I made the spot diagnosis of prolonged compression when I saw the patient showing his hand to me….However the nurse had hinted me as soon as I walked into ED that he belonged to the “sleeping group”. The sleeping group refers to a bunch of local IV drug addict who inject themselves with Stilnox apart from the regular heroin. Yes, Stilnox is a kind of “ORAL” sleeping pill. However this group of people would grind the pills into fine powder and mixed it with distilled water and injected in their body. I had had such act before. They would come to our psy OPD and sometimes ED requesting for Stilnox.
compare the nail bed...
The hand was cyanosed and I could only felt the radial pulse. The ulna pulse was absent. I asked him what he had injected himself with and he denied initially and told me to give him something to ease the pain. I told me I am not going to give him anything unless he tells the truth. I finally got the word out from his mouth and he admitted that he had injected himself with Stilnox powder. I gave a ketoprofen IM shoot and a referred letter to a nearby hospital with radiology facilities. Don’t expect to see him in a near future….but just wandered what would happen to his hand?
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