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Medical Toxicology

The toxicology group consists of five Weill Cornell faculty members who are board certified in both Emergency Medicine and Medical Toxicology: Neal Flomenbaum, Brenna Farmer, Joseph Rella, Zhanna Livshits, and Rama B. Rao, who directs the toxicology service.

Patient Care

The Division of Emergency Medicine, Medical Toxicology Service offers bedside and telephone consultations throughout the hospital for all acutely ill or potentially poisoned patients, and to those patients experiencing the effects of acute or chronic overdoses, withdrawal syndromes, medication errors, adverse drug reactions, chemical exposures, and exposure to drugs of abuse. Since its inception in October of 2009, the toxicology service consults on between 300 and 400 patients a year. We serve the general medical and pediatric floors, psychiatry as well as several critical care units including burn, cardiac, medical, pediatric, surgical, and neuroscience intensive care units.

Geriatrics Team

In addition to a commitment to patient care, the medical toxicology service is dedicated to enhancing patient safety throughout the institution, collaborating with nurses and clinical pharmacists to create safer drug ordering and administration.

We also analyze adverse events for the emergency department and represent the ED on hospital committees such as Medication Safety, Adverse Events, Sub-committee on Critical Care Medicine, Formulary and Therapeutics, and Workforce Health and Safety. Nationally, Dr. Farmer currently serves as chair of the American College of Medical Toxicology Subcommittee on Pharmacy and Therapeutics, and Dr. Rao serves on the Medical Toxicology Sub-board for the American Board of Emergency Medicine.

Academics

All members of the toxicology service contribute to peer review publications and textbook chapters, serve as reviewers for national and international journals in toxicology and emergency medicine, and speakers at regional and national meetings. Lectures in medical toxicology are also offered regularly throughout the institution across specialties.

Members of the toxicology service have presented abstracts at the North American Congress of Clinical Toxicology, American College of Medical Toxicology and the annual meeting of the European Association of Poison Control Centers. Collaborations with faculty and house-staff throughout the hospital are encouraged.

Several members of the medical toxicology service are engaged in active research protocols and academic projects, often with emergency medicine residents, and residents across specialties.

Resident Experience

Emergency medicine residents can access the medical toxicology service for bedside teaching and consultation, academic mentorship, and research opportunities. EM residents rotate at the New York City Poison Control Center (NYCPCC) as juniors where they will learn a basic approach to the poisoned patient through case-based interactive learning and journal club. Senior residents in EM and other specialties can also enjoy a tailored rotation with the NYPH medical toxicology service for bedside clinical experience and didactics by contacting J. Prosser, who directs the rotation.

Philosophy and Collaboration with the New York City Poison Center

Our service works closely with the New York City Poison Control Center (NYCPCC), and all of our consultations are confidentially reported there as required by New York City law. Our faculty collaborates with NYCPCC faculty and fellows regularly in research, publications, resident rotations, and participation in various educational programs and academic meetings. We strongly support the public health efforts of poison control centers and encourage reporting of cases. Centralization of reporting readily identifies clusters of toxicological illness for prompt harm-reduction efforts. In addition, poison centers help families decide which pediatric exposures need emergent medical attention and which can be managed at safely at home. For more information about poison control centers, please see aapcc.org for the American Association of Poison Control Centers. To be connected to the nearest poison control center serving your phone's area code, please call 1-800-222-1222.

Contacts

Director, Rama B. Rao rar2023@med.cornell.edu
Bedside Elective Rotation for Seniors (requires approval): Zhanna Livshits, zhl9006@med.cornell.edu

For information regarding medical toxicology fellowships across the country, please see the resident and fellow links at the American College of Medical Toxicology or the American Association of Clinical Toxicologists

 
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