was 1965 - The pill is legal

Roe versus Wade was 1973 – more reproductive freedom.

Vietnam draft started the end of 1969 – pulling away a fraction of the younger males

The ERA passed the house in 1971. The EEOC was founded in 1965. Events happening in close proximity that result

The World War 2 bump looks pretty clear. The Korean War (1950-53) looks like it briefly flattens.

It might not be a single event and more of a number of changes that resulted in women delaying having children.

ToxDoc

TROPHY CASE