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Severe stimulant intoxication with hyperthermia — RCPSC EM MCQ

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HardPsychiatric emergenciesSevere stimulant intoxication with hyperthermiaRCPSC EM

A 30-year-old is brought by police after cocaine use. He is extremely agitated, temperature 40.3°C, HR 168/min, BP 198/112 mmHg, and CK is 2800 U/L. Glucose is normal and ECG shows sinus tachycardia. What is the most likely diagnosis?

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Correct answer: A — Severe sympathomimetic toxicity with hyperthermia

Severe sympathomimetic toxicity with hyperthermia is correct: the clues indicate Severe stimulant intoxication with hyperthermia and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Goldfrank's Toxicologic Emergencies; Canadian poison centre practice