Beta Blocker Toxicity

44 y/o male presents to ER following ingestion of an entire bottle of metoprolol. Patient declines, requiring multiple management and decontamination strategies.

  • Donavan MacDonald, Daniel Ovakim    
  • Mateo Orrantia   
  • Oct. 5, 2022, 4:48 p.m.   

  • Critical Care, Toxicology   
  • Physicians, Nurses   
  • Airway Equip., Manakin - LF, Manakin - HF, Rhythm Box   

  • 4   
  • 40 - 60 Min   
  • Rural Hospital   

  • PRACTISS Verified   
Beta Blocker Toxicity

A 44-year-old male presents to the emergency department following the ingestion of an entire bottle of metoprolol. Decontamination strategies should be utilized alongside consultation with poison control. Patient clinically deteriorates as the drug reaches peak effects, requiring IVF, atropine, glucagon, multi-dose vasopressors, high dose insulin, and a discussion around potential salvage therapies.

Goals and Learning Objectives
Technical/Equipment Recommendations
Supporting Roles and Scripts - OPTIONAL (Information can be provided by Facilitator)
Moulage and Scenario Set-Up
Printable Supporting Documents (Will also be accessible at relevant Scenario Stage)

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Original Author: Donovan MacDonald, Daniel Ovakim
Date: April 2020
Originally published on: 
EM Sim Cases
Most Recent Modification: July 2021
Modified by: Mateo Orrantia