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The Chemicals Between Us


chbare

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What area of the country are they from?

Are they by chance in the four corners region and did he get into some mouse droppings?

Did he get bit or stung by something?

What might he have brought with him from his old house that the parents might not have found on him, like nice pretty little pills from Grandma's house that he wanted as a souvenir and then thought they might taste yummy.

Does he smell like any pesticide or chemical?

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Uh oh. I don't know what the berries are... when I snap a pic and run it thru Google what do I get? Grab a sample in a baggie, look into kiddo's mouth to see if he's all berrylicious and hightail it to the ER. Also ask the brother if he ate any of the goddamn things...

What's our updated vitals?

Wendy

CO EMT-B

RN-ADN

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oh crap, let me get my field guide out. Berries that are not in clusters like blackberries are not ever safe to eat unless proven otherwise.

How long has this kid been sick again? What is our timeline now??? How many hours???

hmmm let's look these berries up

They appear to be nightshade berries and they are bad bad mojo - treat as atropine poisoning. Depending on how many berries this kid took and how long it took to call 911 from when symptoms appeared, this kid will either survive or Die.

Start gastric lavage if you can

IF you cannot, then drop an NG tube and give activated charcoal

IV fluids,

For what I can find this might be the correct treatment

In the event of toxic overdosage (See ADVERSE REACTIONS), a short acting barbiturate or diazepam may be given as needed to control marked excitement and convulsions. Large doses for sedation should be avoided because central depressant action may coincide with the depression occurring late in atropine poisoning. Central stimulants are not recommended. Physostigmine, given as an atropine antidote by slow intravenous injection of 1 to 4 mg (0.5 to 1.0 mg in children), rapidly abolishes delirium and coma caused by large doses of atropine. Since physostigmine is rapidly destroyed, the patient may again lapse into coma after one to two hours, and repeated doses may be required. Artificialrespiration with oxygen may be necessary. Ice bags and alcohol sponges help to reduce fever, especially in children.

The fatal adult dose of atropine is not known; 200 mg doses have been used and doses as high as 1000 mg have been given.

In children, 10 mg or less may be fatal. With a dose as low as 0.5 mg, undesirable minimal symptoms or responses of overdosage may occur. These increase in severity and extent with larger doses of the drug (excitement, hallucinations, delirium and coma with a dose of 10 mg or more).

Edited by Captain ToHellWithItAll
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The plant's deadly symptoms are caused by atropine's disruption of the parasympathetic nervous system's ability to regulate involuntary activities, such as sweating, breathing, and heart rate.

Symptoms may be slow to appear but last for several days. They include dryness in the mouth, thirst, difficulty in swallowing and speaking, blurred vision from the dilated pupils, vomiting, excessive stimulation of the heart, drowsiness, slurred speech, hallucinations, confusion, disorientation, delirium, and agitation. Coma and convulsions often precede death.

The two paragraphs above are taken from 2 different websites.


No medications in the house. The family recently moved in and have not unpacked any pharmaceuticals. The breath sounds are clear and in all lobes. The patient is very agitated and not at all oriented, but is awake. An IV has been placed and the patient is becoming more agitated.

Yep, LOL. You guys are typically so spot on, I struggle to make a scenario last more than a few posts before everybody has it figured out.

You note no overt scene hazards. The child's parents are home and you can insert any ethnic or apparent ethnic background you want. The child is sitting on the floor quickly moving his head in a lateral (side to side), repetitive manner. He appears to be breathing about 30 times a minute with a few periods of irregularity. SPO2 is reading 97% on room air. Your partner is pulling equipment for the baseline vital sign assessment.

No past medical or developmental problems noted. Parents appear very concerned but not overly dramatic. The patient does not maintain eye contact and appears to be interacting with stimuli that are not present.

These all support Nightshade or Atropine overdose.

I would think that if we don't do something with this kiddo he's not long for this world.

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