Case #12

A 25 year old male is found unresponsive by paramedics at an inner city night club called "The Passion Pit" and brought to your emergency department. An IV line ofnormal saline was established in the field prior to arrival.

PHYSICAL EXAM

• General: Dishevelled appearance, breathing spontaneously but shallow,
• responding only to painful stimuli.
• Vitals: P= 56 RR=6 BP= 110/70 T=95.8
• Head: Normocephalic/atraumatic
• Eyes: Pupils pinpoint, 1©2mm
• TM's normal; no bleeding from nose or mouth no gag reflex appreciated.
• Neck: Supple
• Lungs: Clear to auscultation and percussion
• Heart: RRR S1S2, no murmurs
• Abd: Soft with hypoactive BS
• Rectal: Normal tone (©)Heme
• GU: Ice cubes placed on groin by friends at nightclub
• Neuro: Moves all 4 exts, responds to painful stimuli
• Skin: Cool, dry, (+)needle tracks noted along the upper exts

Toxin and Discussion References