AN INTERESTING CASE

A 30 year old female was found unconscious  with weak pulse and apnea (Respiratory rate=0). The paramedics completed the Airway, Breathing & Circulation (ABC). Naloxone, glucose and thiamine levels are normal. Head CT scan shows no hemorrhage or ischemia. The EEG shows flat lines.

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The answer is NO; the patient is not brain dead. We will order a drug screen. The patient was having phenobarbital poisoning which can present as a brain dead patient! Whilst actually its not!

TREATMENT

The patient may receive:

  • Activated charcoal
  • Gastric lavage
  • Laxative

PROGNOSIS

The prognosis (probable outcome) depends on the symptoms observed by the health care provider.

  • Mild — The patient can be aroused. No further treatment will probably be necessary, but the patient will be monitored in the hospital.
  • Moderate — Breathing and other vital signs are normal, but the patient cannot be aroused. Recovery will probably occur within 24 – 48 hours with proper care.
  • Severe — Breathing and other vital signs may be abnormal and the patient cannot be aroused. Recovery will probably occur within 3 – 5 days, depending on the amount swallowed.
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Burhan Ahmed, MD, MACP, MSc is currently Editor-in-Chief at Medicalopedia.org. He completed his residency from Michigan State University in 2015. He has has 14 publications to his name. He is pursuing career in dermatology and practices at SKINFUDGE and also blogs at Ninvah.com