Case presentation A 37-year-old female was hospitalized with complaints of confusion, nausea, vomiting, and abdominal pain. Earlier, in the morning, she was found on the floor having a seizure and urine incontinence. The patient had none of the above-mentioned symptoms during the previous night.
She had applied a fentanyl patch before going to bed; she had bipolar disorder. Medication history – Oxycodone/paracetamol, mirtazapine, and trazodone Initial observation and treatment Pupils - Less than 2 mm Naloxone (0.2 mg) which induced a seizure after administration Intravenous midazolam (5 mg) to treat the seizure Vital signs Blood pressure – 165/81 mmHg Heart rate – 184 beats/min Respiratory rate – 39 breaths/min Temperature – 104°F Due to extreme agitation, the patient was held in a four-point restraint. Physical examination Dilated pupils with no reaction to light Extreme body…
