# GHB overdose victim



## Odin Arrow (Jul 21, 2015)

I'm studying currently and was wondering what would you do if you have a victim of GHB, who was given a deadly amount (over 1000mg), and was having the general symptoms , such as seizure like movement, unconsciousness, nuesea (victim is puking), and labored breathing. What would you do from the scene to the ambulance to the hospital and what would you do to try to stabilize the victim?


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## chaz90 (Jul 21, 2015)

Supportive treatment. I'm not overly familiar with GHB ODs, but I don't believe massive and potentially fatal dosing is too common. 

Benzodiazepines if seizing, airway control as necessary.


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## DesertMedic66 (Jul 21, 2015)

chaz90 said:


> Supportive treatment. I'm not overly familiar with GHB ODs, but I don't believe massive and potentially fatal dosing is too common.
> 
> Benzodiazepines if seizing, airway control as necessary.


This. Just treat the issues that you find. The GHB patients that I have come into contact with are usually passed out cold. 

If I remember correctly some GHB is also mixed with opiates so narcan may be indicated if there is respiratory arrest or depression.


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## zzyzx (Jul 22, 2015)

I've seen a number of these. They are quite interesting because the patient will go from being completely unresponsive and w/o a gag reflex to suddenly being fully awake, like someone flipped a switch in their brain. While they are unconscious, they will be breathing normally, but then have periods of apnea.

Prehospital treatment? Other than the obvious things, check the blood sugar and give Narcan. Since they will likely not have a gag, intubate them. If you're an EMT, put in an OPA and otherwise protect their airway.


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## Clare (Jul 22, 2015)

zzyzx said:


> I've seen a number of these. They are quite interesting because the patient will go from being completely unresponsive and w/o a gag reflex to suddenly being fully awake, like someone flipped a switch in their brain. While they are unconscious, they will be breathing normally, but then have periods of apnea.
> 
> Prehospital treatment? Other than the obvious things, check the blood sugar and give Narcan. Since they will likely not have a gag, intubate them. If you're an EMT, put in an OPA and otherwise protect their airway.



Exactly this.  Pt with GHB OD can go from rapidly unconscious to wide awake in short period of time.  

It is best to avoid intubating them for this reason. 

Basic airway care and let them wake up.


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## mgr22 (Jul 22, 2015)

The GHB patients I had about 15 years ago were bradycardic, in addition to going back and forth between comatose and awake. I'm pretty sure we paced one of them.


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