Nicholas Benton Hurst

Interests

Research

Rattlesnake envenomationCare of the acutely poisoned patient

Teaching

Rattlesnake envenomationScorpion envenomation

Courses

Scholarly Contributions

Books

• Walter, F. G., Gaither, J. B., Ori, M. R., French, R., Hurst, N., Rice, A. M., Rice, A. M., Hurst, N., Ori, M. R., French, R., Gaither, J. B., & Walter, F. G. (2016). Advanced Hazmat Life Support for Tox-Medics, ed 1.. Tucson, Arizona: The University of Arizona, Arizona Board of Regents.

Chapters

• Shirazi, F., Shirazi, F., Hurst, N., Sloan, C. T., Karpen, S. R., Karpen, S. R., French, R., French, R., French, R., Karpen, S. R., Sloan, C. T., Sloan, C. T., Hurst, N., Hurst, N., & Shirazi, F. (2016). Critical Care Pharmacotherapy. In American College of Clinical Pharmacology(pp 781-792). Chapter 38, Medication Withdrawal in the Intensive Care Unit: American College of Clinical Pharmacy.
• Hurst, N., & Jones, A. L. (2015). Pediatric UTI. In EMRA Emergency Medicine's Top Pediatric Clinical Problems. Irving, TX.

Journals/Publications

• Edwards, C. J., Ng, V., Hurst, N. B., Contreas, J., & Shirazi, F. (2022). Pharmacy Calls for Prescription Clarification at an Academic Emergency Department. Journal of Emergency Medicine, 62(6), 783-788. doi:10.1016/j.jemermed.2022.01.005
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  Approximately 14.75 hours spent on project for 2020, manuscript preparation and review Approximately 2 hours spent on project for 2021, manuscript preparation and review
• Pacheco, G. S., Leetch, A. N., Patanwala, A. E., Hurst, N. B., Mendelson, J. S., & Sakles, J. C. (2022). The Pediatric Rigid Stylet Improves First-Pass Success Compared With the Standard Malleable Stylet and Tracheal Tube Introducer in a Simulated Pediatric Emergency Intubation. Pediatric emergency care.
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  Pediatric emergency intubation is a high-acuity, low-occurrence procedure. Despite advances in technology, the success of this procedure remains low and adverse events are very high. Prospective observational studies in children have demonstrated improved success with the use of video laryngoscopy (VL) compared with direct laryngoscopy, although reported first-pass success (FPS) rates are lower than that reported for adults. This may in part be due to difficulty directing the tracheal tube to the laryngeal inlet considering the cephalad position of the larynx in infants. Using airway adjuncts such as the pediatric rigid stylet (PRS) or a tracheal tube introducer (TTI) may aid with intubation to the cephalad positioned airway when performing VL. The objectives of this study were to assess the FPS and time to intubation when intubating an infant manikin with a standard malleable stylet (SMS) compared with a PRS and TTI.
• Pacheco, G. S., Patanwala, A. E., Leetch, A. N., Mendelson, J. S., Hurst, N. B., & Sakles, J. C. (2022). Intubation During Pediatric Cardiac Arrest in the Emergency Department Is Associated With Reduced First-Pass Success. Pediatric emergency care, 38(5), e1271-e1276.
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  Airway compromise and respiratory failure are leading causes of pediatric cardiac arrest making advanced airway management central to pediatric resuscitation. Previous literature has demonstrated that achieving first-pass success (FPS) is associated with fewer adverse events. In cardiac arrest for adult patients, increasing number of intubation attempts is associated with lower likelihood of return of spontaneous circulation (ROSC) and favorable neurologic outcome. There is limited evidence regarding advanced airway management for pediatric out-of-hospital cardiac arrest (OHCA) in the emergency department (ED). The purpose of this study was to compare FPS in pediatric OHCA and non-cardiac arrest patients in the ED.
• Sakles, J. C., Hurst, N. B., Mendelson, J. S., Leetch, A. N., Patanwala, A. E., & Pacheco, G. (2022). Intubation During Pediatric Cardiac Arrest in the Emergency Department Is Associated With Reduced First-Pass Success. Pediatric Emergency Care.
• Sakles, J. C., Mendelson, J. S., Hurst, N. B., Patanwala, A. E., Leetch, A. N., & Pacheco, G. S. (2022). The pediatric rigid stylet improves first pass success compared to the standard malleable stylet and tracheal tube introducer in a simulated pediatric emergency intubation. Pediatric Emergency Care.
• Sakles, J. C., Sakles, J. C., Mendelson, J. S., Mendelson, J. S., Hurst, N. B., Hurst, N. B., Patanwala, A. E., Patanwala, A. E., Leetch, A. N., Leetch, A. N., Pacheco, G. S., & Pacheco, G. S. (2022). The pediatric rigid stylet improves first pass success compared to the standard malleable stylet and tracheal tube introducer in a simulated pediatric emergency intubation. Pediatric Emergency Care.
• Shirazi, F., Contreas, J., Hurst, N. B., Ng, V., & Edwards, C. J. (2022). Pharmacy Calls for Prescription Clarification at an Academic Emergency Department. Journal of Emergency Medicine.
• Walter, F. G., Appel, J., French, R. N., Williams, A., Solem, C., Groke, S., Stolz, U., Knapp, S., Grossart, E., & Hurst, N. B. (2022). Do Mnemonics Help Healthcare Professionals Learn & Recall Cholinergic Toxidromes?. Clinical Toxicology. doi:10.1080/15563650.2022.2042551
• Pacheco, G. S., Hurst, N. B., Patanwala, A. E., Hypes, C., Mosier, J. M., & Sakles, J. C. (2021). First Pass Success Without Adverse Events Is Reduced Equally with Anatomically Difficult Airways and Physiologically Difficult Airways. The western journal of emergency medicine, 22(2), 360-368.
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  The goal of emergency airway management is first pass success without adverse events (FPS-AE). Anatomically difficult airways are well appreciated to be an obstacle to this goal. However, little is known about the effect of the physiologically difficult airway with regard to FPS-AE. This study evaluates the effects of both anatomically and physiologically difficult airways on FPS-AE in patients undergoing rapid sequence intubation (RSI) in the emergency department (ED).
• Sakles, J. C., Mosier, J. M., Hypes, C., Patanwala, A., Hurst, N. B., & Pacheco, G. (2021). First Pass Success Without Adverse Events is Reduced Equally with Anatomically Difficult Airways and Physiologically Difficult Airways. Western Journal of Emergency Medicine.
• Sakles, J. C., Sakles, J. C., Hurst, N. B., Hurst, N. B., Mendelson, J. S., Mendelson, J. S., Leetch, A. N., Leetch, A. N., Patanwala, A. E., Patanwala, A. E., Pacheco, G., & Pacheco, G. (2021). Intubation During Pediatric Cardiac Arrest in the Emergency Department Is Associated With Reduced First-Pass Success. Pediatric Emergency Care.
• August, J. A., Boesen, K. J., Hurst, N. B., Shirazi, F. M., & Klotz, S. A. (2018). Prophylactic Antibiotics Are Not Needed Following Rattlesnake Bites. The American journal of medicine, 131(11), 1367-1371.
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  Antibiotics are sometimes administered to victims of rattlesnake bites in the hope of preventing infections. Experts in the field recommend that prophylactic antibiotics not be used because secondary infections are rare. Current recommendations are based on a small number of studies conducted in the United States. We decided to reexamine the issue by taking advantage of a large database on snakebites in Arizona. This allowed us to determine how often prophylactic antibiotics were used and whether or not they were effective.
• Hurst, N. B., Boesen, K. J., Basilim, A., & Dudley, S. (2018). Severe rattlesnake envenomation in a patient with impaired lymphatic flow after double mastectomy. CLINICAL TOXICOLOGY, 56(10), 942-943.
• Rinner, G., Watkins, S. A., & Hurst, N. B. (2018). Severe potassium poisoning after intentional ingestion. CLINICAL TOXICOLOGY, 56(10), 1003-1003.
• Alharthi, M., Hurst, N., Boesen, K. J., & Shirazi, M. (2017). Venous thrombosis as a complication of rattlesnake envenomation. CLINICAL TOXICOLOGY, 55(7), 709-709.
• August, J., Hurst, N., Shirazi, F. M., & Boesen, K. J. (2017). Incidence of infection in crotalid snake envenoming reported to a regional poison control center. CLINICAL TOXICOLOGY, 55(7), 729-729.
• Hurst, N. B., Lipe, D. N., Karpen, S. R., Patanwala, A. E., Taylor, A. M., Boesen, K. J., & Shirazi, F. M. (2017). Centruroides sculpturatus envenomation in three adult patients requiring treatment with antivenom. Clinical toxicology (Philadelphia, Pa.), 1-3.
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  Envenomation by Centruroides sculpturatus can manifest with cranial nerve dysfunction and neuromuscular hyperactivity. While these symptoms are most commonly seen in young children, they may also be seen in adults.
• Hurst, N. B., Reilly, J. N., Boesen, K. J., & Shirazi, F. M. (2017). Epidemiology of rattlesnake envenoming reported to an Arizona Poison Center. CLINICAL TOXICOLOGY, 55(5), 492-493.
• Hurst, N. B., Karpen, S. R., French, R. N., Boesen, K. J., & Shirazi, F. M. (2015). ST elevation myocardial infarction following envenomation by North American Crotalus species. CLINICAL TOXICOLOGY, 53(7), 678-679.
• Hurst, N. B., Karpen, S. R., French, R. N., Typpo, K. V., & Walter, F. G. (2015). Use of a real-time continuous glucose monitor in a pediatric sulfonylurea exposure. CLINICAL TOXICOLOGY, 53(7), 695-696.
• Hurst, N. B., Karpen, S. R., Myrtle, C., French, R. N., Boesen, K. J., & Shirazi, F. M. (2015). Prolonged recurrent coagulopathy after North American crotalus envenomation. CLINICAL TOXICOLOGY, 53(7), 676-676.
• Hurst, N., Karpen, S. R., Brillhart, D. B., French, R., Boesen, K. J., & Shirazi, F. (2015). Venous Thrombosis Following Rattlesnake Envenomation. Toxicon.
• Hypes, C., Hoverstadt, P., Lowry, J. S., Hurst, N., & Shirazi, F. (2015). Medical image of the week: fluorescent urine. Southwest Journal of Pulmonary & Critical Care. doi:http://dx.doi.org/10.13175/swjpcc083-15
• Karpen, S. R., Hurst, N. B., & Boesen, K. J. (2015). Three cases of medication error resulting in unintentional human inoculation with equine vaccine. CLINICAL TOXICOLOGY, 53(7), 680-680.
• Karpen, S. R., Hurst, N. B., Plitt, J., Chase, P., & Shirazi, F. M. (2015). Congenital lead poisoning in three siblings from a mother with retained bullet fragments. CLINICAL TOXICOLOGY, 53(7), 743-744.
• Karpen, S., Hurst, N. B., Lipe, D. N., Patanwala, A., Boesen, K. J., & Shirazi, F. M. (2015). Centuroides sculpturatus envenomation in three adult patients requiring treatment with antivenom. CLINICAL TOXICOLOGY, 53(7), 671-672.
• Karpen, S., Moench, J. D., Hurst, N. B., Boesen, K. J., & Shirazi, F. M. (2015). Incidence of delayed and recurrent coagulopathies following rattlesnake envenomation in patients initially treated with rattlesnake antivenom. CLINICAL TOXICOLOGY, 53(7), 680-680.
• Shirazi, F., Shirazi, F., Boesen, K. J., Boesen, K. J., French, R., French, R., Brillhart, D. B., Brillhart, D. B., Karpen, S. R., Karpen, S. R., Hurst, N., Hurst, N., Shirazi, F., Boesen, K. J., French, R., Brillhart, D. B., Karpen, S. R., & Hurst, N. (2015). Venous Thrombosis Following Rattlesnake Envenomation. Toxicon.

Presentations

• Hurst, N. B. (2020, February). ITE Preparation Review. Resident Didactics.
• Hurst, N. (2019, April). CKS: Food Borne Illness - Seafood. Resident Didactics.
• Hurst, N. (2019, January). CKS: Fractures of the Foot. Resident Didactics.
• Hurst, N. B. (2019, February). CKS: Mushrooms & Poisonous Plants. Resident Didactics.
• Hurst, N. (2018, August). Toxicologic Jeopardy. Resident Didactics.
• Hurst, N. (2018, January). Envenomations of the Southwest. Resident Didactics.
• Hurst, N. (2018, November). Envenomations of the Southwest. Resident Didactics.
• Hurst, N. (2017, August). CKS: STI. Resident Didactics.
• Hurst, N. (2015, February). Envenomations of the Southwest. 48th Annual Southwestern Clinical Pharmacy Seminar.
• Hurst, N. (2015, June). Toxicology Update. Arizona Chapter of American College of Emergency Physicians Summer Retreat.
• Hurst, N. (2013, July). Cyanide Poisoning. Arizona Poison and Drug Information Center.
• Hurst, N. (2013, June). Pediatric UTI. Emergency Medicine Education Conference.
• Hurst, N. (2013, September). Rattlesnake Envenomation. Emergency Medicine Education Conference.
• Hurst, N. (2012, June). Colchicine Poisoning. Arizona Poison and Drug Information Center.
• Hurst, N. (2011, September). Herpes Meningitis. Emergency Medicine Case Conference.

Poster Presentations

• Hurst, N. B. (2020, September). Incidence of recurrent and delayed coagulopathies in North American rattlesnake envenomation patients treated with crotalidae polyvalent immune Fab, an update of the Arizona Poison and Drug Information Center experience. NACCT 2020. Virtual: American Academy of Clinical Toxicology.
• Hurst, N. B. (2020, September). Rattlesnake Envenomations Reported to a Southwestern United States Poison Center Analysed by Season, Daily Temperature, and Recent Rainfall. NACCT 2020. Virtual: American Academy of Clinical Toxicology.
• Hurst, N. B., Sakles, J. C., Patanwala, A., Mosier, J. M., Hypes, C., & Pacheco, G. (2019, November). Adverse Events in Patients with Physiologically Difficult and Anatomically Difficult Airways in the Emergency Department.. World Airway Management Meeting. Amsterdam, NE: SAM, EAMS.
• Shirazi, F., Shirazi, F., Hurst, N., Reilly, J. N., Boesen, K. J., Boesen, K. J., Reilly, J. N., Reilly, J. N., Boesen, K. J., Hurst, N., Shirazi, F., & Hurst, N. (2017, May). Epidemiology of rattlesnake envenoming reported to an Arizona Poison Center. 37th International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT). Basel, Switzerland: European Association of Poisons Centres and Clinical Toxicologists (EAPCCT).
• Hurst, N., & Boesen, K. J. (2015, October). Venous Thrombosis Following Rattlesnake Envenomation. IST 2015 World Congress. Oxford, UK: International Society on Toxinology.
• Appel, J., Groke, S., Hurst, N., Solem, C., Williams, A., Stolz, U., French, R., & Walter, F. G. (2013, June). Do Mnemonics Help Healthcare Professionals Learn and Recall Toxic Syndromes for Cholinergic Hazardous Materials?. SAEM National Research Meeting. Atlanta, GA.

Creative Productions

• Hurst, N., & Ng, V. (2015. EMRA Hangouts – Program Director Interview Tucson College of Medicine. Emergency Medicine Residents' AssociationEmergency Medicine Residents' Association. https://vimeo.com/299764271
  More info

  EMRA Hangouts Video describing University Campus residency program for the EMRA Match website.
• Ng, V., & Hurst, N. (2015. EMRA Hangouts– Program Director Interview Tucson College of Medicine. https://vimeo.com/299764271Emergency Medicine Residents' Association. https://vimeo.com/299764271
  More info

  EMRA Hangouts Video describing University Campus residency program for the EMRA Match website.

Other Teaching Materials

• Hurst, N. B., & Dudley, S. (2016. Rattlesnake Bite Simulation Case. ACEP Toxicology Section.