When is inpatient care for cocaine toxicity indicated?

Updated: Dec 31, 2020
  • Author: Lynn Barkley Burnett, MD, EdD, JD; Chief Editor: Sage W Wiener, MD  more...
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Answer

A brief observation period with 2 blood samples sent for troponin measurement within 9-12 hours is a reasonable approach for low-risk patients with cocaine-related chest pain. Admission is indicated for patients whose chest pain has any of the following characteristics:

  • Severe, sustained, or recurrent
  • Associated with significant cardiac risk factors
  • Associated with any acute cardiopulmonary symptoms
  • Accompanied by positive cardiac markers or ECG changes suggestive of ischemia

Other indications for admission to a critical care unit may include unresolved moderate-to-severe signs and symptoms, including seizures and focal neurologic deficits, and suspected ingestion of packages of cocaine.

If critical care is not available, transfer patients requiring such care to an appropriate facility, preferably in an advanced life support unit.


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