An empty bottle of mother’s amitriptyline. Unconscious, hot and dry, wide pupils — and a QRS of one hundred fifty. Looks anticholinergic; dies sodium-channel. This Atlas edition walks the classic exam emergency: the lethality ladder (dosulepin to SSRI), the three killers, the ECG as prognosis (QRS one hundred, one-sixty, and the tall R in aVR — the only independent predictor), sodium bicarbonate’s two engines with the seven-forty-five to seven-fifty-five target, the forbidden syringes (phenytoin, class one A and C, flumazenil, physostigmine), lipid rescue, and the six-hour rule that ends ever…
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