Simulation Case Library

Below are our Peer Reviewed Case Library

We hope you learn something new and helpful to further your toxicology education.

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Please download these to build your medical knowledge and education.

The cases will emphasize key teaching points important in emergency toxicology.

All cases below can be downloaded in PDF format.

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Supratherapeutic INR following warfarin ingestion

This is a 4-year-old female with no significant past medical history who presents with her mother for an uncontrollable nosebleed and frank hematuria. The patient has some scattered bruises to the shi...

Pediatric Valproic Acid Overdose

This is a 3-year-old male with a past medical history significant for Lennox-Gastaut Syndrome who presents with his mother for concerns of increasing drowsiness and lethargy over the preceding week.

Acute Amitriptyline Overdose

Patient is a 36-year-old female with a history of anxiety and depression brought to the emergency department by EMS for altered mental status and possible overdose.

Acute Aspirin Overdose

Patient is a 40-year-old female with a history of anxiety, ADHD, and polysubstance abuse brought to the emergency department by EMS for altered mental status, agitation, and rapid respirations.

Acute Calcium Channel Blocker Overdose

Patient is a 22-year-old female with a history of migraine, depression/anxiety, and ADHD brought to the emergency department by EMS for altered mental status, seizure, and rapid respirations.

Acute Ethanol Withdrawal

Protect the patient’s airway. At a minimum, this must include assigning continuous evaluation and surveillance of the airway to another team member.

Acute Iron Overdose (Pediatric: Adolescent)

Patient is a 15-year-old male with no significant past medical history who is brought to the emergency department by his mother after reportedly ingesting approximately 90 tablets of iron about 3 hour...

Calcium Channel Blocker Overdose

Patient is a 56-year-old man with a history of hypertension and depression who is delivered to the emergency department by EMS following an intentional ingestion of verapamil (both immediate and exten...

Cannabis Ingestion with Severe Intoxication in a Child

This is a 3-year-old male with no significant past medical history who presents after the mother found him lethargic at home with the older sister who is also acting altered. The child presents with s...

Carbon Monoxide-Cyanide Toxicity (House Fire)

Patient is a 26-year-old male with no known PMH who is brought in by EMS from scene of a house fire, unconscious at the scene, status-post witnessed generalized tonic-clonic movements while en route t...

Carbon Monoxide Poisoning

This is a case of a 23-year-old man presenting with altered mental status after complaining of headache and syncope while he was at work.

Caustic Ingestion

The patient is a 17-year-old male with a history of depression and prior alcohol abuse who presents to the emergency department with his ex-girlfriend after ingesting “Poolife Rapid Shock.”

Centruroides Scorpion Envenomation

Patient is a 3-year-old male without medical history brought to the emergency department by parents for agitation and foaming at the mouth

Chronic Aspirin Overdose

A 58-year-old male with a history of gout and coronary artery disease presents to the ED with nausea, vomiting, diarrhea and low-grade fevers.

Chronic Digoxin Toxicity

The patient is a 63-year-old male with a history of atrial fibrillation, HTN, and CHF brought to the emergency department by EMS for nausea and vomiting for the past four days and confusion that began...

Cocaine Overdose

45 year-old male found unresponsive in his office. Patient works at a bank downtown. According to his co-worker, he appeared healthy when arriving to work.

Cyanide Toxicity (House Fire)

This is a case of a 50-year-old male found unresponsive in burning house. EMS found the patient unresponsive, hypotensive, and tachycardic with soot around the mouth/nares.

Digoxin Toxicity

This is a case of a 69-year-old woman who is brought in by EMS after her husband called 911 for increasing confusion, vomiting, and reduced level of consciousness.

Diphenhydramine Overdose

This is a case of an otherwise healthy 15-year-old girl who ingests a large number of diphenhydramine tablets in a self-harm attempt.

Diphenhydramine-Acetaminophen Overdose

This is a case of an otherwise healthy 25-year-old woman brought to the ED by EMS after her roommate found her acting oddly.

Ethylene Glycol Ingestion

Patient is a 52-year-old female with a history of alcoholism and depression brought to the emergency department by EMS for altered mental status and alcohol intoxication.

Hydrocarbon Exposure

The patient is a 2-year-old male with a history of bronchiolitis who presents to the ED with his mother after ingesting “TIKI® torch fuel.”

Hydrofluoric Acid Toxicity

You are a resident in the ED in an urban area. EMS on the radio reports they are transporting to you a 35-year-old male who was working in a glass etching factory and spilled a chemical solution on hi...

INH Toxicity

Patient is a 5-year-old girl with no known medical history brought in from the babysitter’s house after a seizure.

Opioid Overdose

40-year-old man found unconscious at a bar after work. According to his work colleagues, he was in his usual state of health today.

Organophosphate Exposure

This is a case of a 27-year-old man who presents with vomiting, weakness, diaphoresis, and altered mental status.

Pediatric Clonidine Overdose

This is a case of a 5-year-old otherwise healthy boy who is found somnolent by his parents. Unknown to them at the time, he ingested approximately 10 clonidine tablets. The pills belong to his older b...

Pediatric Ethylene Glycol Ingestion

This is the case of a 2.5-year-old male toddler who presents to the ED with an accidental ingestion of ethylene glycol.

Pregnant Patient With Intentional Iron Overdose

This is a case of a 33-yr-old female with no significant PMH who presents with nausea, bloody emesis, abdominal pain. 

Rattlesnake Envenomation

Patient is a 66-year-old female brought to the emergency department by EMS after being bitten by a rattlesnake while gardening in her yard.

Rattlesnake Bite

This is a case of a 32-year-old man who is brought to the emergency department reporting a snakebite by a prairie rattlesnake while working in the local zoo that afternoon.

Repeated Supratherapeutic Acetaminophen Toxicity

This is a case of a 38-year-old man with a past medical history of alcoholism/alcohol abuse and biliary colic who now presents with nonspecific symptoms of malaise, nausea, vomiting, and upper abdomin...

Serotonin Syndrome

Patient is a 24-year-old female with a history of depression and anxiety. The patient is brought to the emergency department by EMS for vomiting, agitation, and “seizures.”

Tricyclic Antidepressant Overdose

This is a case of a16-year-old girl who is brought to the ED from home by her mother for altered mental status.