Tijdens de cursus wordt je toxicologie kennis opgefrist. Daarnaast wordt middels scenariotraining uitvoerig geoefend met het opstellen van een toxicologische differentiaaldiagnose en het behandelen van kritiek zieke patiënten. Tevens zijn er workshops ter verdieping van de kennis. Daarnaast is er ruimte om eigen casuïstiek te bespreken.
Accreditatie
Accreditatie is toegekend door:
- Nederlandse Internisten Vereniging (NIV): 11 punten
- Nederlandse Vereniging van Spoedeisende Hulp Artsen (NVSHA): 12 punten
Docenten
- Prof. Naren Gunja, Emergency Physician, Westmead Hospital, Clinical & Forensic Toxicologist, Sydney Australia
- Prof. Andis Graudins, Emergency Physician, Monash Medical Centre, Clinical Toxicologist, Melbourne Australia
- Sean Scott, MBBS FACEM FCICM, Emergency Physician, Intensive Care Physician, OLVG Amsterdam
- Femke Geijsel, FACEM FRCEM, Emergency Physician, OLVG Amsterdam
Organisatie
Femke Gresnigt, Emergency physician, OLVG Amsterdam
De deelnameprijs bedraagt € 950,00.
Voorbereiding
Tijdens de SimToxNL cursus gaan we 4 verschillende patienten behandelen met de volgende symptomen:
- Coma
- Convulsies
- Aritmie (bradycardie of tachycardie)
- Cardiotoxische shock
Het is de bedoeling dat je je hierop voorbereid. Websites:
Literatuur
Algemeen:
JS Boyle, LK Bechtel, CP Holstege. Management of the critically poisoned patient. SJTREM 2009, 17:29
BS Judge. Metabolic acidosis: Differentiating the causes in the poisoned patient. Med Clin N Am 89 (2005) 1107–1124
Riskassessment:
F F S Daly, M Little, L Murray. A risk assessment based approach to the management of acute poisoning. Emerg Med J 2006;23:396–399. doi: 10.1136/emj.2005.030312
ADME:
SDAC: Juurlink. Activated charcoal for acute overdose: a Reappraisal. Br J Clin Pharmacol 2015
MDAC: JA Vale, EP Krenzelok, and GD Barceloux. Position Statement and Practice Guidelines on the Use of Multi-Dose Activated Charcoal in the Treatment of Acute Poisoning. Clinical Toxicology, 37(6), 731–751 (1999)
Gastric lavage: B. E. BENSON et al. Position paper update: gastric lavage for gastrointestinal decontamination. Clinical Toxicology (2013), 51, 140–146
WBI: Ruben Thanacoody, E. Martin Caravati, Bill Troutman, Jonas Höjer, Blaine Benson, Kalle Hoppu, Andrew Erdman, Regis Bedry & Bruno Mégarbane (2015) Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients, Clinical Toxicology, 53:1, 5-12, DOI: 10.3109/15563650.2014.989326 http://dx.doi.org/10.3109/15563650.2014.989326
Dialyse: Ghannoum et al. EXTRIP – Use of extracorporeal treatments in the management of poisonings -Kidney International (2018) 94, 682–688
Cardiotoxic:
C Yates, AF Manini. Utility of the Electrocardiogram in Drug Overdose and Poisoning: Theoretical Considerations and Clinical Implications. Current Cardiology Reviews, 2012, 8, 137-151
AA Kan, DW de Lange, DW Donker, J Meulenbelt. Management of prolonged Qt interval and torsades de pointes in the intoxicated patient. The Netherlands journal of medicine 2014;72(3):119-126
RE Bruccoleri, MM Burns. A Literature Review of the Use of Sodium Bicarbonate for the Treatment of QRS Widening. J. Med. Toxicol. (2016) 12:121–129
N Gunja and A Graudins. Management of cardiac arrest following poisoning. Emergency Medicine Australasia (2011) 23, 16–22
BSH Chan and NA Buckley. Digoxin-specific antibody fragments in the treatment of digoxin toxicity. Clinical Toxicology early Online 2014
A Graudins, HM Lee, D Druda. Calcium channel antagonist and betablocker overdose. antidotes and adjunct therapies. Br J Clin Pharmacol / 81:3 / 453–461
JB Cole, AM Arens, JR Laes et al. High dose insulin for beta-blocker and calcium channel-blocker poisoning: 17 years of experience from a single poison center. American Journal of Emergency Medicine 2018
Antidepressiva en lithium:
J Baird-Gunning, T Lea-Henry, LCG Hoegberg et al. Lithium Poisoning. Journal of Intensive Care Medicine 2016;1-15
HKR Thanacoody, SHL Thomas. Antidepressant poisoning. Clin Med 2003;3:114–8
EM Caravati, PJ Bossart. Demographic and Electrocardiographic Factors Associated With Severe Tricyclic Antidepressant Toxicity. Journal of Toxicology: Clinical Toxicology, 29:1, 31-43, DOI: 10.3109/15563659109038595
JL McCabe, DJ Cobaugh, JJ Menegazzi, J Fata. Experimental Tricyclic Antidepressant Toxicity: A Randomized, Controlled Comparison of Hypertonic Saline Solution, Sodium Bicarbonate, and Hyperventilation. ANNALS OF EMERGENCY MEDICINE 32:3 SEPTEMBER 1998, PART 1
GK Isbister, SJ Bowe, A Dawson, IM Whyte. Relative Toxicity of Selective Serotonin Reuptake Inhibitors (SSRIs) in Overdose. Journal of Toxicology CLINICAL TOXICOLOGY Vol. 42, No. 3, pp. 277–285, 2004
IM Whyte, A Dawson, NA Buckley. Relative toxicity of venlafaxine and selective serotonin reuptake inhibitors in overdose compared to tricyclic antidepressants. Q J Med 2003; 96:369–374
CA Kelly, N Dhaun, WJ Laing, et al. Comparative Toxicity of Citalopram and the Newer Antidepressants After Overdose, Journal of Toxicology: Clinical Toxicology, 2004;42:1, 67-71, DOI: 10.1081/CLT-120028747
Antipsychotica:
HH Tan, J Hoppe, K Hear. A systematic review of cardiovascular effects following atypical antipsychotic medication overdose. Am J Emerg Med. 2009 June ; 27(5): 607–616. doi:10.1016/j.ajem.2008.04.020.
Hyperthermie syndromen:
BD Hayes, JP Martinez, F Burrueto Jr. Drug induced hyperthermic syndromes. Part I. Hyperthermia in overdose. Emerg Med Clin N Am 31 (2013) 1019–1033
ME Musselman and S Saely. Diagnosis and treatment of drug-induced hyperthermia. Am J Health-Syst Pharm—Vol 70 Jan 1, 2013
F Eyer and T Zilker. Bench-to-bedside review: Mechanisms and management of hyperthermia due to toxicity. Critical Care 2007, 11:236
GK Isbister, NA Buckley, IM Whyte. Serotonin toxicity: a practical approach to diagnosis and treatment. MJA • Volume 187 Number 6 • 17 September 2007
R Velamoor. Neuroleptic malignant syndrome: A neuro-psychiatric emergency: Recognition, prevention, and management. Asian Journal of Psychiatry 2017;Vol29:106-109
Drugs en EDS:
JP Thompson. Acute effects of drugs of abuse. Clin Med 2003;3:123–6.
Philippe Gonin; Nicolas Beysard, MD; Bertrand Yersin, MD; Pierre-Nicolas Carron. Excited Delirium: A Systematic Review. ACADEMIC EMERGENCY MEDICINE 2018;25:552–565.
Intralipid en ECMO:
Hoegberg et al. Systematic review on the effect of intravenoud lipid emulsion therapy for local anesthetic toxicity. Clin Tox 2016;54(3):167-193
D W de Lange, M A Sikma, and J Meulenbelt. Extracorporeal membrane oxygenation in the treatment of poisoned patients. Clinical Toxicology, 2013 vol. 51 (5) pp. 385-393. http://www.tandfonline.com/doi/full/10.3109/15563650.2013.800876
Convulsies en anticonvulsiva:
H. Chen, TE Albertson, KR Olson. Treatment of drug-induced seizures. Br J Clin Pharmacol / 81:3 / 413
Toxische alcoholen:
JA Kraut, ME Mullins. Toxic Alcohols. N Engl J Med. 2018 Jan 18;378(3):270-280. doi: 10.1056/NEJMra1615295.
GA Beauchamp, M Valento. Toxic Alcohol Ingestion: Prompt Recognition And Management In The Emergency Department. EBMedicine sept 2016;vol18,No9
Femke Gresnigt
I am an emergency physician trained in the JBZ hospital in ‘s-Hertogenbosch. After working 7 months in Brighton, England and a long holiday travelling the world, I started working in the OLVG hospital in Amsterdam in 2012. Since then my interest in toxicology has grown with a special interest in TCA, cardiotoxic and drug poisoning. When I was a board member of the NVSHA responsible for setting up the new national training program, I initiated the toxicology section and toxicology course. Currently I am president of the Dutch multidisciplinary clinical toxicology platform and developing a toxicology expert center at OLVG. Recently started my PhD on acute cardiovascular complications of drugs of abuse at the UMC Utrecht and a master in medical toxicology at the Colombo university Sri Lanka. With all these efforts and this SimToxNL course I hope to contribute to the care for toxicology patients. I am confident this is going to be a valuable course to contribute to this goal and hope to see many of you there!
Sean Scott
I’m a part time emergency physician, part time intensivist and full time itinerant medic. Although Australian by birth I have spent about as much time overseas as I have in Australia. My medical and specialty training in Australia were punctuated by extended periods in Sri Lanka, Italy, London and Lesotho.
I pride myself on having seen an extremely varied spectrum of critical care medicine from aeromedical retreival in rural Africa to total artificial hearts and ECMO CPR in a quaternary transplant centre. I have a passion for medical education, critical care ultrasound and international emergency medicine.
Andis Graudins
- Clinical toxicologist and emergency physician at Monash Health in Melbourne, Australia
- Director of Monash Toxicology unit
- Clinical Toxicologist with Victorian and NSW Poisons Information Centres
- Chair of the Monash Emergency research collaborative
- Clinical researcher in clinical toxicology with interests in paracetamol poisoning and treatment of cardiovascular drug intoxication for over 20 years
- Over 25 years experience as a clinical toxicologist
- Passionate about training next generation clinicians in clinical toxicology.
Naren Gunja
Femke Geijsel
Femke Geijsel, FACEM, FRCEM, SEH-arts KNMG Opgeleid in Emergency Medicine in Australasia, inclusief een fellowship Simulatie, ben ik nu al weer een aantal jaar terug in Nederland waar ik met veel plezier in het OLVG werk en betrokken ben bij de opleiding en allerlei opleidingsactiviteiten. Zo zijn we in 2017 begonnen met het Fellowship SEG. Buiten het OLVG doe ik graag allerlei projecten met betrekking tot SEG en opleiden. EM-Masterclass is hier een voorbeeld van, waar we in 15 weken SEH artsen KNMG een enorme groei laten doormaken op medisch inhoudelijk vlak en in specialistisch denken. Ik heb veel zin in de SimTox cursus, op specialistisch niveau simulaties doen is een enorme uitdaging en ontzettend leuk en waardevol.
