Tag: Zeff Koutsogiannis

Toxicology with Zeff

Thanks to local legend Dr Zeff Koutsogiannis who gave two presentations related to toxicology.

UPDATE 26/9/17: Thanks to Dr Neil Long FACEM for providing audio for these talks

Murder she wrote (or toxicology and the blood gas)




Masterchef (or cardiovascular toxicity in the poisoned patient)



Slides only versions:

Murder,she wrote (Western teaching)


Cardiovascular Toxicity in thepoisoned patient (Western teaching)

Winter’s Wrap 15/2/17 – Toxicology with Zeff

A great turnout for the first Footscray session!

A massive thanks to Dr Zeff Koutsogiannis for enlightening us on the usefulness of ABGs and cardiotoxic drug ingestions.



6 easy steps

1-2-3-4 rule

causes of metabolic acidosis – CAT MUDPILES (you fill it in!)

osmolar gap – make sure osmolality and UEC are requested at the same time

lactate gap  – compare the lab lactate measurement with blood gas machine measurement, consider “glycolate” a metabolite of ethylene glycol



SALT              NaBicarb – give as a bolus in TCA OD (not an infusion)

SUGAR          High dose insulin-dextrose to improve pump function in BB and CCB OD

COLOUR       Methylene blue for profound hypotension despite fluid, available from theatre 1-2ml/kg/hr

FAT                Intralipid only for LA injection with CVS toxicity


QT measurement – 3 limb leads, 3 V leads, take the MEDIAN measurement then plot on QT nomogram to determine likelihood of developing torsades


TAPNA  Australasia Toxicology Network Scientific Meeting April 27-29, 2017