![]() The triage nurse should follow protocols for patients suspected of poisoning and have them admitted right away. The management of thallium toxicity is by an interprofessional team that includes an emergency provider, poison control, internist, neurologist, nurse practitioners, and intensivist. Though similar to the tin when isolated, thallium discolors when exposed to air. Thallium is a gray post-transition metal that is not found in free nature. Exercise or drugs used to vasodilate normal coronary arteries cause alteration of circulating blood, leading to a reduction of coronary blood circulation (coronary steal syndrome). ![]() Scintigraphy using thallium evaluates blood supply to tissue thallium uptake. This type of thallium is more than 4000 times less potent. Before the use of technetium-99m for nuclear medicine studies, thallium-201, a radioactive isotope, was the mainstay and is still used for stress tests evaluating coronary artery disease. ![]() Similar thallium salts were once used to treat dermatophytosis. Due to thallium being tasteless, odorless, and water-soluble, accidental and criminal intoxication has been reported. Thallium is readily absorbed through the skin as well as during inhalation. Levels of 15 mg/m^3 are considered immediately dangerous to one’s health. The occupational limit for thallium exposure is 0.1 mg/m^3 to the skin for eight hours a day. Thallium sulfate was once used as an ant and rat poison. Thallium, a chemical element with the symbol TI, has an atomic number 81 on the periodic table.
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