Overdoses...

altomga, ADN, BSN, MSN, DNP, RN, APRN · May 13, 2003

my floor get's illegal and legal drug OD's.

One that comes to mind is a guy that was using cocaine..didn't give him a good enough high so he started cutting rat poison into it...

Until he admitted that he was using the rat poison the police were involved thinking his girlfriend may have been trying to kill him b/c of the orificenic levels in his blood stream..The dude is lucky he didn't DIE!! How dumb can you get?? :confused:

If you mean do the police do anything? NO, not if the pt didn't have any drugs on them.

Treatment...depends on what they did..sometimes it is just let the drugs wear off and watch them for any medical changes (drugs that affect the heart, etc..)

gwenith, BSN, RN · May 13, 2003

Personnally the worst was the "experimenters" The ones that would go around the backyard chewing/smoking whatever they could find to see what made them high. And THEN they would discover the Datura. The next time they launch a rocket to the moon it will be beaten by some bloke on Datura jogging past - talk about hyper! Hard to treat them when they are doing circuits around the ceiling fan - and outpacing it!

Often we did not know what they had taken or what combination so it came down to guessing games and treating the symptoms.

Probably the most tongue curling substance I know of is dried cane toad skin - they were licking it.

EEERRRRKKKKK!!!

SmilingBluEyes · May 13, 2003

What is Datura?

BadBird, BSN, RN · May 13, 2003

We drawn a toxicology screen, notify posion control depending upon the substance, admit to ICU, monitor cardiac and respiratory, watch for kidney failure and liver failure. Some patients are intubated others just sleep it off, all depends on what they took and how much. Treatment varies depending upon the substance. Once the patient is stable, off to psych, social service consult for chemical dependency, etc...

Nurse Ratched, RN · May 14, 2003

Most of my worst overdose patients are on alcohol. Lot of Tylenol, ibuprofen and benadryl OD's from the local college around finals time.

sandgroper · May 14, 2003

Datura is a plant commonly known as the trumpet lily. The characteristic pendulous flowers resemble trumpets which are boiled to make a tea. They contain three of the belladonna alkaloids which can be hallucinogenic in the right amount (also lethal).

Gwenith, in the recent controversy involving Pan pharmaceuticals, the drug Travacalm was sold containing excessive amounts of one of these alkaloids causing similar experiences.

Our favourite OD is paracetamol (acetominophen) (sp?) The treatment is the antidote acetylcysteine which is given if the levels exceed a certain amount. These may take up to eight hours to peak (depending of the fomulary of the drug. In the meantime the patient has time to contemplate the severity of their actions.

boggle, ASN, RN · May 14, 2003

rnnurse2b, why do you ask?

rnnurse2b · May 14, 2003

Im just always thinking of different things i will come across while in Nursing, and was just curious about the treatment of people who are detroying their own bodies...also, drugs are everywhere and hurting people everyday, but we very rarely hear about these things...Thanks

Nurse Ratched, RN · May 14, 2003

Originally posted by sandgroper
Our favourite OD is paracetamol (acetominophen) (sp?) The treatment is the antidote acetylcysteine which is given if the levels exceed a certain amount. These may take up to eight hours to peak (depending of the fomulary of the drug. In the meantime the patient has time to contemplate the severity of their actions.

I love it when we have to give mucomyst for acetaminophen od's. Before I am branded cruel, one has to understand that the vast majority of them are young people (18-22 or so) who had some stupid romantic notion about a boyfriend rushing back to them when they found out about the attempt, or a way to temporarily get them out of desperate academic straits. The pt always carries on about the horrible smell and the worse taste. But by then they have settled on living and don't dare not drink it for fear of killing their liver. Apparently it also can be given IV, but I've never seen it done (I think the sensory experience is part of the don't-do-this-again therapy.)

RNPD · May 14, 2003

For opiate ODs, you give Narcan-and man, can they become nasty & combative when they wake up and find out you ruined their high! Then it's mostly supportive tx with IVs, monitors, etc,-and more Narcan prn, because Narcan doesn't last as long as the opiate. Once they're stable, they can have a safe medical detox, using methadone. For ETOH, supportive tx again, depending on s/s. IVs, monitors, seizure precations (tx seizures with IV Valium), etc, until the patient wakes up and is stabilized for medical detox. Then we use po/im Librium every 2 hrs prn until patient is detoxed.

Pills-just usually supportive, although activated charcoal thru an NGT and/or gastic lavage is used if the OD is recent enough that the pills may remain in the GI tract.

Coke, m/j-usually just supportive tx.

I'm not usually in on the acute phase in the ER or the ICU. I get 'em when they are stabilized!

Hope this helps!

sanakruz, ADN · May 14, 2003

Datura is called Jimson weed in the US; also called loco weed I believe. Quite common,have some in my yard.Very pretty white flowers. An ancient medicinal plant known to witchcrafters for centuries.

There are web sites that tell folks its a good thing to get high on;NOT!