Episode 42

Toxicologist vs The internet (#12) with Dr. Joe Kennedy MD

In this episode of The Poison Lab, host Ryan Feldman is joined by Dr. Joe Kennedy, medical toxicologist at the University of Vermont and consultant for the Northern New England Poison Center. Together they work through real poisoning cases to sharpen toxic differentials, sum up practical resuscitation priorities, and connect first-principles pharmacology to bedside decisions. They also answer listener questions on THAM vs bicarbonate, when to dialyze even with “normal” kidneys, and why rattlesnake antivenom costs so much—plus the real-world logistics of sourcing exotic antivenoms in the U.S.

Dr. Kennedy and Ryan discuss the topics below. Looking for timestamps? Join the subscribed feed!

Case set #1: Shock with hyperglycemia, big pupils, and probably NOT what you think it is.
Case set #2: Massive bleeding after gas-station “herbal” products
Case set #3: Refractory wide-complex rhythms in a teen overdose
Case set #4: Sudden collapse at a hog farm- (SPOLIER) Recent outbreak of deaths as related to case 4

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Listener Q&A

THAM vs bicarbonate (closed vs open buffering; “breathe for bicarb, tinkle for THAM”)
Why dialyze if the kidneys work? (EXTRIP-style thinking, gradients, and properties)
Snake antivenom pricing & how zoos help hospitals obtain non-U.S. antivenoms

Call outs from the show