What is included in prehospital care for cocaine toxicity?

Updated: Dec 31, 2020
  • Author: Lynn Barkley Burnett, MD, EdD, JD; Chief Editor: Sage W Wiener, MD  more...
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Prehospital care includes the following:

  • Assess the patient's airway, breathing, and circulation (ABCs); intervene if necessary
  • Provide oxygen
  • Obtain intravenous access
  • Closely monitor vital signs, including temperature
  • Monitor glucose levels for patients with altered mental status
  • Carefully use naloxone for patients with depressed mental status, if opioid use cannot be excluded
  • Administer benzodiazepines to manage agitation or seizures

Patients with cocaine toxicity may be combative, aggressive, and disoriented, and have delusions of persecution or hallucinations. Caution is appropriate because the patient may attempt to harm care providers. Physical restraint should be avoided if possible due to risks of rhabdomyolysis and hyperthermia. When physical restraint is required it should be used only with caution and adequate personnel.

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