Female 21yo of average height and weight brought into ED with diminished level of conscious (responded to sternum rub), vomiting, confusion, low bp, low ox level, and bradycardia.
Friend who brought her in claimed she had one drink at a bar then told him something was wrong. He brought her in after she began losing consciousness.
Based on symptoms and history, we narrowed it down to alcohol intoxication, drug overdose, or a head injury.
I got off my ed shift before a diagnosis was made, so I'll update below once I can find out tomorrow.
What would your protocols be in a case like this? When a pt is brought in with unknown loc? Stabilize and treat for drugs and alcohol overdose and run tests for head injury?
And, with many synthetics out here, and some being opioid receptive, couldn't it be feasible that somebody DID slip something in her drink?
Lie, or no, unless I'm there, I'm sticking to the treatment...
Yes it's possible, but not very likely. Yes we are all sticking to the treatment.
I don't judge too much. Not my job, but I don't refuse to accept that we should treat even if the pt says I don't do drugs. It's also possible she took a pill and was drugged. Even on different days. Opiate tox shows up long after use, and roofie probably aren't showing up on an er utox.
Did they Narcan her? Unknown AMS which requires intubation should get a dose of Narcan and assessed for improvement.
Are you new to the E.D.? Just curious. People come to the E.D. with similar presentation all the time. Stabilize airway, hemodynamics, then CT head, labs, detox, etc. ASAP.
CraigB, RN's post above does highlight a true phenomenon: "someone slipped something into my (my friend's) drink" is used to deflect judgement/consequences of experimentation.
However, it is also true that drug-facilitated sexual assault is a major public health issue, and perpetrators are often not very sophisticated or subtle in their attempts. You can google some CDC statistics on the subject.
Note the recent case in California...Brock Turner...
LadyFree28, BSN, LPN, RN
8,429 Posts
How can we be sure?
And, with many synthetics out here, and some being opioid receptive, couldn't it be feasible that somebody DID slip something in her drink?
Lie, or no, unless I'm there, I'm sticking to the treatment...