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The use and maintenance of firearms is a common and often preventable source of adult lead exposure that is often poorly understood by medical professionals. This case describes an elevated blood lead level (BLL) in an adult man due to the exposure sources of ammunition reloading and indoor target shooting in the basement of his home and details the challenges involved in the diagnosis and management of such cases. The elevated BLL was reduced through strict attention to personal hygiene during the reloading process and while shooting, improved ventilation and cleaning of the basement, and avoidance of vacuuming and use of dry cleaning techniques. Medical providers may be unfamiliar with the risks of indoor residential shooting and how to ameliorate them; this knowledge deficit may result in delays in diagnosis as well as an inability to successfully mitigate the risks for exposure. Time‐sensitive diagnosis and treatment, comprehensive risk assessments, and reduction of exposure sources are important facets in the care of adult patients who are exposed to lead through recreational activities. Health care professionals should be aware of the potential dangers of ammunition reloading and indoor shooting, be familiar with ways to reduce lead exposure during these activities, and understand the resources that are available for the management of lead‐exposed patients.

Scombroid fish poisoning (SFP), the most common fish-related illness worldwide, is a histamine response caused by the heat stable toxin histamine. A healthy 48-year-old woman and co-author of this paper developed palpitations, tachycardia and hypotension 10 min after a tuna steak dinner. She subsequently developed numbness of her face, flushing, conjunctival erythema, abdominal pain, nausea, vomiting, diarrhoea, headache and chest pain. Her ECG revealed tachycardia with ST depression. Her hypotension did not respond to fluid resuscitation, and she required phenylephrine. Based on exposure history, clinical syndrome, exclusion of other diseases and consultation with poison control, a diagnosis of scombroid poisoning was established. The state health department was notified. The patient was weaned off vasopressors, dosed famotidine and discharged 43 hours after fish ingestion with no symptoms and normal ECG. SFP is an often misdiagnosed and underreported illness with the potential to cause life-threatening hypotension.

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