Wetli C V, Fishbain D A
J Forensic Sci. 1985 Jul;30(3):873-80.
Fatal cocaine intoxication presenting as an excited delirium is described in seven recreational cocaine users. Symptoms began with the acute onset of an intense paranoia, followed by bizarre and violent behavior necessitating forcible restraint. The symptoms were frequently accompanied by unexpected strength and hyperthermia. Fatal respiratory collapse occurred suddenly and without warning, generally within a few minutes to an hour after the victim was restrained. Five of the seven died while in police custody. Blood concentration of cocaine averaged 0.6 mg/L, about ten times lower than that seen in fatal cocaine overdoses. Police, rescue personnel, and emergency room physicians should be aware that excited delirium may be the result of a potentially fatal cocaine intoxication; its appearance should prompt immediate transport of the victim to a medical facility. Continuous monitoring, administration of appropriate cocaine antagonists, and respiratory support will hopefully avert a fatal outcome.
七名吸食可卡因的娱乐使用者出现了以兴奋谵妄为表现的致命可卡因中毒情况。症状始于强烈偏执狂的急性发作，随后是怪异且暴力的行为，需要强制约束。这些症状常伴有意想不到的力量和体温过高。致命的呼吸衰竭突然且毫无征兆地发生，通常在受害者被约束后的几分钟到一小时内。七人中有五人在警方拘留期间死亡。可卡因的血液浓度平均为0.6毫克/升，约为致命可卡因过量中毒时浓度的十分之一。警察、救援人员和急诊室医生应意识到兴奋谵妄可能是潜在致命可卡因中毒的结果；其出现应促使立即将受害者送往医疗机构。持续监测、给予适当的可卡因拮抗剂和呼吸支持有望避免致命后果。
