SK, aged 24 years, is a hosteller in Banglore. He is intermittent heroin & cocaine abuser. His roommate found him in a comatose condition & got him admitted in Emergency. He informed the Physician there that his friend had consumed a bottle of whiskey in 24 hours & had smoked both heroin & cocaine of doubtful purity. On Examination: He was dehydrated.PR 80 /min BP 100/70.ECG-Tall T waves. Shortened Q T interval.
ST segment depression. Urine was Coca-cola colored. Biochemistry : Na-148 (135-145 ) mmol,K 5.8 ( 3.5 -5 ) mmol /l .Ca.1.74 (2.2-2.55 )mmol/L Phosphate -2 ( .9-1.5) mmol/ L creatinine-460 mumol/L 50-120 creatinine Kinase-8000 (less than 200 )Urine dipstick Positive for blood but no RBCs on microscopy.Coca-cola colored.Free Myoglobin in Serum. How to manage this case of poisoning? Please guide.
