14th August 2024

You are asked to review a 29-year-old female patient who has been brought to the Emergency Department unresponsive

You are asked to review a 29-year-old female patient who has been brought to the Emergency Department unresponsive. She was discovered by her parents at home this morning and had empty packets of her mother’s tablets around her. It is not known when she took them.

Her mother’s medical history includes atrial fibrillation, hypertension, and chronic back pain.

Her observations are recorded: heart rate 125 bpm, blood pressure 96/53 mmHg, SpO2 99% on air, respiratory rate 19/min. The admission ECG demonstrates sinus tachycardia with a QRS interval of 168 ms. A venous blood gas shows a pH of 7.39.

On examination, she is unrousable but withdraws from a deep, painful stimulus and makes a sound when it is applied. Pupils are equal and reactive to light and measure 6 mm. Her skin is dry.

Which is the single most definitive indicator for active management of this overdose?

Select the SINGLE most appropriate option from the list below. Select ONE option only.