Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • tachycardia
  • hypertension
  • hyperthermia
  • agitation
  • mydriasis
  • diaphoresis

Risk factors

  • high ambient temperature
  • poverty
  • cocaine body packing
  • male gender
  • plasma cholinesterase deficiency
  • age 20-30 years
  • history of cocaine use
  • concomitant use of other sympathomimetics

Diagnostic investigations

1st investigations to order

  • ECG
  • bedside serum glucose
  • serum creatinine
  • urea
  • serum creatine phosphokinase (CPK)
  • serum troponin
  • chest x-ray
  • CT scan of brain
Full details

Investigations to consider

  • urine cocaine assay
  • CT scan of abdomen
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Attending Physician

Johns Hopkins Hospital

Baltimore

MD

Disclosures

AS declares that he has no competing interests.

Peer reviewers VIEW ALL

Head

Critical Care Division

The Methodist Hospital

Houston

TX

Disclosures

JZ declares that she has no competing interests.

Dean

School of Medicine

Campbelltown Campus

University of Western Sydney

Australia

Disclosures

AJ declares that she has no competing interests.

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

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