Pt presents to the ED unresponsive. Airway is intact but patient is taking shallow respirations without response to painful stimuli. Nasopharyngeal airway was placed, patient oxygenated and ventilated with BVM and intubated.
HR 140s, BP: 150/57, RR: 12, T: 36.8, Glucose: 137
...100 mEq Sodium Bicarb given
...Patient was started on Sodium Bicarb drip 150 mEq in 1,000 mL at 150 mL/hr
-Cocaine is a Class I antiarrhythmic (Na channel blockade) which causes widening of the QRS complex
-QT prolongation (K+ rectifier channels) has also been described.
-Other cardiovascular events - e.g.: coronary artery spasm and /or thrombosis, MI, hemorrhagic stroke and aortic dissection related to sympathomimetic toxidrome
Written by Alec Weir, MD. Edited by Ben Cooper, MD.