Dr. Kelsy Greenwald: This is a case of a 27-year-old male who was brought to our emergency department (ED) by security after he was found unresponsive in the lobby of the hospital. Almost immediately upon arrival to the ED, clinicians were called to his bedside for somnolence with shallow breathing. His pupils were 3 mm bilaterally. An i.v. line was inserted and he was given 0.4 mg naloxone i.v. for a suspected narcotic overdose, after which he awoke. He then stated that he was in the hospital because he has a seizure disorder and had not been taking his medication. He was placed on a monitor and his initial vitals were otherwise unremarkable. He was afebrile, with a heart rate of 60 beats/min, blood pressure 137/90 mm Hg, respiratory rate 14 breaths/min, and oxygen saturation 99% on room air. However, during further questioning, he would have intermittent episodes of unresponsiveness, lasting 30 s to 1 min, with staring and drooling. These would resolve spontaneously, and he was breathing spontaneously throughout.
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Published online: July 08, 2019
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