Cocaine-related symptoms in patients presenting to an urban emergency department

✍ Scribed by John A Rich; Daniel E Singer

• Publisher: Elsevier Science
• Year: 1991
• Tongue: English
• Weight: 618 KB
• Volume: 20
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(05)82378-9

✦ Synopsis

Stud); objectives: Cocaine abuse is a serious social problem that precipitates a significant number of emergency hospital encounters. To determine the nature of cocaine-relat'ed symptoms, we studied patients with cocaine use presenting to all adult services of an urban emergency department.

Design: Review of consecutive cases, with analysis of clinical features.

Setting: All adult EDs of an urban teaching hospital. Type of participants: Patients acknowledging recent use of cocaine (within 72 hours) and~or with cocaine detected on a toxicologic screen.

Measurements and main results: Psychiatric complaints accounted for 44 (30.6%)presentations, followed by neurologic (17.4%), cardiopulmonary (16 %), trauma (11.8 %), and addiction-related (1I.i %) symptoms. Cardiopulmonary symptoms were more frequently associated with intranasal than with IV or smoked cocaine (P = .003). Suicidal intent was the most common psychiatric reason for presentation, occurring in 24 patients (16.6%). Seventeen presented with trauma, including three involved in motor vehicle accidents.

Conclusion: Cardiopuhnonary symptoms such as chest pain and palpitations may be significantly more frequent in patients who use intranasal cocaine; suicidal intent is common among patients presenting with psychiatric symptoms related to cocaine; and the range of cocaine-related symptoms is varied, including not only psychiatric and cardiopulmonary symptoms but also trauma. [Rich JA, Singer DE: Cocaine-related symptoms in patients presenting to an urban emergency department. Ann