PDF(Pubmed)
Abstract：
The opioid-abuse epidemic is a problem that continues to persist world-wide. As such, appropriately evaluating and treating such patients is crucial, especially when considering the various complications that may arise. In rare cases, opioid overdoses can be complicated by compartment syndrome, rhabdomyolysis, and acute renal failure. All three of these complications can result in life threatening emergencies. We present a case of a 38-year-old male who was brought to the emergency department after reportedly being found lying on the ground for an unknown period of time from suspected heroin overdose. He was initially treated with 2 milligrams (mg) of intramuscular naloxone en route via emergency medical services with appropriate response. Shortly after arrival to the emergency department, the patient complained of severe right lower extremity pain, paresthesia and paralysis. Patient developed acute lower extremity compartment syndrome that was further complicated by rhabdomyolysis and acute renal failure. While emergency medicine physicians are familiar with the common complications of heroin overdose including mental status changes, respiratory depression and gastrointestinal symptoms, they must also be familiar with the less common ones. Notably, acute compartment syndrome. Compartment syndrome is ultimately a clinical diagnosis and warrants emergent surgical consultation. Every patient presenting to the emergency department warrants a complete, thorough physical examination to evaluate for any and all life-threatening conditions, regardless of the presenting complaint.
摘要：
阿片类药物滥用的流行是一个在世界范围内持续存在的问题。因此，适当评估和治疗这些患者至关重要，尤其是在考虑可能出现的各种并发症时。在极少数情况下,阿片类药物过量会因室综合征而变得复杂，横纹肌溶解症,和急性肾衰竭.所有这三种并发症都可能导致危及生命的紧急情况。我们介绍了一例38岁的男性，据报道，他因怀疑海洛因过量而被发现躺在地上，时间不详，因此被带到急诊室。最初通过紧急医疗服务对他进行了2毫克（mg）的肌内纳洛酮治疗，并有适当的反应。到达急诊室后不久，病人主诉严重的右下肢疼痛,感觉异常和瘫痪.患者发展为急性下肢骨筋膜室综合征，并进一步并发横纹肌溶解和急性肾功能衰竭。虽然急诊医生熟悉海洛因过量的常见并发症，包括精神状态改变，呼吸抑制和胃肠道症状，他们也必须熟悉那些不太常见的。值得注意的是,急性骨筋膜室综合征。筋膜室综合征最终是临床诊断，需要紧急手术咨询。每个到急诊科就诊的病人都有完整的，彻底的身体检查，以评估任何和所有危及生命的条件，不管提出的投诉。
