Body Stuffers - Ingrid Berling, Nick Dafters

In this episode we look at the emerging phenomenon of peptide use. These are non-regulated compounds being marketed in the performance and image enhancing drugs space (PIED). We focus on the large variety of compounds available, the limitations of the clinical evidence around their use in humans, and some of the complications and adverse effects being reported from their use.

In this episode, Nick Dafters & Ingrid Berling dive into the sharp rise of GHB (gamma-hydroxybutyrate) presentations across Australian Emergency Departments. They review recent literature on the incidence of aspiration events and unpack strategies to risk-stratify patients most vulnerable to severe complications as well as discussing the clinical challenge of delayed-onset toxicity caused by GHB precursors—especially when co-ingested with alcohol.  There's a segment on the rare presentation of toxicity following a sting from a duck-billed platypus, the limited evidence around treatment options and the potential clinical sequelae. Finally, they review the rollout of the state-wide Electronic Medical Record (eMR) in NSW and its potential to transform future emergency and toxicology research. If you're interested in learning more about Emergency Toxicology, check out the Tox Course at ETM Online  Growing burden of gamma-hydroxybutyrate intoxication on emergency department resource utilisation Indications for and complications of endotracheal intubation in gamma-hydroxybutyrate (GHB) overdoses admitted to a toxicology unit Trends in gamma-hydroxybutyrate use, harms and treatment in Australia, 2013 to 2024  A multicentre case series of analytically confirmed gamma-hydroxybutyrate intoxications in Western Australian emergency departments: Pre-hospital circumstances, co-detections and clinical outcomes Prevalence of GHB-Related Presentations to a Metropolitan Emergency Department in Melbourne Platypus Envenomation        

This podcast is a preview for the much anticipated Tox Course Module 4 - Bites, stings and envenomation, soon to be released at etmonline.com In this episode we are joined by our expert guest, Professor Geoff Isbister.  Geoff is head of the Clinical Toxicology Research Group at the University of Newcastle and is a world leading expert on Venom and Antivenom Research, having published over 340 original research publications on these topics. In this episode we discuss: The Australian Snakebite Project, the epidemiology of snakebites in Australia and the practice changing impacts the A.S.P. is having on the modern clinical management of snakebite Venom detection kits or VDK's, the reasons these are actually being phased out in a lot of places and may actually disapper altogether What to do with snakes and spiders that get brought to the ED A wide range of interesting and occult ways people can present after a snakebite, including collapse, syncope and seizures, as well as some of the more subtle, interesting and humorous ways that people have run into trouble with snakes This is a great episode packed with practical pearls from one of the world leaders in the field of snakebite research. If you want to learn more about toxicology/toxinology in general, or spefically about how to treat the full range of Australian poisonous-creature related presentations from Professor Isbister, check out Module  4 of the Tox Course at etmonline.com

This is the second of a 2-part series on "Packers and Stuffers". In this episode Andy, Ingrid and Nick discuss body stuffing, or  desperate drug concealment in the real world. We pulled this content from Module 2 of the Tox Course at ETM Online as we felt it was so valuable we should release it for free. If you haven't already, head over to ETM Online and check out modules 1, 2 and 3 of the Tox Course now!

This is the first of a 2-part series on "Packers and Stuffers". In this episode Andy, Ingrid and Nick discuss the process of managing a patient suspected of body packing (ingestion of large quantities of drugs for the purpose of smuggling) in the ED.  We pulled this content from Module 2 of the Tox Course at ETM Online as we felt it was so valuable we should release it for free. Be sure to subscribe to the podcast and you can catch the next episode on body stuffers as well! If you haven't already, head over to ETM Online and check out modules 1, 2 and 3 of the Tox Course now!

In this episode we take a deep dive into assessing and managing acute behavioural disturbances that intoxicated patients frequently present with. We cover safety and security, medico-legal issues, capacity and consent, how to run a code grey/black, physical restraint, the extreme risk associated with prone restraint and medical assessment of these patients. If you enjoyed this episode, check out the Tox Course at etmonline.com

In this episode we talk to Dr Martin Dutch, Emergency Physician and one of the most experienced doctors in Australia in the emerging field of "mass gathering medicine" (or as we like to call it "festival medicine"!). Martin gives us an in-depth view of how medical care at music festivals has evolved over the last two decades, then we take a deep dive into the management of one of the scariest medical conditions Emergency care providers can be faced with: the young, severely hyperthermic, critically unwell serotonergic/sympathomimetic toxicity patient. This is a sphincter-tightening situation for even the most experienced clinicians, and Martin walks us through his approach on how to successfully manage and then safely transport these patients from festival to hospital. This is a must-listen episode for anyone who may treat substance affected patients, and could literally help you one-day save a life that hangs in the balance. References: Martin and his team have published a case series of these patients, it's a fascinating read: Characteristics, presentation and outcomes of music festival patrons with stimulant drug-induced serotonin toxicity.  A more sobering read on music festival related deaths in Australia was also published recently: Drug-related deaths at Australian music festivals.  If you enjoyed the podcast check out the Tox Course at ETM Online Also check out our new free toxicology blog at toxcourse.com

Welcome to the first episode of the new Tox Course Podcast. In this episode Clinical Toxicologist Dr Ingrid Berling and Emergency Physician Dr Nick Dafters discuss the Poisons Information Centre and Clinical Toxicology services in Australia. If you enjoyed the podcast check out the Tox Course at ETM Online Also check out our new free toxicology blog at toxcourse.com Links: TAPNA – Toxicology And Poisons Network Australasia Virtual Toxicology Service decreases the average length of stay of poisoned patients and saves bed days Poisons Information Services: NSW VIC WA QLD SA