Evan S Schwarz, MD

Associate Professor, Emergency Medicine

Education

  • BA: University of Texas at Austin 2001
  • MD: University of Texas Medical Branch at Galveston 2005

Training

  • Residency: Barnes-Jewish Hospital, St. Louis, MO 2009
  • Chief Resident: Barnes-Jewish Hospital, St. Louis, MO 2009
  • Fellowship: Toxicology, University of Texas Southwestern Medical Center, Dallas 2011

Licensure and Board Certification

  • Emergency Medicine
  • Medical Toxicology
  • Addiction Medicine

Honors and Awards

  • Resident board member of the Missouri College of Emergency Physicians, 2007-2008
  • Chief Resident Emergency Medicine Washington University, 2008-2009
  • Missouri State Medical Association Resident Fellow Division councilor, 2008
  • Fellow of the American College of Emergency Physicians, 2012
  • American College of Emergency Physicians Teaching Fellowship, 2014-2015
  • WUSM Academic Medical Leadership Development Program, 2015
  • Advisory Dean in the Office of Student Affairs, 2015- Present
  • Vice president of the Missouri College of Emergency Physicians. 2016-2018
  • Board member of the American College of Medical Toxicology, 2016-present
  • Fellow of the American College of Medical Toxicology, 2017
  • President of the Missouri College of Emergency Physicians, 2018-2020
  • Board of Governors for ACEP’s Pain and Addiction Care in the Emergency Department

Recent Publications

Peer reviewed manuscripts

  1. Schwarz ES, Mullins ME, Brooks CB.  Ciguatera poisoning successfully treated with delayed mannitol.  Ann Emerg Med. 2008 Oct;52(4):476-7.[PMID:18809112]
  2. Schwarz ES, Barra M, Liao MM.  Successful Resuscitation of a Patient in Asystole after a TASER Injury Using a Hypothermia Protocol.  Am J Emerg Med2009;27(4):515.e1-2.[PMID:19555635]
  3. Roth B, Schwarz ES, Feng S, Young AC.  Good Outcomes despite High Urinary Arsenic Concentrations from Overdose with Crab Grass Killer.  J Med Tox 2011.7(2):158-61.[PMID: 21318449]
  4. Forrester M, Schwarz ES, Kleinschmidt KC, Young AC.  Synthetic Cannabinoid Exposures Reported to Texas Poison Centers.  J Addict Dis 2011;30(4):351-358.[PMID:22026527]
  5. Young A, Schwarz E, Genevieve M, Obafemi A, Feng SY, Kane C, Kleinschmidt K.  Cardiotoxicity Associated with the Synthetic Cannabinoid, K9, with Laboratory Confirmation.   Am J Emerg Med 2012;30(7):e5-7.[PMID: 21802885]
  6. Horwitz DA, Schwarz ES, Scott MG, Lewis LM.  Emergency Department Patients with Diabetes Have Better Glycemic Control when They have an Identifiable Primary Care Provider.  Acad Emerg Med 2012;19(6):650-5.[PMID:22632540]
  7. Forrester M, Kleinschmidt KC, Schwarz ES, Young AC.  Synthetic Cannabinoid and Marijuana Exposures Reported to Poison Centers.  Hum Exp Toxicol 2012;31(10):1006-11.[PMID:22859662]
  8. Mullins ME, Schwarz ES.  No need to change treatment of early presenting patients with acetaminophen overdose.  Clin Tox 2012;50(1):78.[PMID:22115058]
  9. Mullins ME, Schwarz ES.  Re: Remien et al. “Mathematical modeling of liver injury and dysfunction after acetaminophen overdose.” Hepatology 2012;56(6):2427-8. [PMID:22806570]
  10. Schwarz ES, Chung WM, Wax PM, et al.  MMWR Morb Mortal Wkly Rep. Sodium azide poisoning at a restaurant – Dallas County, Texas, 2010.  MMWR June 29, 2012;61(25):457-460 [PMID: 22739775]
  11. Young AC, Schwarz ES, Velez LI, Gardner M.  Two cases of disseminated intravascular coagulation due to “bath salts” resulting in fatalities, with laboratory confirmation.  Am J Emerg Med 2013.31(2):445.e3-5. [PMID: 22867829]
  12. Schwarz ES, Mullins ME. Response to: “Introduction of an N-acetylcysteine weight-based dosing chart reduces prescription errors in the treatment of paracetamol poisoning.  Emerg Med Australas. 2013;25(3):285-6. [PMID: 23759054]
  13. Liss DB, Paden MS, Schwarz ES, Mullins ME.  What is the clinical significance of 5-oxoprline (pyroglutamic acid) in high anion gap metabolic acidosis following paracetamol (acetaminophen) exposure?  ClinToxicol (Phila) 2013;51(9):817-27. 2013. [PMID:24111553]
  14. Abdelmalek D, Schwarz ES, Halcomb SE, Sampson C, Arroyo-Plasencia A, McCammon C, Stenger A, Krehbiel N, and Mullins ME.  Life threatening diphenhydramine toxicity presenting with seizures and a wide complex tachycardia improved with intravenous fat emulsion.   Am J Ther 2014.21(6):542-4. [PMID:24096706]
  15. Schwarz ES, Cohn BG.  Is Intravenous Acetylcysteine More Effective than Oral Administration for the Prevention of Hepatotoxicity in Acetaminophen Overdose?  Ann Emerg Med. 2014;63(1):79-80. [PMID: 23927960]
  16. Schwarz ES, Chung WM, Wax PM, Kleinschmidt KC, Sharma K, Cantu G, Spargo E. Multiple Poisonings with Sodium Azide at a Local Restaurant.  J Emerg Med 2014;46(4):491-494. [PMID: 24262061]
  17. Mullins ME, Schwarz ES.  “Krokodil” is an urban legend and not a medical fact.  Am J Med 2014;127(7):e25. [PMID:24970607]
  18. Schwarz ES, Arroyo AM, Mullins ME.  Other Complications Following Lipid Emulsion Therapy. J Med Toxicol 2014;10(2):247-8. [PMID: 24639198]
  19. Schwarz ES, Thoelke M.  Altered Mental Status and Hyperammonenemia after Overdose of Valproic Acid with Therapeutic Valproic Acid Concentrations.  International Journal of Clinical Medicine 2014;5(10)[ID:2100587][DOI:10.4236/ijcm.2014.510075]
  20. Schwarz ES, Cohn BG.  Is Dexamethasone as Effective as Prednisone or Prednisolone in the Management of Pediatric Asthma Exacerbations?  Ann Emerg Med 2015;65(1):81-2.[PMID:24954577]
  21. Mullins ME, Schwarz ES, Dribben W, Halcomb SE, Arroyo-Plasencia A.  Silibinin: Where is the Ethical Conundrum.  Chest 2015;147(3):e105.[PMID:25732452]
  22. Watkins W, Schwarz ES, Arroyo-Plasencia AM, Mullins ME, on behalf of the ToxIC Investigators. The Use of Physostigmine by Toxicologists in Anticholinergic Toxicity. J Med Toxicol 2015;11(2):179-184.[PMID: 25510306]
  23. Mullins M, Liss D, Schwarz E. Comment: severe anaphylactic reaction following Crotalidae Polyvalent Immune Fab (Ovine) administration for copperhead snakebite. Ann Pharmacother 2015;49(4):496.[PMID:25762655]
  24. Schwarz ES, Mullins ME.  Paracetamol: Is all the concern valid.  Ann Rheum Dis 2015;74(8):e48.[PMID:25858642]
  25. Kolinsky D, Schwarz ES.  Are New Oral Anticoagulants Safer Than Vitamin K Antagonists in the Treatment of Venous thromboembolism? Ann Emerg Med 2015;67(6):702-3.[PMID: 26707884]
  26. Kolinsky D, Keim SM, Cohn BG, Schwarz ES, Yealy DM. Is a Prehospital Treat and Release Protocol for Opioid Overdose Safe? Journal of Emergency Medicine 2016.52(1):52-58.[PMID: 27769615]
  27. Mullins ME, Schwarz ES. Commentary on “A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user.” J Am Acad Dermtaol 2016;2(5): 418. [PMID: 27872889]
  28. Connolly SJ, Milling TJ, Eikelboom JW, ANNEXA-4 Investigators. Andexanet Alfa for Acute Major Bleeding Associated with Factor Xa Inhibitors. N Engl J Med 2016;375(12):1131-41. [PMID: 27573206]
  29. Willman MW, Liss DB, Schwarz ES, Mullins ME. Do Heroin Overdose Patients Require Observation after Receiving Naloxone? Clin Tox 2017;55(2): 1-7. [PMID: 27849133]
  30. Willman MW, Liss DB, Schwarz ES, Mullins ME. The authors reply regarding “Do heroin overdose patients require observation after receiving naloxone?” Clin Tox 2017;55(4):2017.[PMID:28152639]
  31. Schwarz ES, Kopec TK, Wiegand TJ, Wax PM, Brent J. Should we be using the poisoning severity score? J Med Toxicol 2017;13(2):135-45.[PMID:28283941]
  32. Dezieck L, Hafez Z, Conicella A, Blohm E, O’Connor MJ, Schwarz ES, Mullins ME. Resolution of cannabis hyperemesis syndrome with topical capsaicin in the emergency department: a case series. Clin Toxicol (Phila) 2017;55(8):908-913.[PMID: 28494183]
  33. Schwarz ES, Mullins ME. When 2 is Not Better Than One. Br J Clin Pharmacol 2017. Accepted for publication.[PMID:28543530]
  34. Farrugia LARhyee SHCalello DPCampleman SLRiederer AMMalashock HRPizon AWiegand TWax PMBrent JToxicology Investigators Consortium Study Group.  The Toxicology Investigators Consortium Case Registry-the 2016 Experience.  J Med Toxicol. 2017. [PMID: 28766237]
  35. Hafez Z, Mullins ME, BLohm E, O’Connor MJ, Dezieck L, Schwarz ES, Conicella A. Cannabinoid hyperemesis syndrome and topical capsaicin: treating smoke with fire?-the authors reply. Clin Toxicol (Phila) 2017;55(8):908-913.[PMID: 287130852]
  36. Thoma B, Sebok-syer SS, Krishnan K, the METRIQ Study Collaborators, et al. Individual Gestalt Is Unreliable for the Evaluation of Quality in Medical Education Blogs: A METRIQ Study. Ann Emerg Med 2017;70(3):394-401.[PMID: 28262317]
  37. Liss DB, Schwarz ES, Mullins ME. Sodium Acetate Infusion for Serum and Urine Alkalinization. Ann Emerg Med 2017;70(4):601-602.[PMID: 28946986]
  38. Liss DB, Phillips TM, Pizon AF, Schwarz ES. Delayed Seizures in Bupropion Overdose with Concomitant Ingestion of Alpha-2 Agonist: A Case Report. Toxicology Communications 2017;1(1). https://doi.org/10.1080/24734306.2017.1364839
  39. Lewis L, Carpenter CR, Schwarz ES, Jotte RS, Waller C, Winograd R, Williams R, Stenger S, Rehder H, Governick S, Giuffra L. The Opioid Crisis in Missouri: A Call to Action for Physicians, Legislators, and Society. MO Medicine 2017;114(6):440-6. [PMID: 30228662]
  40. Mullins ME, Schwarz ES. Safety and Efficacy of Physostigmine: Seeing the Trees from the Forest Plot. Clin Toxicol(Phila) 2018;56(9):868-9. [PMID: 29490506]
  41. Carpenter CR, Lewis L, Jotte R, Schwarz ES. A Bridge to Nowhere? Challenging Outpatient Transitions of Care for Acute Pain Patients in the Opioid Epidemic Area. MO Medicine 2018.[PMID: 30228730]
  42. Karlow N, Schlaepfer CH, Stoll C RT, Doering M, Carpenter CR, Colditz GA, Motov S, Schwarz ES. A Systematic Review and Meta-Analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. Academic Emergency Medicine 2018. In press. [PMID: 30019434]
  43. Kao L, Pizon A, ACMT Fellowship Directors Committee. Medical Toxicology Fellowship Training is Available to Applicants from Many Specialties. J Med Toxicol 2018;14(3):177-178. [PMID: 29785474]
  44. Farrugia LA, Rhysse SH, Campleman SL, Judge B, Kao L, Pizon A, Porter L, Riederer AM, Wiegand T, Calello D, Wax PM, Brent J, Toxicology Investigators Consortium (ToxIC) Study Group. The Toxicology Investigators Consortium Case Registry-the 2017 Annual Report. J Med Toxicol 2018;14(3):182-211. [PMID: 30094774]
  45. Marks LR, Munigala S, Warren DK, Liang SY, Schwarz ES, Durkin MJ. Addition medicine consultations reduce readmission rates for patients with serious infections from opioid use disorder. Clinical Infectious Diseases 2019;68(11):1935-1937.[PMID: 30357363]
  46. Lange J, Gaddis G, Varner E, Schmidt S, Cohen R, Schwarz E. Residents Access to the St. Louis County Prescription Drug Monitoring Program: Why PDMPs Matter and How to Gain Access. MO Medicine 2018; 115(6):487-493.[PMID: 30643325]
  47. Mullins ME, Liss DB, Fishburn SJ, Dribben WH, Schwarz ES. Comments on Chhabria et al. “Lipid emulsion for acute organophosphate insecticide poisoning.” Clin Toxicol (Phila) 2019;22:1. [PMID: 30666881]
  48. Connolly SJ, Crowther M, Eikelboom JW, Gibson M, Curnutte JT, Lawrence JH, Yue P, Bronson MD, Lu G, Conley PB, Verhamme P, Schmidt J, et al, ANNEXA-4 Investigators. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors. N Engl J Med 2019;380(14):1326-1335.[PMID:30730782]
  49. Mullins ME, Jones MS, Nerenz RD, Schwarz ES, Dietzen DJ. 5-Oxoproline concentrations in acute acetaminophen overdose. Clin Toxicol (Phila) 2020;58(1):62-64. [PMID:31050299]
  50. Wax PM, Stolbach AI, Schwarz ES, Warrick BJ, Wiegand TJ, Nelson LS. ACMT Position Statement: Buprenorphine Administration in the Emergency Department. J Med Toxicol 2019;15(3):215-216.[PMID: 31087272]
  51. Schwarz ES, Laes JR, Wiegand TJ. A New Way Forward in the Emergency Department. J Med Toxicol 2019;15(4):220-222. [PMID:31278586]
  52. Marino R, Perrone J, Nelson LS, Wiegand TJ, Schwarz ES, Wax PM, Stolbach AI. ACMT Position Statement; Remove the Waiver Requirement for Prescribing Buprenorphine for Opioid Use Disorder. J Med Toxicol 2019;15(4):307-309. [PMID 31414402]
  53. Reynolds WR, Schwarz ES. Dentists’ Current and Optimal Opioid Prescribing Practices: A Proactive Review. Mo Med 2019;116(5):347-350.[PMID: 31645771]
  54. Baumgartner K, Doering M, Schwarz ES. Vilazodone Poisoning: A Systematic Review. Clin Tox 2020;58(5):360-67. [PMID: 31777303]
  55. Carpenter J, Amirshahi M, Laes J, Nacca N, Nelson L, Perrone JM, Schwarz ES, Wiegand T, Wax P. Leadership roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder among Medical Toxicologists. J Med Toxicol 2020;16(2):204-11.[PMID: 31863312]
  56. Schwarz ES, Moy HP. In acute pain in prehospital settings, opioid and nonopioid analgesics do not differ for pain at 15 or 60 min. Ann Intern Med 2020;172(4):JC20 [PMID: 32066153]
  57. Marks LR, Munigala S, Warren DK, Liang SY, Schwarz ES, Durkin MJ. Evaluation of partial oral antibiotic treatment for persons who inject drugs and are hospitalized with invasive infections. Clinical Infectious Diseases 2020. [PMID:32239136]

Invited Publications

  1. Critical Connections
    1. Need A Pressor but Don’t Really Want a Pressor…How ‘Bout Some Calcium? July 2013
    2. Snakes in the ED. Be Very Concerned…or Should You? June/July 2015
  2. Missouri College of Emergency Physicians EPIC
  3. Emergency Physicians Monthly Reviews
  4. Emergency Physicians Monthly Articles
  5. Editory for ACEP Now Opiod and Addiction Column
  6. Washington Manual Chapters in the 34th, 35Th, and 36th Editions
  7. Washington Manual of Emergency Medicine Chapter 79
  8. Tintinalli’s Emergency Medicine and Board Review 3rd Edition Question Book, Chapters 55-61
  9. Schwarz ES. Therapeutic Approach to the Critically Poisoned Patient, Including GI Decontamination. Critical Care Toxicology, 2nd ed. SpringerMeteo.

Texts

Schwarz ES, Kleinschmidt KC.  Chapter 187: Toxic Inhalants.  Vincent:  Textbook of Critical Care, 6th edition

PEPID 2012 update:  edited chapters on Toxicology General Principles: overview, charcoal hemoperfusion, dialysis in toxicology; isopropranol; Plants:  insoluble oxalates; industrial herbicides (paraquat, diquat); hydrofluoric acid (HF)

Halcomb SE, Mullins ME, Schwarz E.  Overdoses. Washington Manual of Medical Therapeutics, 34th Ed.  Washington University School of Medicine.  WoltersKluwer, Lippincott Williams and Wilkins.  St. Louis, 2012.

PEPID 2013 update:  edited chapters on multiple sclerosis, fever age 3-36 months, masotiditis, perforated tympanic membrane, and tinea corporis.

PEPID Pediatric Chapters:  Wrote chapters on Anticholinergic toxidrome, Cardiac Gylcosides, Carbon monoxide toxicity, Cholinergic toxidrome, Digoxin toxicity, Ethylene Glycol toxicity, Hydrocarbons, Cyanide, Cocaine toxicity, Carbamate toxicity

Schwarz ES, Arroyo AM.  Clinical Decision Support System on Clinical Toxicology. Antidepressants; serotonin syndrome.

Halcomb SE, Mullins ME, Schwarz ES.  Toxicology. Washington Manual of Medical Therapeutics, 35th Ed.  Washington University School of Medicine.  WoltersKluwer, Lippincott Williams and Wilkins.  St. Louis, 2015

Bavolek R, Sampson C, Schwarz ES, Wagner JC.  Chapter 24 Medical Emergencies. Washington Manual of Medical Therapeutics, 35th Ed. Washington University School of Medicine. WoltersKluwer, Lippincott Williams and Wilkins. St. Louis, 2015

Schwarz ES.  Therapeutic Approach to the Critically Poisoned Patient, including GI Decontamination.  Critical Care Toxicology, 2nd ed. SpringerMeteor. 2016.

Schwarz ES.  The Washington Manual of Emergency Medicine, 1st edition.  Chapter 79 Addiction. Washington University School of Medicine. Philadelphia; WoltersKluwer, Lippincott Williams and Wilkins. St. Louis, 2018.

Tintinalli’s Emergency Medicine & Board Review 3rd edition. Edited by Dr. Susan B. Promes. McGraw-Hill Global Holdings, LLC. To be published in 2018. I wrote questions for chapters 55-61.

Emergency Medicine Resident’s Association Toxicology Guidebook. Published in 2018. I edited the chapters on Anesthetics, Antihypertensives, Atypical Antipsychotics, Hydrocarbons, NOACs, Opioids, Tramadol, and Warfarin/Heparin.

Hilbert S, Levine MD, Schwarz ES.  Chapter 26 Medical Emergencies. Washington Manual of Medical Therapeutics, 36th Ed. Washington University School of Medicine. WoltersKluwer, Lippincott Williams and Wilkins. St. Louis, 2020

Dunn SE, Schwarz ES, Mullins ME.  Chapter 28. Toxicology. Washington Manual of Medical Therapeutics, 36th Ed.  Washington University School of Medicine.  WoltersKluwer, Lippincott Williams and Wilkins.  St. Louis, 2020

American College of Emergency Physicians Guide to Coronavirus Disease (COVID-19) Field Guide. Patients with Substance Use Disorders. https://www.acep.org/corona/covid-19-field-guide/special-populations/patients-with-substance-use-disorders/