Week 1

Toxicology Introduction

• The top 10 commonly encountered toxins in small animal patients will be reviewed along with up-to-date evidence-based guidelines looking at treatment recommendations and options
• We will review the reported antidotes as well as the use of intra-lipid emulsion and other supportive measures we may implement in patients suffering from intoxication
• Common complications of the various intoxications we can encounter will be reviewed as well as discussion of how we may pre-empt and manage these

Learning objectives
After completion of this week, participants should be able to:

• Recognise the main toxins we see in practice
• Develop a systematic approach to the intoxicated patient
• Discuss the evidence bases looking at use of activated charcoal, intra-lipids and other antidotes, along with supportive measures for the intoxicated patient
• Appreciate the main complications we may encounter with an intoxicated patient
• Understand how to address and nurse intoxicated patients into recovery

Learning materials this week:
(released on Monday morning for on demand learning until the course ends – approximate timings)

• Pre-recorded tutorial with Kath = 75 minutes
• Further reading = 60 minutes
• Forum discussion topic = 10 minutes
• Crossword quiz = 10 minutes

Week 2

Central Nervous System Toxins

• Detailed discussion of the toxins that commonly affect the central nervous system, including recreational drugs, human medications, organic toxins, household and environmental concerns
• We will look at decontamination of these patients as well as effective nursing care and monitoring for the patient with severe CNS depression associated with intoxication
• Discuss when an antidote may be indicated and the systemic effects we can see associated with CNS intoxications

Learning objectives
After completion of this week, participants should be able to:

• Understand the effects of the main toxins affecting the CNS
• Consider how to provide emergency treatment for these patients and also develop a plan for longer term care
• Discuss whether decontamination is appropriate for patients when the CNS is depressed
• Understand the complications and challenges we may encounter

Learning materials this week:
(released on Monday morning for on demand learning until the course ends – approximate timings)

• Pre-recorded tutorial with Kath = 75 minutes
• Further reading = 60 minutes
• Written task (clinical case nursing plan) = 60 minutes
• Multiple choice quiz = 10 minutes

Week 3

Renal System Toxins

• Discuss toxins that affect the patient’s renal system, including ethylene glycol, NSAID ingestion, baclofen and raisins / grapes
• Consider how we can identify a patient with acute kidney injury due to a toxin and the treatment options available, including peritoneal dialysis and haemodialysis
• Nursing care for these patients is intensive and a focus on fluid balance and electrolyte status is vital, so this will be covered in detail

Learning objectives
After completion of this week, participants should be able to:

• Understand the different toxins that affect the renal system and how we can approach nursing and monitoring these patients
• Consider approaches to acid-base stabilisation and electrolyte abnormality management
• Understand why volume overload occurs, and how we monitor, prevent and manage this condition

Learning materials this week:
(released on Monday morning for on demand learning until the course ends – approximate timings)

• Pre-recorded tutorial with Kath = 85 minutes
• Further reading = 60 minutes
• Forum discussion topic = 10 minutes
• Crossword quiz = 10 minutes

Week 4

Hepatic, Cardiac and Respiratory System Toxins

• Round up of other common toxins including those affecting the hepatic, cardiovascular and respiratory systems and other miscellaneous agents. We will look at identifying these patients, common sources of intoxication and approaches to management
• Review of the process of gastric lavage and contraindications associated with this method of contamination
• Specific concerns associated with other toxins, including xylitol, baclofen, beta blockers, paracetamol, garlic and onions

Learning objectives
After completion of this week, participants should be able to:

• Discuss appropriate treatment options and interventions for the mentioned toxins
• Confidently provide nursing care and monitoring for these patients
• Discuss gastric lavage and when it may not be appropriate
• Appreciate the long term effects these toxins may or may not have on our patients