Continuing Professional Development: Cocaine toxicity: assessment and cardiac risk

Overview The UK has the highest prevalence of drug use within Europe, with a 13% increase in cocaine and ecstasy related deaths between 2004–2005. This is significant to emergency medical personnel as cocaine toxicity may present clinically as acute coronary syndrome (ACS) minus typical associated risk factors. Cocaine use has an immediate effect on the body within seconds to minutes of administration. The resultant effect is manifold and can be divided into the two broad categories of central nervous system (CNS) and cardiovascular. Cocaine has a strong association as a trigger of ACS, acute myocardial infarction (MI) and sudden death in a population of patients largely free of classic cardiovascular risk factors. This module will assist in understanding the effects of acute cocaine toxicity, recognizing electrocardiogram (ECG) changes and implementing an appropriate treatment plan. Learning Outcomes After completing this module you will be able to: ▪ Refresh your understanding of the anatomy and physiology of cardio-vasculature and the central nervous system (CNS) ▪ Have an understanding of the effect of cocaine on the body, and how this may present in the clinical setting ▪ Further develop ECG recognition in the symptomatic patient, and understand the consequences of significant cardiac changes. ▪ Explore the concept of critical thinking within clinical decision-making ▪ Be able to better anticipate and implement a treatment plan in accordance to JRCALC guidelines.