Toxicology Rotation

Medical toxicology is a required rotation for second year emergency residents in both the UAMC and UACOM South programs and for Emergency Medicine Pharm.D residents. It is an elective for residents from other specialties, including Pediatrics, Internal Medicine, and Family Medicine. It is also a fourth-year Medical Student and Pharm.D student elective. The rotation provides a mixture of formal didactic and clinical experiences and introduces the rotator to poison center operations.

Requirements

The Medical Toxicology rotation is based out of the Arizona Poison and Drug Information Center (APDIC) in the College of Pharmacy. It is located on the third floor of Drachman Hall. The rotation lasts four weeks for UACOM South EM residents and two weeks for UAMC EM residents. Rotators on elective can choose either length with permission from their program director. All rotators are expected to complete the pre-test prior to the first day of the rotation.

Rotators are expected to be in the APDIC or engaging in other toxicology-related activity from 0800 - 1700. Home call begins at 1700 and lasts until 0800 for those on call.

On the first day of the rotation, the resident will take the Tox pre-test.

On the first day of the rotation there will be an orientation, including an introduction to poison center operations. The lecture schedule and reading assignments will be provided at this time, and a call schedule will be determined.

Every weekday (except Tuesdays for EM residents) the rotators will arrive at 0800 and review all of the active cases being followed by the APDIC. They will present these cases to the attending medical toxicologist at morning rounds. Bedside rounds will also be conducted for admitted patients at UAMC and UAMC South.

Rotators will see all consults from 0800-1700 and leave a written note for the requesting service.

When not evaluating patients, rotators are expected to be at the APDIC.

Lectures will be given after rounds according to the didactic schedule issued at the beginning of the rotation.

Each rotator will spend two five-hour shifts answering calls under the supervision of a Certified Specialist in Poison Information (CSPI).

Each rotator will also be expected to complete and present a project by the end of the rotation. This can consist of an APDIC chart review of a particular intoxicant or an in-depth presentation on a controversial topic in toxicology.

At the end of the rotation, the rotator will complete a post-test and rotation evaluation.


Lecture list

  1. Intro to Poison Center Operations                                                      
  2. General Management of the Poisoned Patient                             
  3. Envenomations ‚Äì Reptiles                                      
  4. Envenomations – Arthropods
  5. Toxic Alcohols
  6. Aspirin
  7. Acetaminophen
  8. Psych meds
  9. Critical Heat Illness
  10. Drugs of Abuse
  11. Cardiovascular Toxins
  12. Anticonvulsants
  13. Teratology
  14. Alcohol emergencies

Additional lectures may be given at the discretion of toxicology faculty.

Reading list

Required and optional readings will be provided in a binder on the first day of the rotation.