Chloral Hydrate Toxicity

A guide to the first 10 minutes of resuscitation in chloral hydrate toxicity

Case

#1 A 4 year old girl was prescribed chloral hydrate to be taken at home prior to a procedure by her dentist. After a successful procedure, she was monitored for 1 hour, at which point she was described as tired but rousable and she was discharged home. Three hours later her mother finds her unresponsive and calls 911. Paramedics arrive to find a child in respiratory arrest and quickly package her up for the 5 minute drive to your small community hospital… (Nordt 2014)

#2 Later that evening, a 21 old man is transported from a local bar unresponsive after drinking a beer. The monitor reveals a wide complex tachycardia. There is a faint odor of pears on his breath, which triggers a vague recollection from medical trivia night. You have a nurse talk to his friends, and sure enough, they admit to slipping him a “Micky Finn” as a prank…

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