Published: 10 July 2018
Author(s): Fabrizio Elia, Michela Chiarlo, Andrea Verhovez
Issue: July 2018
Section: Internal Medicine Flashcard

A 41-year-old man was found unresponsive at home. On arrival, the air Ambulance team reported Glasgow Coma Scale 5 (E1V1M3), myosis, afinalistic movements and cold skin (28 °C). Blood glucose levels were normal. A history of recent drug and alcohol abuse was reported by friends around. Naloxone and Flumazenil administration was ineffective; intravenous fluids were administered and orotracheal intubation was performed. On admission to the hospital the vital signs were stable and the patient was quickly extubated.

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