medic53226 Posted November 22, 2006 Share Posted November 22, 2006 I was posting for a another unit that had a ldt, and was disp for a possible OD, Enroute as you all we try to asume what we a possible going to be faced with, and in this town meth is bad, and other illegal drugs. So upon arrival I was thinking that it was illegal or script OD. We found a 41 y/o male pt with a friend and she stated that he had taken 10 Lortab 10/500 with 30 Phenergan 25-50mg pills and chased them with ETOH. However, the pt was still AOX3, and said it had been 2 hours since he had taken these meds, so placed on the monitor, IV, O2 by N/C to start V/S stable, with no distress, just I getting back at my wife, so in the ambulance enroute to ER pt started to LOC, so I gave he a 1 mg of Narcan to start, and new full well what was to come, from my action and knowing that we don't have RSI, and have to have orders for intubation in this scenario, He got narcan just enough to keep him breathing, but also knowing that the phenergan is increasing the effects of the narcotic in Lortab. We as I though he woke up and proceed to kick my but while he was vomiting, what a thrill. So we get the pt to the hospital and have all his bottles, we find that he had just filled his lortab the day before and their was 180 lortab missing and with the phenergan, he also had vistaril, neurotin with the other meds so the drs figured that he had ingested the whole bottle he would have ingested 90,000 mgs of Acetamiphen, and 1800 mg of Hydrocodone with the phenergan, That has to be the most I think I have ever seen on pt take. I would like to know what you have seen and done for similar pts, and conditions. Thanks Chad Link to comment Share on other sites More sharing options...
akroeze Posted November 22, 2006 Share Posted November 22, 2006 My brain hurts Link to comment Share on other sites More sharing options...
jw-c152 Posted November 22, 2006 Share Posted November 22, 2006 Worst OD I've ever had was dead. Can't get any worse for the patient than that. Cheers. Link to comment Share on other sites More sharing options...
windsong Posted November 22, 2006 Share Posted November 22, 2006 He's the Stephen King version Link to comment Share on other sites More sharing options...
vs-eh? Posted November 22, 2006 Share Posted November 22, 2006 I guess all I can say is that my brain hurts. Link to comment Share on other sites More sharing options...
whit72 Posted November 22, 2006 Share Posted November 22, 2006 vs-eh wrote: If you saw a doctor or RN post in a similar fashion you would be ok with that Have you seen a doctor write? I dated one for about 3 years I could never figure out if I was suppose to pick up milk or put the dog out. Yes, I agree his post was a tough read, but I got the point. I agree with JW, the worst ODs I have done are the dead ones. Link to comment Share on other sites More sharing options...
akroeze Posted November 22, 2006 Share Posted November 22, 2006 Worst OD I had? 24 or 25 y/o female, on arrival pt supine on floor between bathroom and kitchen incontinent of urine. On assessment, pt pulseless with agonal respirations, finger tips still warm therefore she probably arrested as we were coming up the stairs. Hook up the LP12, perform 3 no-shock protocol (Asystole on the monitor). CPR could not be performed during extrication from apartment as we had to use a stairchair. The halls were too narrow. It was an upstairs apartment with exterior icy stairs. Estimate atleast 2.5-3 mins of no CPR during extrication. Transport x 3mins ER gets PEA on second round of ACLS Called roughly one hour after our arrival The freakiest part? She was still agonal respirations... a full hour of arrest and still had agonal resps! That was one of those holy shit moments, certainly made the doc check again to make sure they weren't missing the pulse! To me, this said that we did effective CPR, kept O2 going to that part of her brain. Link to comment Share on other sites More sharing options...
medic53226 Posted November 23, 2006 Author Share Posted November 23, 2006 All thank you for your replies and I'm sorry for the grammar, and this is my last topic and reply. Link to comment Share on other sites More sharing options...
alpha23958 Posted November 23, 2006 Share Posted November 23, 2006 My brain hurts I was posting for a another unit that had a LDT, and was tapped out for a possible OD. As for what we would be facing, the possibilities are endless, so we assumed the worst. This town has a serious drug problem, METH being high on that list. So upon arrival, I was thinking that it was recreational or prescription OD. We found a 41 y/o/m pt, a bystander stated that he had taken 10 Lortab 10/500, 30 Phenergan 25-50mg pills and had consumed a large quantity of ETOH. However, the pt was still C/O/A X3, and said it had been 2 hours since he had taken these meds. So, we placed the patient on the monitor, IV, O2 by N/C. V/S stable, with no respiratory distress. While enroute to ER pt began to show signs of an altered level of consciousness. I gave him 1mg of Narcan and prepared for the recourse. Unable to perform a RSI, in case of respiratory depression, I would have to request orders from OMC. I pushed just enough Narcan to maintain respiratory efforts, b/c I also knew that the Phenergan would increasing the effects of the narcotic in Lortab. As I thought, he woke up and proceed to kick my butt, while at the same time, vomiting. What a thrill! So we get the pt to the hospital and have all his med bottles. It was discovered that his recently filled Rx for Lortab, was missing 180 tablets. Along with several other meds, the physician assumes he took a lot of Hydrocodone with the Phenergan, and even more Acetaminophen. That has to be the most I've heard of a patient taking. I would like to know what you have seen and done for similar pts with this condition. Thanks Chad Link to comment Share on other sites More sharing options...
alpha23958 Posted November 23, 2006 Share Posted November 23, 2006 All thank you for your replies and I'm sorry for the grammar, and this is my last topic and reply. Oh, come on now, we still love ya! Not everyone is perfect! Link to comment Share on other sites More sharing options...
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