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. 2019 Oct 22;15(4):228–254. doi: 10.1007/s13181-019-00736-9

Table 35.

2018 Fatalities reported in ToxIC Registry with known toxicological exposurea: Single Agent

Age/genderb Agents involved Clinical findingsc Life support withdrawn Brain death confirmed Treatmentd
20M Abrus precatorious TC, CNS, SZ, GIB, WBC, RFX, OTH1 Yes No None listed
41F Acetaminophen CNS, MA, HPT Yes Unknown NAC, IV fluids
5mF Acetaminophen None listed No No None listed
21F Acetaminophen CNS, HGY, MA, AG, HPT, GIB, AKI Yes No Folate, NAC, thiamine, vitamin K, benzodiazepines, IV fluids
59M Acetaminophen HT, TC, ALI, CNS, HGY, MA, HPT, CPT, AKI, RBM No No NAC, vasopressors, hemodialysis, continuous renal replacement, intubation, IV fluids
57F Acetaminophen CNS, DLM, HGY, MA, AG, HPT, WBC Yes Unknown NAC, glucose > 5%, intubation
37M Acetaminophen HT, CNS, HGY, MA, AG, HPT, PNC, CPT, PLT, AKI Yes No Fomepizole, NAC, vasopressors, glucose > 5%, opioids, intubation IV fluids
54F Acetaminophen HT, QTC, RD, CNS, MA, AG, HPT, AKI Yes No NAC, physostigmine, vasopressors, intubation, IV fluids
42F Acetaminophen HT, CNS, HGY, MA, AG, HPT, AKI, OTH2 Yes No Factor replacement, NAC, vitamin K, vasopressors, glucose > 5%, activated charcoal
32F Acetaminophen HT, HTN, BP, VD, AGT, CNS, MA, AG, HPT, CPT No No NAC, vasopressors, antiarrhythmics, antipsychotics, steroids, activated charcoal, hemodialysis, intubation, IV fluids, transfusion
61M Alprazolam HT, TC, QTC, MI, RD, CNS, MA, AKI Unknown Unknown None listed
50M Aspirin ALI, AG Yes Unknown NaHCO3, urinary alkalinization, IV fluids
16M Canabinoid nonsynthetic HT, BC, BP, RAD, CNS, MA, WBC Yes Yes Naloxone/nalmefene, albuterol, benzodiazepines, neuromuscular blockers, steroids, CPR, intubation, IV fluids
44M Carbamazepine CNS Yes Yes None listed
35F Carbon monoxide None listed No No None listed
23M Carbon monoxide CNS No No HBO
23F Carbon monoxide HT, TC, ALI, CNS, MA, AG Yes Yes Hydroxocobalamin, NaHCO3, thiosulfate, vasopressors, antiarrhythmics, neuromuscular blockers, steroids
9M Carbon monoxide HT, ALI, RD, CNS, MA, AG, No No Hydroxocobalamin, thiosulfate, vasopressors, CPR, intubation, IV fluids
66F Carbon monoxide HT, BC, ALI, RD, CNS, No No None listed
10M Carbon monoxide HT, RD, CNS, AG Yes Yes Intubation, IV fluids
56F Clonidine BC, CNS Yes Yes Vasopressors, intubation, IV fluids
46M Cocaine SZ, VD Yes Yes None listed
18 mM Dextroamphetamine TC, AGT No No Benzodiazepines, IV fluids
48F Diltiazem HT, BC, ALI, MA, AG No No Calcium, HIE, NaHCO3, vasopressors, benzodiazepines, glucose > 5%, neuromuscular blockers, activated charcoal, continuous renal replacement therapy, ECMO, intubation, IV fluids
31M Diltiazem HT, BC, AVB, ALI, AP, HPT, CPT, BL Yes Unknown Calcium, HIE, vasopressors, CPR, ECMO, intubation, IV fluids
13F Diphenhydramine HT, TC, QRS, RD, CNS, SZ Yes Yes NaHCO3, vasopressors, anticonvulsants, benzodiazepines, neuromuscular blockers, CPR, intubation, IV fluids
59F Ethanol HT, CNS, MA, AG, GIB, CPT, PLT, WBC No Unknown Fomepizole, octreotide, NaHCO3, thiamine, vitamin K, vasopressors, CPR, intubation, IV fluids, transfusion
29F Ethylene glycol AG, AKI Yes No Fomepizole, hemodialysis
34F Fentanyl HT, RD, CNS, AKI Yes Yes Naloxone, vasopressors, intubation, IV fluids
35M Fentanyl HT, BC, BP, VD, MI, RD, CNS, SZ, MA, AG, HYS Yes Yes NAC, naloxone, NaHCO3, vasopressors, antiarrhythmics, antipsychotics, benzodiazepines, neuromuscular blockade, opioids, CPR, intubation, IV fluids
77F Flecainide HT, BC, VD, QRS, QTC, AVB, MI, ALI, AP, CNS, MA, HPT, AKI Yes No HIE, NaHCO3, vasopressors, continuous renal replacement therapy, CPR, intubation
38M Heroin CNS No No Naloxone
26F Heroin HT, QTC, RD, CNS Yes Yes Naloxone, CPR, intbuation
45F Insulin TC, QTC, RD, CNS Yes Unknown Naloxone, glucose > 5%, intubation, IV fluids
38F Lidocaine HT, BC, AGT No No HIE, vasopressors, CPR, IV fluids
57M Metaxalone HT, QTC, RD, CNS, MA No No Vasopressors, continuous renal replacement therapy, intubation
48M Methadone CNS Yes Yes Naloxone, vasopressors, intubation, IV fluids
48F Methadone HT, CNS Yes Yes Vasopressors, antiarrhythmics, intubation, IV fluids
86 M Methotrexate HYT, GIB, HYS, CPT, PLT, PCT Yes No None listed
29F Oxycodone HT, ALI, CNS, MA, AKI, RBM No No Naloxone, vasopressors, intubation
43M Phentolamine HT, TC, CNS, AKI Yes No Vasopressors, intubation,
19F Propranolol HTN, TC, BC, VD, AVB, ALI, RD, CNS, SZ, MA No No Calcium, glucagon, HIE, NaHCO3, vasopressors, anticonvulsants, benzodiazepines, glucose > 5%, CPR, intubation, IV fluids
45M Quinine VD, CNS, AKI, RBM Yes Yes Naloxone, intubation
19M Sodium hypochlorite <6% HT, CRV No No None listed
10M Unknown agent HT, RD, CNS Unknown Unknown Naloxone prevention kit, vasopressors, CPR, intubation
87F Verapamil HT, BC, QTC, AVB, ALI, AKI Yes Unknown HIE, vasopressors, glucose > 5%, IV fluids
40M Water RD, CNS, SZ Yes Yes Folate, thiamine, anticonvulsants, benzodiazepines, intubation, mannitol
62M None listed AG, HPT, PNC No No NAC, vasopressors, continuous renal replacement therapy, intubation, IV fluids
70M None listed None listed Unknown Unknown None listed

aBased on response from Medical Toxicologist “Did the patient have a toxicological exposure?” equals Yes with known agent(s)

bAge in years unless otherwise stated. wk: weeks, m: months

cAG: anion gap, AGT: agitation, AKI: Acute kidney injury, ALI: acute lung injury/ARDS, AP: aspiration pneumonia, AVB: AV block, BC: bradycardia, BL: blisters/bullae, BP: bradypnea, CNS: coma/CNS depression, CPT: coagulopathy, CRV: corrosive injury, DLM: delirium, GIB: GI bleeding, HGY: hypoglycemia, HPT: hepatoxicity, HT: hypotension, HTN: hypertension, HYS: hemolysis, HYT: hyperthermia, MA: metabolic acidosis, MI: myocardial injury/ischemia, OTH1: choreoathetoid movement, OTH2: hypothermia, PCT: pancytopenia, PLT: thrombocytopenia, PNC: pancreatitis, QTC: QTc prolongation, RAD: asthma/reactive airway disease, RBM: rhabdomyolysis, RD: respiratory depression, RFX: hyperreflexia/tremor, SZ: seizures, TC: tachycardia, VD: ventricular dysrhythmia, WBC: leukocytosis

dPharmcological and non-pharmacological support as reported by Medical Toxicologist; BAL: Dimercaprol, CPR: Cardiopulmonary resuscitation, ECMO: Extra-corporeal membrane oxygenation, HBO: hyperbaric oxygenation, HIE: high dose insulin euglycemic therapy, NAC: n-Acetyl cysteine, NaHCO3: Sodium bicarbonate