ER Diaries : Sleeping pills overdose

hey all!
Like a blue moon or eclipse I appear . Tell a tale and disappear .

Today’s discussion is about the little dilemma book VS practice.

Around 60 year old lady presented to ER in a drowsy state . Alleged h/o consumption of 10 tabs of 0.5 Alprazolam and 10 tabs of 500mg PCM 1.5hr back. No Vomiting / seizure / frothing/ sweating/ palpitation/ or any incontinence . KCO DM HTN CAD Depression

Hemodynamically stable

Patient drowsy yet aggressive

pupils 2mm RL+

Power 5/5

Lungs clear

Abdomen soft B.S.+

MLC was registered

Treatment wise

Pantoprazole

Ondasetron

And Gastric Lavage was done

They had affordability issues , they took the patient away.

So the twist of the tale was OHEM says no gastric lavage for Benzodiazepines as it’s not fatal except for elderly and COPD cases . Only supportive management. Since pCM was 5g n she was elderly . ( mixed poisoning) It was not a blunder.

But the consultants do gastric lavage for benzodiazepines. What to do ? As ERP you follow OHEM which says no doing it dude! But consultants say, kar bhai kar !

To see alertness of the lady I ask

kaiku khaaye ?

she says marne ke waaste khaae aur kaiku khaate?

You feel like saying , Aao kabhi Haveli pe , Ill give you better ideas.😒

So far so much bye!

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