The Toxiscape Hunt: An Escape Room-Scavenger Hunt for Toxicology Education

• Main Authors: Megan Boysen-Osborn, Sara Paradise, Jeffrey R Suchard
• Format: Article
• Language: English
• Published: eScholarship Publishing, University of California 2018-01-01
• Series: Journal of Education and Teaching in Emergency Medicine
• Subjects: Toxicology; small-group activity; team-building exercise; acetaminophen overdose; N-acetylcysteine; overdose; toxicology; anion gap; osmolal gap; toxic alcohols; ethylene glycol; fomepizole; poisonous plants; poisonous animals; mushroom toxicity; hemodialysis in the poisoned patient; tricyclic antidepressant overdose
• Online Access: http://jetem.org/toxiscape/

Audience: This scavenger hunt/escape room is a didactic activity for emergency medicine residents or fourth-year medical students rotating in emergency medicine. Introduction: Between 2008-2011, 1.1 million patients presented to U.S. emergency departments each year for poisonings,1 including acute ingestions, envenomations, occupational exposures, and overdoses. Toxicologic exposures are considered part of the core curriculum for emergency medicine (EM) residents, who must understand the presentation and treatment of such patients.2 Educating residents in a unique, engaging format such as an “escape room” activity provides an alternative to the didactic format of teaching this material, which may build medical knowledge and team rapport amongst residents.3 Objectives: By the end of the activity, learners should be able to: Calculate an anion and osmolal gap. Recognize poisonings amenable to hemodialysis. Interpret EKG changes related to a variety of ingestions, including beta-blockers and calcium channel blockers, digitalis, and tricyclic antidepressants. Recognize poisonous plants and their clinical toxidromes. Calculate loading dose of N-acetylcysteine as antidote for acute acetaminophen ingestion. Collaborate as a team to arrive at solutions of problems. Recognize poisons that have available antidotes Know the clinical effect of various types of snake envenomations. Recognize the toxicity associated with at least four household chemicals. Know the antidotes for six common poisonings. Methods: This didactic exercise is a small group activity, utilizing puzzles to apply toxicology knowledge.