Okay, I'm stumped...

[Luno]

Has anyone had any experience with a short acting (<2hrs) psychosis inducing street drug, that does not present with observerable halucinations, and the patient can experience pain, but does not pain from taser application?

Patient goes from non-aggressive/delusional to aggressive/delusional and back again
Intake time is unknown but time in care, patient is observed returning to appx 90% of baseline mentation
patient had no pain indication from taser application, but was in visible pain with bp cuff @ 80, arm was normal 0DCAPBTLS
Pupils were unreactive to direct light, but under observation equally dialated and constricted between 2mm and 6mm
BP was unobtainable before returning to 90% mentation
Resp 20
HR 104
Patient did not hurt self, and did not continue movement against a joint/bone that would of caused a break or dislocation.

Any ideas?

 

[FF-EMT Diver]

Was the pt. AMS or "90% baseline mentation" when they were tazed?

And what was mental status when BP attempted?

To answer your question I can't say that I have.

 

[rescue99]

Has anyone had any experience with a short acting (<2hrs) psychosis inducing street drug, that does not present with observerable halucinations, and the patient can experience pain, but does not pain from taser application?

Patient goes from non-aggressive/delusional to aggressive/delusional and back again
Intake time is unknown but time in care, patient is observed returning to appx 90% of baseline mentation
patient had no pain indication from taser application, but was in visible pain with bp cuff @ 80, arm was normal 0DCAPBTLS
Pupils were unreactive to direct light, but under observation equally dialated and constricted between 2mm and 6mm
BP was unobtainable before returning to 90% mentation
Resp 20
HR 104
Patient did not hurt self, and did not continue movement against a joint/bone that would of caused a break or dislocation.

Any ideas?

Sounds like a couple of GHB calls from the past. Always suspected something else was combined with it but, never followed up to find out for certain.

 

[Luno]

Was the pt. AMS or "90% baseline mentation" when they were tazed?

And what was mental status when BP attempted?

To answer your question I can't say that I have.

Patient was AMS when tazed and when BP was attempted. 90% baseline mentation was regained after apx 30min in the ER. It was a quick change <10 min from AMS as found onscene to 90% of patient's known baseline mentation. There were no interventions performed during his first 30min in the ER other than a change of restraints.

 

[triemal04]

Doesn't completely sound like it, but could be salvia. It's kind of the new drug that's been making the rounds for awhile now. Depending on how it's taken the effects kick in and then dissipate pretty quick.

Also wonder if the taser didn't work because one of the barbs wasn't embedded into the body; most common cause I've heard of.

 

[Seaglass]

Doesn't completely sound like it, but could be salvia. It's kind of the new drug that's been making the rounds for awhile now. Depending on how it's taken the effects kick in and then dissipate pretty quick.

I'd second that, especially combined with aggressive/delusional behavior. It sometimes causes some trips that really upset patients.

Could be anything combined with anything, though.

 

[DV_EMT]

Salvia could be it... I've had a few run ins with idiot college students that take it... however it can have halucinations... but not always. Its only a 10 minute high though....

GHB.... maybe, but I think you'd feel the tazer with that.

I'm thinking maybe something laced with Acid... maybe PCP... those are more likely to have the "numb" feeling and cause the body not to freeze with the tazer.

 

[thatJeffguy]

Salvia could be it... I've had a few run ins with idiot college students that take it... however it can have halucinations... but not always. Its only a 10 minute high though....

GHB.... maybe, but I think you'd feel the tazer with that.

I'm thinking maybe something laced with Acid... maybe PCP... those are more likely to have the "numb" feeling and cause the body not to freeze with the tazer.

LSD lasts hours though.

I'm not sure if I buy into the theory of drugs commonly being "laced" with other drugs. Years ago I was talking with a cop buddy and he was showing me "street prices" of drugs and sharing his "knowledge" of illicit substances. He mentioned that Ecstacy pills (MDA/MDMA) are "frequently" cut with heroin in order to increase profitability and get people "hooked". However, the sheet that he'd written with "street values" of drugs showed that heroin was about $300/g and MDMA powder ("Molly") was about $150/g. You'd be "cutting" your product with something that costs twice as much!

I'm sure that people do mix drugs and I know that some drugs are sold that have been laced. I just don't think it's common practice for a "dealer" to mix and match his stuff... if he's selling LSD, he's got clientele that want that specific substance, same if he's selling marijuana, cocaine, etc. It's like the notion that you can "lace" a blunt with cocaine, then get the effect by smoking it. Complete urban legend, but it sounds good.

Didn't mean to be contrary there, not disputing what you're saying at all! Just offering another point of view

 

[Aidey]

This drug has a very short duration, does it fit your patient?

 

[firetender]

Drugs are often merely triggers for physical reactions to begin, then, what the body does in response takes precedence over the actions of the drugs.

Salvia has no gross physiological reactions that fit the bill. Nor do LSD or other psychotropics, and the "speedier" stuff Crystal Meth, Coke, etc. tend to stay consistent in their tweaking. This guy seemed to go high/low in his physical responses.

That got me wondering about hyperventillation and PCP. I've seen PCP induced psychosis that whipsawed back and forth. During the lows the pt. would be relatively normal and during the highs of heavy respiration be completely impervious to pain (like fighting off and hurting 5 cops!).

 

[thatJeffguy]

This drug has a very short duration, does it fit your patient?

When someone is peaking on n,n-DMT, they're out of this WORLD! I've never seen someone on DMT become violent, it's just too intense. DMT experiences begin as the vapors are inhaled, the presence of an "oil pipe" nearby could indicate it's DMT. Very rare, though. DMT can also be taken with a MAOI to make it orally active, referred to as ayahuasca in South America.

Most likely some "normal" drug combined with a whacko.

 

[NomadicMedic]

Sounds like Sherm.

It took me, my partner and three King County deputies to get a guy restrained. He went from altered to normal to full on *** kicker in the blink of an eye.

He was smoking sherm.

http://en.wikipedia.org/wiki/Phencyclidine