Mushroom poisoning

Use latency to triage: • <6 h: usually GI-only (Russula, Boletus, Amanita muscaria muscarinic, hallucinogenic Psilocybe). Generally lower risk — but does NOT exclude later amatoxin (mixed ingestions reset the clock). • 6–24 h: amatoxin (Amanita phalloides, virosa, verna; Galerina; Lepiota) — life-threatening. • 24 h–14 days: orellanine (Cortinarius — renal failure 1–3 weeks); gyromitrin (Gyromitra esculenta — hepato-CNS). ABCDE; bloods: FBC, U&E, creatinine, LFTs (ALT, ALP, bilirubin), INR, glucose, lactate, paracetamol/salicylate, VBG. Attempt to identify mushroom: photograph cap, gills, stem, base, habitat; preserve any uneaten mushroom or vomitus for mycologist (RBG Kew or local mycological society). Multiple species per ingestion is common — assume amatoxin if any uncertainty.