Sunday, May 26, 2019 • 13:00 - 14:30
Track 5 - From Door to Morgue: Advanced Topics in Toxicology
Track Chair: Dr. Nancy Murphy

Considerations for Dialysis in the Poisoned Patient - Dr. Marc Ghannoum

Description: A systematic and comprehensive approach for techniques such as hemodialysis in the management of the poisoned patient. This assessment requires an understanding of pharmacokinetics, the poison’s characteristics, alternative therapies, available extracorporeal techniques, and clinical condition, all of which will be presented. Current EXTRIP guidelines will be presented.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Integrate extracorporeal modalities within a clinical framework.
  2. Determine what makes a poison “dialyzable”.
  3. Review EXTRIP recommendations.

Pearls

  1. Do a proper stepwise assessment: it only takes minutes.
  2. Call your nephrologist early on. Be convincing.
  3. The management of a poisoned patient does not start and certainly does not end with dialysis.

Nephrologist and internist with research interest in pharmacology, acute kidney injury and enhanced elimination of poisons. EXTRIP workgroup chair.

Case Files from the Medical Examiner - Dr. Matt Bowes

Description:

Learning Objectives
At the end of this presentation, participants will be able to:

Pearls

Organ Donation in the Poisoned Patient - Dr. Osama Loubani

Description: Severe brain injury can occur in poisoned patients either directly because of the poisoning, or due to a secondary cause such as trauma. In these cases, organ donation should be considered, whether or not the patient is brain dead.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Review criteria for organ donation in patients that are brain dead, and those that are not brain dead.
  2. Describe considerations specific to the poisoned patient when considering organ donation.

Pearls

  1. Organ donation is possible even in patients who are not brain dead. Donation after cardiac death can be used in patients with severe brain injuries who are not brain dead.
  2. Brain death often cannot be declared clinically in the acutely poisoned patient, ancillary are needed.
  3. Organ failure due to poisoning is sometimes reversible even in severe cases. Do not discount the potential to donate an organ just because it is injured.

I am an Emergency Physician with a fellowship in ICU. I split my time between the emergency department and intensive care in Halifax.