Not a lot of fentanyl, BUT could've needed more narcan like stated above? And I also wonder about her ABG... Also, with her pressure 190's systolically with issues with her liver (clotting etc.), her H/H and possibly PLT.. could've had a head bleed leaving her obtunded. Our neurosurgeons really like to keep the pressure under 140 systollically if they have a hx of bleeding or liver fxn issues, etc.