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.
