An ambulance is called to a nightclub where a young male has collapsed. The crew arrives to find 19 year old Stephen who is semi-conscious and has bleeding from a gash to the scalp. His friends say that he fell and hit his head but they don’t know why; he is normally fit and well. They appear nervous and a little disorientated. The crew feels they are not being told the full story.
Initial examination reveals a tachycardia of 120b.p.m. and an elevated blood pressure of 160/110. The patient’s pupils are dilated and he is having difficulty focusing; he appears to be hallucinating. He does not respond to pain during basic neurological observations or on examination of his head injury. There is no smell of alcohol and no injection site marks on the arms.
En route to A and E, Stephen begins to convulse. Frightened by this, the friend who has accompanied him admits that he has taken something called ‘CK-1’, a combination of cocaine and Ketamine. He shows the crew a small plastic bullet-shaped object containing a whitish powder which has been used to administer the drug nasally. After using the drug combination, Stephen had become increasingly ataxic and eventually collapsed.
The friend is primarily concerned with the possible involvement of the police in connection with the use of cocaine.
On investigation at A and E, Stephen is diagnosed as having collapsed due to the effects of Ketamine and cocaine. The head injury sustained during his collapse was not found to be serious.
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