Illustrative Case: a 48-year-old man with chief complaint of dizziness. Additional complaints include perioral paresthesias, nausea, vomiting, generalized fatigue, and a possible syncopal episode. He seems confused and cannot add much history, but his family states that he may have ingested something he purchased from the internet.

Initial vitals include HR 33, BP 80/65, Oxygen saturation 98% on RA, temperature 36.7.