Heroine OD/ hyperglycemic

[Redcell19512]

Had a guy in his early 20s. Injected "3 bags" of heroine tonight. His friends found him unresponsive and started ventilations and chest compression and called 911. The bls unit arrived first and found the guy breathing about 6 times a minute but not very much effort. Anyway, I gave him two 0.5 mg doses of IV narcan and things got all better.

He reported no history of health problems, he takes no medications. His blood sugar was 375 mg/dl. Is this guy an undiagnosed diabetic or could the hyperglycemia be a result of his near death experience tonight? I asked the ER nurse and she said she didn't know (her shift was over in 20 minutes).

[AZCEP]

Too many variables not accounted for to be able to tell.

As the oxygen supply decreases the body will try to compensate by releasing more epinephrine/norepinephrine to increase the heart rate. By doing this, it causes a relative hypoglycemia that is compensated by glycogen stores being catabolized. Since the metabolic demand is decreased by the time the glycogen enters the circulation, the blood sugar can elevate.

With no other history, his body may return to normal in a few hours following an increased metabolic demand after the narcotics are out of the picture.

[njmedic1485]

the Herion could also have been cut with powdered sugar

[fiznat]

the Herion could also have been cut with powdered sugar

LOL true true! haha

[AZCEP]

the Herion could also have been cut with powdered sugar

Or any of a thousand different things that could provide a little nutrition with it.

Nah, that's just to bloody simple.

[Doczilla]

Any severe physiologic stressor, such as the aforementioned near death experience, will drive up catecholamine and steroid levels and raise blood sugar. And before AZCEP lets me have it with both barrels, yes he said it first. I'll disagree though with the initial hypoglycemia.

I asked the ER nurse and she said she didn't know (her shift was over in 20 minutes).

Amazing how medical knowledge drops off toward the end of the shift.

'zilla

[AZCEP]

Would one keg suffice?