Dia de los Muertos

​A 27-year-old man presented by EMS was agitated, confused, and combative. EMS said they had received a call for a patient who was minimally responsive lying on the sidewalk. They noted the patient with pinpoint pupils and decreased respirations. The concern was that he had been using heroin, so he was given 2 mg intranasal naloxone. This caused the patient to become acutely confused and combative. He was awake and alert but oriented x 0. His vital signs included a temperature of 99.1°F, a heart rate of 122 bpm, a respiratory rate of 26 bpm, and pulse oximetry of 97% on room air.At least 160 people were admitted to Philadelphia hospitals over one weekend in July for overdose caused by an adulterated heroin named Santa Muerte. This drug was being sold as some of the last remaining "pure heroin" in the city. Naloxone reversed patients' somnolence but then made them agitated and confused. A sample of the seized drug was analyzed by GC/MS and was found to contain heroin, fentanyl, and 5F-ADB. 5F-ADB is a synthetic cannabinoid, which explains the severe agitation and confusion that ensued. ("Information Regarding 'Santa Muerte' Stamped Drug Seizures Causing Hospitalizations in the Greater Philadelphia Area." The Center for Forensic Science Research and Education. July 25, 2018. http://bit.ly/2BQs0lN.)This recent epidemic of overdoses from adulterated heroin is similar to another epidemic in 1995 when heroin adulterated with scopolamine led to 370 reporte...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs