Toxicology cases can be some of the more challenging cases that present to the emergency department (ED). Often the patient is altered or there is minimal history available. Many cases involve the combination of more than one toxic ingestion or exposure which can lead to a complex clinical picture.

The patient is a 33-year-old female with a medical history of ADHD and depression presenting with altered mental status. Per emergency medical services (EMS), the patient’s friend called for an episode of unresponsiveness. The patient’s ability to provide history is limited, but the friend reported that shortly prior to this event, the patient ingested a “pill” which he believed to be alprazolam (a medication she is prescribed). While awaiting evaluation, the patient had witnessed seizure-like activity in the waiting room, lasting approximately 30 seconds and was brought to a critical care room.

This patient is a 57 year old female who had no known medical history who presented to the emergency department for visual disturbances…

While dieulafoy lesion is a known etiology of GI bleeding in adults, it is less described in the pediatric population..

Traumatic fingertip amputations are among the most frequently encountered hand injuries in the emergency department, particularly affecting individuals engaged in manual labor using hand tools with metal blades. A review of data from the National Electronic Injury Surveillance System from 1997 to 2016 showed that 464,026 patients sustained a finger amputation in the US, with an estimated yearly incidence of 7.5/100,000 person-years…