MedBugs: SAQ #239

Case: Reduced conscious state and impaired practitioner

An unidentified 40-year-old man is brought in with reduced conscious state after collapsing at a party. His vital signs on arrival are as follows: - HR 50, BP 110/55, sats 95% RA, RR 14 - GCS 9/15 (E2 V2 M5).

1. Excluding toxicological causes, list six possible causes for this presentation. 3 marks

Your management has been implemented and he is now GCS 15/15. He reports that he works as a GP interstate and is currently on holiday in your town. Upon further questioning, he admits to using GHB & benzodiazepines. Your registrar asks you whether his occupation requires any additional action on your part.

2. List four questions you would ask to determine whether mandatory notification is required. 2 marks

3. List four concerns that may trigger a mandatory notification. 4 marks

Your registrar asks you about the diagnosis and management of GHB withdrawal.

4. List 3 factors that predict severity of GHB withdrawal 3 marks

5. List 2 medications that can used to manage GHB withdrawal. Include dose, route and endpoint. 2 marks

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