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Ryan Feldman PharmD DABAT Profile picture
Ryan Feldman PharmD DABAT
@EMPoisonPharmD
Host @LabPoison. EM PharmD, PGY2 faculty, Prof📚 @ https://t.co/xOXivTxtPA, Toxicologist(DABAT) @Center_poison,🔬https://t.co/Ul3qaTKbfG views=mine
Mar 25 • 22 tweets • 8 min read
You're working in the ED when a 30 y.o male presents 30 minutes after envenomation to the right index finger by his pet snake (left).

He has a picture of culprit (right) , and it is definitely NOT from America.

A 🧵on U.S. exotic envenomation management.

(shared with consent)
Image
Image This involved a Blue Indonesian pit viper (Trimereserus Insularis) but this could have been any exotic snake. There have been 50-110 exotic snake bites reported to Poison Centers annually since 2012.

P.S. limited free copies of report available here:
tandfonline.com/eprint/D6PYXIG…
Jun 21, 2023 • 15 tweets • 7 min read
Toxicologists are often consulted about 🍄foraging misadventures (wild mushroom ingestion).

Usually you don't get a clear mushroom image like this video (at best a blurry photo of some OTHER mushroom), or more often no image.

So what to do?

A 🍄🧵
#FOAMed #FoamCC #MedEd If you do have a good sample or photo you can work with a mycologist (your posion center knows one) to identify the shroom. But this is not frequent.
Jan 17, 2023 • 12 tweets • 6 min read
Had the opportunity to be part of a fascinating work. Americas Poison Center Annual report.

A comprehensive poisoning epidemiology study compiled of data from all 55 U.S. Poison Centers

Free 🔗➡️bit.ly/3wbIwWS
Pubmed🔗➡️bit.ly/3wdgeLP

A🧵on emerging trends This year we highlighted two important trends in addition to baseline poisoning data.

Firstly, THC product exposures have been increasing since 2016, and the demographics are changing. In 2021, edible products (red line) eclipsed plant based marijuana (blue line) for products Image
Jan 16, 2023 • 15 tweets • 5 min read
We wrote this case of #fentanyl exposure w/ NO clinical effects (bit.ly/3k7I1dF) to help realign fentanyl exposure risk perception.

I thought it was one of the only confirmed cases...turns out there are quite a few.

A 🧵on NIOSH health hazard evaluations
#MedEd If someone is concerned that hazards are interfering with their job function, NIOSH can get called in to do a field evaluation.

They review exposures, med records, forensics, and write public reports.

They have QUITE a few confirmed fentanyl reports.

cdc.gov/niosh/hhe/defa…
Jan 4, 2023 • 14 tweets • 20 min read
A few years ago I made a digital resuscitation game with a working cardiovascular system. A playground to play with pressors/resuscitation.

TODAY I REALIZED I COULD PLAY IT IN Virtual Reality

So I made a video. An 11 part 🧵for VR septic intubation!
#FOAMcc #FOAMed #MedEd Part 2/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Dec 31, 2022 • 27 tweets • 14 min read
Tomorrow is NYE, there will be partying, pills, and powders. Some leading to overdose.

I work in the ER NYE/NYD & expect a few "OD's" from said pills n powders. What exactly is in them?

A 🧵from Camden, a VERY human 28 y.o male, on the illicit drug supply

#MedED #FOAMed Image Cam was out with his friends celebrating NYE with some beverages when one of his friends offered him a tan powder. Cam was pretty hesitant at first but.. ImageImage