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The Poisoned Patient with Altered Consciousness, Controversies in the Use of a"Coma Cocktail"
JAMA 274:562-569, Hoffman,R.S.&Goldfrank,L.R., 1995
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Article Abstract
Analysis favors empirical administration of hypertonic dextrose and thiamine hydrochloride to patients with altered consciousness.Although rapid reagent test strips can be used to guide this therapy,they are not infallible,and they fail to recognize clinical hypoglycemia that may occur without numerical hypoglycemia.Administration of naloxone hydrochloride should be reserved for patients with signs and symptoms of opioid intoxication.Flumazenil is best left for reversal of therapeutic conscious sedation and rare select cases of benzodiazepine overdose.
 
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altered states of consciousness
benzodiazepine
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coma
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flumazenil
naloxone
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