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Fri Oct 7 22:22:14 BST 2005

Check Out Naloxone (Narcan) Allergy

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Charlene M Morris
Sent: 07 October 2005 21:21
To: Trauma & Critical Care mailing list
Subject: Paradoxical Reaction!

Despite reading, I have been unable to resolve in my own mind what occurred
last pm..
 We had a 50-ish white male brought in by police, found slumped over his
steering wheel, but became combative when the county-finest arrived--
corroborated by EMS. In the ED, he was somnolent, but cooperative to exam
A&O, walking to the bathroom and with a glucose of 71-- hungry.
 He wore two 75 mcg Fentanyl patches and admiited to taking one xanax that
am. He stated he *forgot* to remove his old patch, which he immediately
peeled and tossed.nHe denired alcohol or other drugs-- later confirmed by
his drug and EtOH screen.
 The doc requested an IV and 2 mg of Narcan, which sent the pt obtunded. The
last thing he said to me is "I feel very hot". His rhythm/rate was fine, but
his lungs began to sound wet and he did not respond to sternal rub. He did
not actually seize to my eye, but had some definite posturing and
tonic/clonic movement with sequential sneezing and yawning as he
deteriorated.
 We got him on O2, a monitor and within an hour he was responsive to pain.
Hospitalized, he improved by later that evening. PLEASE explain to me what
happened?
 C M Morris, PA-C
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Paradoxical Reaction!