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The roadside high: Jimson weed toxicity

2005; Elsevier BV; Volume: 24; Issue: 6 Linguagem: Inglês

10.1016/j.amj.2005.08.007

1532-6497

Jason D. Clark,

Plant tissue culture and regeneration

A 19-year-old man was brought to a local emergency department by the police with EMS providing care. While en route to the hospital, police urged hospital staff to be prepared for a combative patient with a possible overdose; he was reported to have erratic behavior at a concert. Once in the emergency department, he was placed on a stretcher for evaluation, with police and hospital security at the bedside. He was looking into the corner of the room and obviously panicked by what he saw. He became combative and tried to run out of the room, yelling, “Get him away from me. It wants to take me!” The patient's face was flushed, and he was drenched with sweat. He was having visual hallucinations that terrified him. After he was placed back on the litter and leather restraints were applied, he started yelling, “Look at me! I'm dead! Hold on to me so I don't float away.” The patient's baseline vital signs were obtained, and an IV line was quickly established. He was given benzodiazepines to facilitate mild sedation and relaxation. His skin was hot to touch. He was hypertensive, and his ECG showed a heart rate of 160 beats per minute. Friends who had accompanied him to the concert denied the use of drugs or alcohol. However, a small plastic bag was found inside the patient's pants pocket; the contents resembled tomato seeds. After a full examination, the diagnosis of anticholinergic toxicity/Jimson weed poisoning was made. Arrangements were made for the patient to be transferred by helicopter to a tertiary care center with toxicology services. A 19-year-old man was brought to a local emergency department by the police with EMS providing care. While en route to the hospital, police urged hospital staff to be prepared for a combative patient with a possible overdose; he was reported to have erratic behavior at a concert. Once in the emergency department, he was placed on a stretcher for evaluation, with police and hospital security at the bedside. He was looking into the corner of the room and obviously panicked by what he saw. He became combative and tried to run out of the room, yelling, “Get him away from me. It wants to take me!” The patient's face was flushed, and he was drenched with sweat. He was having visual hallucinations that terrified him. After he was placed back on the litter and leather restraints were applied, he started yelling, “Look at me! I'm dead! Hold on to me so I don't float away.” The patient's baseline vital signs were obtained, and an IV line was quickly established. He was given benzodiazepines to facilitate mild sedation and relaxation. His skin was hot to touch. He was hypertensive, and his ECG showed a heart rate of 160 beats per minute. Friends who had accompanied him to the concert denied the use of drugs or alcohol. However, a small plastic bag was found inside the patient's pants pocket; the contents resembled tomato seeds. After a full examination, the diagnosis of anticholinergic toxicity/Jimson weed poisoning was made. Arrangements were made for the patient to be transferred by helicopter to a tertiary care center with toxicology services.