45 - Intoxicated Patients, Propranolol, Snake Bites, and more... | The 2 View

Welcome to Episode 45 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!

Show Notes for Episode 45 of “The 2 View” – All things toxicology: the intoxicated patient, propranolol overdose and suicide, snake bites, and a special guest.

Segment 1 – The intoxicated patient

Kaufman J, Fitzpatrick P, Tosif S, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ. The BMJ. Published April 7, 2017.
https://www.bmj.com/content/357/bmj.j1341

Kraaijvanger N, Raven W, van Dijken T, Gresnigt F. The PIRATE mnemonic: providing a structured approach in the care for intoxicated patients at the emergency department. Int J Emerg Med. Educational Advances in Emergency Medicine. BMC: Part of Springer Nature. Published March 1, 2024
https://intjem.biomedcentral.com/articles/10.1186/s12245-024-00606-4

Thiessen P. A simple new technique for collecting urine in infants. Thischangedmypractice.com. The University of British Columbia. Faculty of Medicine: This Changed My Practice (TCMP) by UBC CPD. Published November 18, 2015.
https://thischangedmypractice.com/new-technique-for-collecting-urine-in-infants/

Van Oyen A, Barney N, Grabinski Z, et al. Urine Toxicology Test for Children With Altered Mental Status. Aap.org. Pediatrics. Case Reports. American Academy of Pediatrics: Dedicated to the Health of All Children. Published October 6, 2023.
https://publications.aap.org/pediatrics/article/152/5/e2022060861/194346/Urine-Toxicology-Test-for-Children-With-Altered?autologincheck=redirected

Segment 2 – Propranolol overdose and suicide

Khalid MM, Galuska MA, Hamilton RJ. Beta-Blocker Toxicity. In: StatPearls. StatPearls Publishing. NIH: National Library of Medicine – National Center for Biotechnology Information. Published July 28, 2023.
https://www.ncbi.nlm.nih.gov/books/NBK448097/

Srettabunjong S. Fatal Self-Poisoning With Massive Propranolol Ingestion in a Young Male Physician. Am J Forensic Med Pathol. PubMed®. NIH: National Library of Medicine – National Center for Biotechnology Information. Published September 2017.
https://pubmed.ncbi.nlm.nih.gov/28691951/

Segment 3 – Snake bites

Rohl S, Meredith M, Anderson, T, et al. Comparing the Use of Crotaline-Polyvalent Immune Fab (Ovine) Versus Observation in Children. Pediatric Emergency Care: Dedicated to the Care of the Ill or Injured Child. Lww.com. Published November 2024.
https://journals.lww.com/pec-online/abstract/2024/11000/comparing_the_use_of_crotaline_polyvalent_immune.19.aspx

Snake bites. Wikem.org. WikiEM. Last edited March 17, 2021.
https://wikem.org/wiki/Snake_bites

Toxicology resources

Goldfrank LR, Flomenbaum NE, Howland MA, et al. Goldfrank’s Toxicologic Emergencies. 8th ed. McGraw-Hill Medical; 2006.

Katz K, O’Connor A, Amaducci AM. EMRA and ACMT Medical Toxicology Guide: 2nd Edition.; 2022.

National Poison Data System. Poisoncenters.org. America’s Poison Centers: Treatment, Education, Prevention. Accessed April 9, 2025. https://poisoncenters.org/national-poison-data-system

Poison Control: National Capital Poison Center. Poison.org. Accessed April 9, 2025. https://www.poison.org/

Segment 4 – Special guest: Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN, of Arizona

Linkedin.com. Accessed April 9, 2025. https://www.linkedin.com/in/nancy-denke-dnp-acnp-bc-fnp-bc-faen-a62851

Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN, of Arizona. ENA Hall of Honor. Published July 26, 2024. Accessed April 9, 2025. https://hall-of-honor.org/nancy-denke

PodBean Development. Talking Toxicology: A Recipe for Disaster (Nancy Denke). BCEN & Friends Podcast. PodBean. Published March 7, 2023.
https://bcenandfriends.podbean.com/e/talking-toxicology-a-recipe-for-disaster-nancy-denke/

*Recurring Sources *

Center for Medical Education. Ccme.org. http://ccme.org

The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org

The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx

The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com

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