CASE REPORTS Cocaine/heroin induced rhabdomyolysis and ventricular fibrillation

A case of cardiorespiratory arrest in a 28 year old man after cocaine and heroin ingestion is described. The arrest is attributed primarily to hyperkalaemia/ rhabdomyolysis—a recognised consequence of each of these drugs. The administration of naloxone may have been contributory. He developed acute renal failure, disseminated intravascular coagulopathy with consequent lower limb compartment syndrome requiring fasciotomy. Ventricular fibrillation was identified at thoracotomy. A28 year old man was brought to the emergency depart-ment after intravenous ingestion of cocaine and heroin.He was noted to be pale, cyanosed, bradypnoeic (6/min), and hypotensive (70/40). Initial treatment consisted of oxygen via a facemask, and 800 µg of naloxone intravenously. Within two minutes he developed cardiorespiratory arrest with pulseless electrical activity (PEA). QRS complexes looked normal. PEA protocols were starte