Anticholinergic Toxicity in the Emergency Department

Area of Science:

• Medical Education
• Toxicology
• Emergency Medicine

Background:

• Over 600 compounds possess anticholinergic properties, found in common medications and illicit substances.
• Anticholinergic toxicity presents with diverse symptoms, including agitation, seizures, hyperthermia, and cardiac dysrhythmias, posing a significant challenge in emergency settings.
• Familiarity with managing anticholinergic toxidrome is essential for emergency physicians due to frequent encounters.

Purpose of the Study:

• To develop and evaluate a simulation case for training healthcare professionals in managing anticholinergic toxicity.
• To enable learners to describe clinical presentations, identify causative agents, recognize ECG findings, and review management strategies for anticholinergic toxicity.

Main Methods:

• A high- or moderate-fidelity manikin simulation was employed for the educational scenario.
• The simulation was piloted with emergency medicine residents and subsequently tested on over 100 learners.
• Learner feedback was collected via oral feedback and debriefing sessions utilizing techniques like advocacy/inquiry.

Main Results:

• The simulation case was well-received by learners, who found it useful and engaging.
• Learners reported positive overall feedback, indicating the case's effectiveness in their training.
• The simulation proved effective when combined with structured debriefing sessions.

Conclusions:

• This simulation effectively enhances the ability of medical professionals to evaluate and manage anticholinergic toxicity.
• The training approach, incorporating manikin simulation and debriefing, is a valuable tool for improving preparedness in toxicology emergencies.
• Continued use and refinement of such simulation-based education can improve patient care for anticholinergic poisoning.