Serotonin toxicity: cool the heat, follow the clonus
Educational use only. Not clinically reviewed37-year-old woman for calm interaction, hyperthermia, clonus, airway-risk, rescue-boundary, reassessment, and handoff practice. About 6 simulated minutes.
What you will practise
- Reconcile agents, clock, mental, autonomic, neuromuscular, temperature, and whole-patient findings.
- Recognize the coupled serotonergic pattern without Hunter-, clonus-, temperature-, or medication-list-only closure.
- Activate resuscitation, cooling, airway, toxicology, monitoring, and compassionate safety ownership.
- Review supplied CNS, autonomic, neuromuscular, temperature, ECG, renal, CK, and differential evidence.
- Record bounded qualified source, cooling, support, sedation, surveillance, airway, and rescue intent, then review a strict later report.
- Hand off rebound hyperthermia, clonus, rigidity, seizure, rhabdomyolysis, coingestion, airway, and active risk.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Dunkley EJC et al. The Hunter Serotonin Toxicity Criteria. QJM. 2003;96(9):635-642. PMID 12925718.
- US National Library of Medicine. DailyMed: linezolid tablets prescribing information, Section 5.3. Updated 2026-07-09.
- American Heart Association. 2025 Guidelines for CPR and ECC. Part 10, Section 16.2.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.