Spice Spice Baby

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We have been receiving dozens of spice patients recently who have been holding up beds in the ER and ICU. Just wondering if any other areas have been seeing the same increase in usage?

There are three hospitals here in Anchorage and our EMS often responds to calls of group spice usage and treating it as a mass casualty event.... a few usually end up intubated. Its eating up resources and burning out EMS and ER staff.

Episode 27: Spice Roulette | Frontiers | KTVA Anchorage CBS 11

Spice: Street drug continues to plague Anchorage homeless | KTVA Anchorage CBS 11

Specializes in NICU, ER.

OK....here I am to ask the stupid question. Spice? Is this a new drug?

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I've seen a case result in pulmonary edema (drained 400 cc). Blew their LAD out and was left with EF ~10%. That one blew my mind

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I've seen a case result in pulmonary edema (drained 400 cc). Blew their LAD out and was left with EF ~10%. That one blew my mind

Wow. Probably the most consistent progression I have seen is violent hallucinations, which we use typical im injections to sedate. Hours later they get brady, tachypneic, low ETCO2, and responsive to pain.

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OK....here I am to ask the stupid question. Spice? Is this a new drug?

DrugFacts: K2/Spice ("Synthetic Marijuana") | National Institute on Drug Abuse (NIDA)

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Specializes in ER, PACU, ICU.

We have seen some that have resulted in pulmonary edema as well. However, its hard to say if it was just from spice use or the final factor. Most of our abusers are homeless and already polysubstance use as well as chronic alcoholics.

Most that we see are as AZQuik has stated. The IM injections usually ketamine or versed are given by ems in the field if the pts is violent or aggressive. Sometimes they are intubated in the field because they are no longer maintaining their airway. We continue with the same meds in the ER IM or IV. It just depends on what part of the cycle they seem to be on. However, propofol seems to drastically drop their BP more than expected and most dont hemodynamically tolerate it at all so we have used a lot of precedex for the intubated ones. Or precedex drips on non-intubated ones just to keep them calm for a few hours till they can follow commands.

Ive noticed the ones that end up in the ICU for longer stays are the ones that seem to already have some untreated infection like pneumonia or UTI and were probably already getting septic before the spice use. Otherwise the ones that end up intubated remain intubated between 4-8 hours usually and can be extubated in the ER and discharged. Its just crazy and it takes up a lot of resources.

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Specializes in ER, PACU, ICU.
We've been seeing an increase of spice usage in our pregnant moms, too. Some of those kids are coming out really messed up.

Wow. I can only imagine. Thankfully so far most of our population is older (but they can still get pregnant!). There are a few college age kids every now and then.

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Specializes in ER, PACU, ICU.
Group use is a nightmare I can't even imagine. One of our local crews got their ass handed to them by a seizure patient who ended up being a spice user. Stopped seizing started fighting. No police available locally had to wait for backup from 20 miles away.

I'm in central PA.

Incredible. I guess that is what the FD and PD here are concerned about happening is having a group spice use with people seizing and arresting while on the other end of town a mass casualty event occurs. There are only so many units for our area and only three.... well four hospitals if you count the base.

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Specializes in Emergency, Trauma, Critical Care.

Haven't seen any spice yet. Northern Cali here...I'll just be grateful we haven't.

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Three last week that all went into Rhabdo

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Wow that's crazy, never heard of it. We do get a lot of the street drugs but nothing like this yet

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Specializes in Med-Surg, Emergency, CEN.

Every day we have a pile of them. I asked one guy why he wouldn't just stick to the natural stuff and he said it was because he is on parole and it won't show up in the urine tests.

At least he's honest.

It's bath salts in a different format. We get a lot of it here and it causes all kinds of heart failure and rhabdo from the body trying to keep up with it. Some go to ICU, others sleep it off and go home. Sad to see a kid who will have CHF for the rest of his life at age 18.

Also, people keep calling it "Spike" here instead of spice. No idea why.

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Specializes in ER, progressive care.

In the first ER I worked at, we would occasionally see spice cases. At another trauma center I worked at, I never saw any of those cases. And at the ER I work at now, we see a lot of spice/kush/k2. It's amazing how patient populations differ depending on where you are at. Over the past week we've had at least 4 deaths related to this substance.

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