QUESTIONS and CONTROVERSIAL ISSUES

I) What are some of the commonly abused drugs which may result in violent behavior?

• A) Ethanol
• B) Cocaine
• C) Amphetamines
• D) Hallucinogens (PCP and LSD)
• E) Withdrawal states (ethanol, barbs, benzodiazepines)

II) What therapy should be instituted in this patient?

• A) Protect medical staff from patient
• B) Dimly lit room
• C) Physical or leather restraints
• D) Chemical restraints
  1. Haloperidol
  2. Benzodiazepines (Lorezapam)
• E) Observe patient for seizures, hyperthermia, and rhabdomyolysis.

CLINICAL COURSE

The patient remains combative despite the use of physical restraints at the stadium's first aid station. He is transported to the nearest ED were his labs are WNL and toxicology screen is reported as negative with an ethanol level of 110. The patient is given 10mg of haloperidol X2 with adequate sedation. When he awakes in the AM after an overnight observation, he confesses that he was actually one of the doctors scheduled to work the first aid station. However, he "got mixed-up with the crowd" prior to his shift and ingested several brown "magic shrooms" possibly laced with PCP. The patient recovers uneventfully.