Environmental & Disaster Preparedness | 2026 Total Tox

Environmental & Disaster Preparedness | 2026 Total Tox

Includes a Live Web Event on 12/10/2026 at 8:40 AM (EST)

  • Register
    • Non-member - Tier I - $300
    • Non-member - Tier II - $150
    • Non-member - Tier III - $125
    • Non-member - Tier IV - $100
    • Member - Tier I - $275
    • Member - Tier II - $125
    • Member - Tier III - $100
    • Member - Tier IV - $75

#TotalTox2026

Join us for the next live, virtual session of the Total Tox Course, Environmental & Disaster Preparedness.

Our third day turns the focus outward to Environmental and Disaster Preparedness, providing an essential roadmap for managing critical exposures found in nature, the home, and large-scale emergency scenarios. Attendees will develop their understanding of clinical management of marine, arthropod, and reptile envenomations alongside toxic flora and common household or garage chemical hazards. The curriculum contrasts the complex presentations of heavy metal toxicities, pulmonary irritants, and lethal asphyxiants like carbon monoxide and mitochondrial poisons, offering clear guidelines on advanced interventions such as hyperbaric oxygen and chelation therapy. Finally, dynamic expert panels and deep dives into disaster medicine will equip you with the triage strategies and treatment strategies necessary to rapidly manage casualties from radiation events, nerve agents, and chemical or biological terrorism. 


Learner Objectives

After attending the event, participants should be able to:

  • Evaluate clinical presentation and management protocols for environmental, envenomation, and heavy metal toxicities.
  • Formulate critical interventions for acute asphyxiant, pulmonary irritant, and chemical exposures. 
  • Develop medical preparedness and response strategies for large-scale chemical, biological, and radiological disasters.

Questions?

Please write to ACMT at events@acmt.net

Agenda | Total Tox Day 3 - December 10, 2026


8:50 - 9:00 AM ET | Opening Remarks


9:00 - 9:30 AM ET
Don't Touch That! Marine, Arthropod & Reptile Envenomations
Michael Levine, MD, FACMT, Associate Professor of Emergency Medicine, University of California Los Angeles, Los Angeles, CA

Dr. Levine will kick things off by identifying common envenomations and their management options.


9:30 - 10:00 AM ET
The Toxic Yard
Fiona Garlich Horner, MD, Head of Toxicology & Assistant Professor of Clinical Emergency Medicine, LAC+USC Medical Center & University of Southern California Keck School of Medicine, Los Angeles, CA

Step outside in the garden with Dr. Garlich Horner. She will distinguish different classes of plant derived toxins and their effects on humans. She also identifies hazards of different mushrooms and clinical toxidromes associated with mushrooms.


10:00 - 10:30 AM ET
The Toxic Garage
Andrew King, MD, Associate Professor in the Department of Emergency Medicine & Medical Director, Wayne State University School of Medicine & Michigan Poison and Drug Information Center, Detroit, MI

Join Dr. King in the the garage to discuss common toxins and exposures of chemicals and review the toxicity and management of chemicals and other substances typically found in the garage.


10:30 - 11:00 AM ET
Heavy Metals: Lead, Arsenic & Mercury
Evan Schwarz, MD, FACMT, FASAM, FACEP, Medical Toxicology Fellowship Director, University of California, Los Angeles, Los Angeles, CA

Dr. Schwarz will review the signs and symptoms of lead toxicity, forms of mercury, and the role of chelation in heavy metal toxicity.


11:00 - 11:30 AM ET | Break (30 min)


11:30 - 12:00 PM ET
I Can't Breathe! Pulmonary Irritants & Simple Asphyxiants
Charles McKay, MD, FACMT, Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT

Dr. McKay will describe the clinical presentation and the role of water solubility in the clinical presentation of pulmonary irritants. He also identifies the primary treatment for simple asphyxiant exposure.


12:00 - 12:30 PM ET
Case Panel - It Came From Outdoors!

More information coming soon!


12:30 - 1:00 PM ET
Chemical Suicide & Mitochondrial Asphyxiants
More information coming soon!

More information coming soon!


1:00 - 1:30 PM ET
Carbon Monoxide Poisoning: High Flow Oxygen or the Hyperbaric Chamber?
Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT, Medical Director, National Capital Poison Center & MedStar Georgetown University Hospital, Washington, DC

Dr. Johnson-Arbor will review the common sources for carbon monoxide poisoning and discusses pharmacokinetics and pathophysiciology of carbon monoxide poisoning.


1:30 - 2:00 PM ET
Disaster Preparedness #1: Radiation Events
Joseph K. Maddry, Lt Col, USAF, MC, FS, MD, FACMT Deputy Commander, Department of Emergency Medicine, US Army Institute of Surgical Research, Houston, TX

Dr. Maddry will discuss the diagnosis and management of radiation casualties and radiation mass casualty events. He will also identify different types of radiation and describe the consequences of exposure to radiation.


2:00 - 2:30 PM ET | Break (30 min)


2:30 - 3:00 PM ET
Disaster Preparedness #2: Organophosphates & Nerve Agents
Christina Hantsch, MD, FACEP, DFACMT, FAACT Emergency Physician and Medical Toxicologist, Loyola University Chicago Stritch School of Medicine Maywood, IL

Dr. Hantsch will discuss management options for patients with organophosphate insecticide or nerve agent toxicity and explain cholinergic toxidrome. She will list specific organophosphate insecticides and chemical weapon nerve agents.


3:00 - 3:45 PM ET
Disaster Preparedness #3: Other Chemical & Biological Terrorism
Aaron Frey, DO Emergency Medicine Attending Physician and Medical Toxicology Fellow, Richmond Emergency Physicians, Inc. & University of Virginia, Richmond, VA

Dr. Frey will examine the diagnosis and management of casualties resulting from terrorism and mass casualty events and discuss the history of bioterrorism as a tool for warfare. He will explain and evaluate the agents used in bioterrorist events.


3:45 - 4:15 PM ET
Case Panel

More information coming soon!

Aaron Frey, DO

Aaron Frey, DO

Core Faculty & Medical Toxicologist

WellSpan Health at York Hospital

Dr Aaron Frey is an emergency medicine physician and medical toxicologist. He studied government and international studies at Campbell University in North Carolina and Spanish at Middlebury College in Vermont.  He worked as a firefighter, emergency medical technician, and search and rescue diver during his undergraduate career. The experiences he had in those roles are what influenced him to become a physician. His particular interests include hazardous materials and chemical, biological, radiological, and nuclear (CBRN) weapons, remote, austere, and wilderness medicine, and damage control resuscitation. He currently practices emergency medicine and toxicology at the Wellspan York Hospital in York, PA and holds an academic appointment of assistant professor of emergency medicine and medical toxicology at Drexel University College of Medicine.

Fiona Garlich Horner, MD

Fiona Garlich Horner, MD

Head of Toxicology & Assistant Professor of Clinical Emergency Medicine

LAC+USC Medical Center & University of Southern California Keck School of Medicine

Dr Fiona Garlich Horner is the Head of Medical Toxicology at Los Angeles County + University of Southern California (LAC+USC) Medical Center, and an Assistant Professor of Clinical Emergency Medicine at the University of Southern California Keck School of Medicine. She is a graduate of Oregon Health Sciences University School of Medicine in Portland, Oregon, and completed her residency in Emergency Medicine at Hennepin County Medical Center in Minneapolis, Minnesota. After completing a fellowship in Medical Toxicology at New York University and the New York City Poison Control Center, she served as an attending emergency physician and medical toxicologist with the Poison and Drug Information Service (PADIS) in Calgary, Alberta, Canada. 

Dr. Garlich is now an attending emergency physician and medical toxicologist at LAC+USC Medical Center in Los Angeles, California, one of the largest and busiest public hospitals in the United States. She is the director of the inpatient toxicology consultation service and the resident toxicology rotation, as well as the chair of the hospital’s medication safety committee. Her primary academic interests lie in toxicology education and advancing the care of vulnerable and incarcerated populations.

Christina Hantsch, MD, FACEP, FAACT, DFACMT

Christina Hantsch, MD, FACEP, FAACT, DFACMT

Medical Director, HPlan

UPMC Health Plan

Dr. Hantsch is a graduate of the Honors Program in Medical Education at Northwestern University. She completed an emergency medicine residency, including a year as chief resident, at the Medical College of Wisconsin and then continued her training in a medical toxicology fellowship at Vanderbilt University. After her fellowship, she spent nearly 22 years at Loyola University Chicago Stritch School of Medicine and Loyola University Medical Center. There, she established an inpatient toxicology clinical service and clinical rotations for graduate medical trainees and students in multiple fields. With an interest in medication management and safety, she joined the hospital Pharmacy and Therapeutics Committee, serving as member for 6 years before being appointed chair and leading the committee for another 6 years. Dr. Hantsch earned the academic rank of Professor of Emergency Medicine, was Director of the Division of Toxicology, and Director of Academic Affairs in the Department of Emergency Medicine. As a clinical faculty member, she was appointed to the Stritch Committee on Academic Rank and Tenure, serving for 7 years including 2 as a subcommittee chair leading revision of the clinician educator track guidelines. In 2018, she was the founding Program Director of the Loyola emergency medicine residency. Dr. Hantsch served for more than 8 years as Medical Director of the Illinois Poison Center. In addition, she is a regular organizer and contributor to many local, regional, and national/international continuing education programs. After leaving academics, she worked for the U.S. FDA in pharmacovigilance for a year. As of 2022, she is board certified in addiction medicine in addition to emergency medicine and medical toxicology. Dr. Hantsch was elected to the ACMT Board of Directors in 2021, is a member of the Education Committee, and chair of the Practice Committee.

Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT

Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT

Medical Toxicology Physician and Medical Director of Hyperbaric Medicine

MedStar Georgetown University Hospital

Dr. Kelly Johnson-Arbor is a medical toxicology and hyperbaric medicine physician at MedStar Georgetown University Hospital. She is triple board-certified in Emergency Medicine, Medical Toxicology, and Undersea and Hyperbaric Medicine. She completed her undergraduate education at Harvard College and earned her medical degree from Loyola University Stritch School of Medicine. She completed a residency in Emergency Medicine at the University of Rochester, followed by a fellowship in Medical Toxicology at the University of Connecticut. From 2018 through 2023, she served as the co-medical director of National Capital Poison Center, and she has provided medical toxicology consultation services to the Connecticut Poison Control Center since 2006. Since 2015, she has served as medical director of hyperbaric medicine at MedStar Georgetown University Hospital, and she also maintains an outpatient medical toxicology clinic at this facility. She is an Assistant Professor of Plastic Surgery and Emergency Medicine at the Georgetown University School of Medicine and serves as an associate faculty member of the MedStar Institute for Quality and Safety. 

An avid researcher and writer, Dr. Johnson-Arbor has published numerous articles in peer-reviewed medical journals including New England Journal of Medicine, JAMA Internal Medicine, and Annals of Emergency Medicine. She enjoys teaching toxicology principles and hyperbaric medicine to the public as well as medical professionals. Her work as both a hyperbaric medicine and medical toxicology physician has allowed her to gain unique perspectives on the diagnosis and treatment of acute and chronic carbon monoxide poisoning as well as their long-term complications.

Andrew King, MD

Andrew King, MD

Associate Professor in the Department of Emergency Medicine & Medical Director

Wayne State University School of Medicine & Michigan Poison and Drug Information Center

Dr. King is an Emergency medicine physician, Medical Toxicologist and Addiction Medicine specialist at the Detroit Medical Center and Wayne State University. He works as an emergency physician at Sinai Grace and Detroit Receiving Hospitals. He additionally works at the Tolan Park Research Center where he sees patients with substance use disorders. He is the interim director of the Michigan Poison and Drug Information Center and the Fellowship Director of the Medical Toxicology Fellowship. He is excited to be an organizer and presenter at the Total Tox Course!

Michael Levine, MD, FACMT

Michael Levine, MD, FACMT

Co-Division Chief of Medical Toxicology

University of California, Los Angeles

Michael Levine is a Los Angeles native, who completed his emergency medicine residency at the Harvard Affiliated Emergency Medicine program, based out of Brigham and Women’s Hospital and Massachusetts General Hospital. After residency, he completed his medical toxicology fellowship at Banner Good Samaritan Medical Center in Phoenix, AZ. After staying as faculty for a year in Phoenix, he moved back to Los Angeles, where he joined the faculty at USC. He is currently the division chief of medical toxicology. He is actively involved in patient care, research, and serves on numerous hospital and university committees. He is an active member of American College of Emergency Physicians, the American College of Medical Toxicology, and is a member of the Toxicology Investigator's Consortium.

Joseph K. Maddry, Lt Col, USAF, MC, FS, MD, FACMT

Joseph K. Maddry, Lt Col, USAF, MC, FS, MD, FACMT

Deputy Commander

Department of Emergency Medicine, US Army Institute of Surgical Research

Lt Col Maddry earned his Bachelor’s Degree from the US Air Force Academy in 2001 as a Distinguished Graduate. His first assignment was as Officer in Charge of Bioenvironmental Engineering at Minot Air Force Base, North Dakota. During his tenure, he led his unit’s response to the largest anhydrous ammonia spill in U.S. history. He then attended medical school at the Uniformed Services University, earning Alpha Omega Alpha membership honors. He completed his emergency medicine residency at SAUSHEC and his medical toxicology fellowship at the Rocky Mountain Poison and Drug Center in Denver, Colorado.

Following fellowship, Lt Col Maddry returned to Brooke Army Medical Center as an emergency physician and medical toxicologist. He served as Chief of the BAMC Simulation Center from 2014 to 2015.  Subsequently, he served as Director of the US Air Force En route Care Research Center (ECRC) from 2015 to 2020. In this position, he oversaw 20 personnel and a $14.8 million research portfolio. He is an author of over 100 peer reviewed publications and 150 research presentations and has been awarded over $28 million in research grants. The Society of Academic Emergency Medicine recognized Dr. Maddry’s research as one of the best publications of 2014. Lt Col Maddry was awarded the Defense Health Board Early Career Investigator Award, the 2017 USAF Outstanding Achievement in Clinical Research award and the 2018 Military Health System Research Symposium Small Team Research Accomplishment Award for Excellence. 

Lt Col Joseph Maddry is currently the Deputy Commander of the US Army Institute of Surgical Research, overseeing over 700 personnel focused on optimizing combat casualty care. Dr. Maddry also serves as Director of Medical Toxicology at Brooke Army Medical Center and as the Director of the Clinical Resuscitation, Emergency Sciences, Toxicology, and Triage (CREST2) Research Program. He leads the development of the next generation of military researchers by serving as the Director of the SAUSHEC Military Emergency Medicine Research Fellowship and as Director of the Clinician Scientist Investigator Opportunity Network (CSION). 

He is an Associate Professor of Emergency Medicine with the Uniformed Services University and has academic appointments at the University of Texas Health, Texas A&M, and the University of Colorado Denver. Lt Col Maddry has served in Afghanistan, Iraq, Haiti, Japan and Burkina Faso.

Charles McKay, MD, FACMT

Charles McKay, MD, FACMT

Associate Clinical Professor

University of Connecticut School of Medicine

Dr. McKay was trained in Anatomic and Surgical Pathology, Internal Medicine, Emergency Medicine, Medical Toxicology and was a Medical Director of Occupational Health and Medical Review Officer for a hospital system during more than 30 years of clinical practice, during which he provided toxicology consultation at 3 hospitals, directed a medical toxicology fellowship training program, and provided medical oversight of a regional poison control center. He provides medical legal consultation across the country on toxicology-related issues, and has testified in nearly 100 cases, many related to questions of alcohol- and drug-induced impairment.

Evan Schwarz, MD, FACMT

Evan Schwarz, MD, FACMT

Clinical Professor of Emergency Medicine

University of California, Los Angeles

Dr. Evan Schwarz attended medical school at the University of Texas Medical Branch in Galveston, Texas, before completing a residency in Emergency Medicine at the Washington University School of Medicine in Saint Louis, Missouri.  After residency, he completed a fellowship in Medical Toxicology at the University of Texas Southwestern School of Medicine in Dallas, Texas, before returning to Missouri where he was an Advisory Dean and the Medical Toxicology Division Chief and Fellowship Director at Washington University. In 2023, he took a position in the Department of Emergency Medicine at the University of California Los Angeles.

Registration Rates

Registration includes:

  • Access to the live virtual event on December 10, 2026
  • Access to the on-demand recording for 90 days after the event
  • Access to the Speaker slides
  • 6.75 Continuing Education Certificate. Available credits: Continuing Medical Education (CME), Continuing Nursing Education (CNE), Continuing Pharmacy Education (CPE), Continuing Medical Education for Physician Associates (AAPA CME), and Continuing Education for Nurse Practitioners (AANP CE).

Member Rates


     Member Tier I: Full, Affiliate, International, Emeritus


     $275


     Member Tier II: Fellows


     $125


     Member Tier III: Residents, International - Developing Country


     $100


     Member IV: Medical Students


     $75

Non-Member Rates


     Non-member Tier I: Physicians, Pharmacists, Lawyers, "Other"


     $300


     Non-member Tier II: Fellows, SPIs, Nurses, etc.


     $150


     Non-member Tier III: Educators & Emergency Responders


     $125


     Non-member IV: Residents & Students


     $100


ACMT Membership

ACMT Members receive a discounted rate. Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership


Package Rates

Sign up for the all four days of the 2026 ACMT Total Tox Course and save $150!

Interested in two days? Add two courses directly to your cart and receive an automatic $50 discount!

Purchase the package here!


Refunds and Cancellations

  • Cancellations made 15 days or more in advance of the event date will receive a full refund less a 8% processing fee.
  • Cancellations made within 14 days of the event date will not receive a refund.

All cancellation requests must be made in writing and emailed to: events@acmt.net. No telephone cancellations will be accepted. A refund that results from a cancellation or change to your registration will be returned to the original payer and in the original method of payment. 

Pending review, limited exceptions will be made based on need and circumstance (family emergency, for example) and must be submitted in writing to events@acmt.net. For these instances, the full registration fee, minus a 8% processing fee, will be refunded. Because each exception must undergo a review and approval process, we ask in advance for your patience.


Questions?

For any questions, please email us at events@acmt.net.

Instructions

Once you have completed your registration:

  1. Click on the Contents tab on the day of live event. This is where you will be able view the Zoom link for the course as well as all required components.
  2. Complete the Pre-Test. For best the best learning experience, please complete this before the live event on December 10, 2026.
  3. Watch live event. You can use the Zoom link in the Learning Center to leave and enter the webinar during event.
  4. Complete the Post-Test. These questions are based on content from the lectures to gauge your comprehension of the lectures. It requires a 70% to pass.
  5. Complete the Event CE Survey. If you are completing CE, this survey is required.
  6. Claim your CE certificate. Once you have claimed your CE credit, you will not be able to change your CE certificate.

Full credit can only be claimed after completion of all required components.


Hardware/Software Requirements

Computer or Other Internet-Enabled Device; Internet Connection; Browser. 

Materials

None. 

Prerequisites

None. 

Format

This event is a live Webinar with CME, CNE, CPE, AAPA CME, and AANP CE.


Need Assistance or Have Questions?

For assistance logging in, accessing content, purchasing or completing Continuing Education credits, or for other questions, please contact us at events@acmt.net or visit our FAQ page.

If you are in need of accessible learning accommodations, please contact events@acmt.net for additional assistance.

Continuing Education

Continuing Education credit for this activity is provided by AKH Inc., Advancing Knowledge in Healthcare. The activity is pending approval, and registrants will be able to claim up 6.75 Continuing education credit per activity. 

Continuing Education available for
Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners.

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This content will not be available until 12/07/2026 at 9:00 AM (EST)