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Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication
Steven Jason Crellin1, Kenneth D Katz1
1Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, USF MCOM, Cedar Crest Boulevard and I-78, Allentown, PA 18103, USA.
Case Reports in Emergency Medicine
|February 17, 2016
Summary
A suicide attempt using veterinary euthanasia solution (Euthasol) caused severe CNS and respiratory depression. Prompt medical intervention and toxicology confirmed barbiturate and benzodiazepine exposure, leading to successful patient recovery.
Area of Science:
- Veterinary medicine
- Emergency medicine
- Toxicology
Background:
- Suicide attempts using veterinary euthanasia agents are rare.
- Sodium pentobarbital, a common euthanasia drug, can cause severe toxicity in humans.
Purpose of the Study:
- To report a case of intentional self-administration of a veterinary euthanasia agent.
- To highlight the clinical presentation and management of Euthasol overdose.
- To emphasize the importance of recognizing and treating toxicity from veterinary euthanasia drugs.
Main Methods:
- Case report of a 48-year-old female with a history of depression.
- Clinical assessment including vital signs, neurological status, and rapid drug screening.
- Toxicological analysis using liquid chromatography/mass spectroscopy.
- Emergency medical and intensive care unit management, including intubation and fasciotomy.
Main Results:
- The patient self-administered Euthasol, a solution containing sodium pentobarbital.
- She presented with apnea, hypoxemia, bradycardia, and coma.
- Urine drug screen detected benzodiazepines and barbiturates; expanded toxicology identified multiple substances.
- The patient required intubation and fasciotomy for acute compartment syndrome but recovered fully within 48 hours.
Conclusions:
- Emergency physicians must be vigilant for patients exposed to veterinary euthanasia agents, monitoring for central nervous system and respiratory depression, hypothermia, bradycardia, hypotension, and skin injury.
- Prompt consultation with poison control and medical toxicologists is crucial for managing such cases.
- Early recognition and aggressive supportive care are key to favorable outcomes.