Self assessment

Abstract

A 2-year-old girl was brought to the Emergency Department (ED) by ambulance. The child had been found unconscious and covered in vomitus by the ambulance crew. She was reported to be well that morning. She is known to social services, and there is a history of maternal drug abuse and depression. On arrival to ED her heart rate was 80 beats per minute, respiratory rate 12 per minute, saturation was 96%, BP: 96/66 mmHg. Her GCS was 5/15 and pupils were equal and constricted.1.What is the most likely drug overdose responsible for her clinical condition?a)Fluoxetineb)Opioid intoxicationc)Tricyclic antidepressant intoxicationd)Paracetamol2.Given her clinical condition which TWO are the most important initial investigations?a)Chest X-rayb)Capillary blood gasc)Urine toxicologyd)ECGe)Blood culturef)Blood glucose