Toxicology from across the pond.

Despite extensive educational and preventive efforts, fatality from poisoning is a growing public health concern. While strategies to reduce fatal unintentional poisoning in children have been largely successful, growing numbers of deaths from suicidality and substance abuse present unique challenges to the public health system. This paper explores three areas where new approaches hope to mitigate major causes of poison-related fatality. Included in this discussion are bystander naloxone for opioid overdose, a reconsideration of the optimal dose of N-acetylcysteine therapy and intravenous fat emulsion (lipid rescue) therapy for cardiovascular toxins. These innovative approaches are designed to challenge dogma and provide a stimulus for individualised clinical care.