Two Patients Have Unusual Overdose Symptoms

Medic 453 is dispatched for an unconscious female with a suspected narcotics overdose. In approximately four minutes, the EMTs reach a small, 1.5-story home and are met outside by two police officers. The officers enter the house and declare the scene to be secure and safe to enter. The EMTs find a 40–45-year-old female unconscious and unresponsive on the floor of an upstairs bedroom. The patient’s boyfriend reports he found her about 15 minutes ago. The patient has a history of substance abuse—most recently heroin. The boyfriend claims she hasn’t been using heroin but is on Suboxone (buprenorphine and naloxone). No drug paraphernalia is found around the patient but track marks from prior use are evident on both arms. The patient has shallow, labored breathing and no apparent trauma, cuts, bruises or other visual injuries. The patient’s pupils are 3 mm and nonreactive. Her respiratory effort is suppressed and she’s unresponsive to a sternal rub. Oxygen is delivered via a non-rebreather mask at 15 Lpm. The patient’s airway is patent, motor control is flaccid in all extremities, jugular vein distension isn’t appreciated and capillary refill is less than two seconds. Radial pulses are thready on the left and right. Skin is clammy and pale. Lung sounds are clear. The patient’s vital signs show a pulse of 120, blood pressure at 120/80, blood glucose of 112 mg/dL, and respirations of 4 and shallow. A 20-gauge IV is inserted in the patient’s left antecubital vein...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Case of the Month Patient Assessment Toxicology Special Topics Patient Care Source Type: news