Reference no: EM133796747

Question

Unresponsive in the Emergency Room Dept. History A 30-year-old man is brought to the emergency department by his girlfriend in an unresponsive state. His girlfriend provides the history. She left him in his bedsit last night but found him lying unconscious this morning. She says that he has been an intravenous heroin addict for the past 5 years but is certain that he never shares needles and has had regular negative tests for HIV. In the past he has made several unsuccessful attempts to quit heroin, the last one being as recent as a week ago. There is no significant medical or psychiatric history. He is unemployed and lives on his own. His parents died when he was young, and he does not have any surviving relatives. Examination His pulse is 70 beats per minute regular, blood pressure 108/58 mm Hg. His respiratory rate is 10 breaths per minute. He is in a hypotonic hyporeflexic coma but there are no focal neurological signs. There is no verbal response though he groans in response to pain. His Glasgow Coma Scale (GCS) score is 4/15. His SpO2 (percutaneous oxygen saturation) is 75%. He has pinpoint pupils. His arms and legs.