Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose?

Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose?

• A. BP 190/90 mm Hg; pulse 40 beats/min
• B. BP 180/100 mm Hg; pulse 50 beats/min
• C. BP 200/100 mm Hg; pulse 150 beats/min
• D. BP 60/40 mm Hg; pulse 140 beats/min

Answer: (C)

Acute cocaine overdose triggers a surge of sympathetic activity, causing a sharp rise in blood pressure and a fast heart rate. The most characteristic finding is hypertension with tachycardia, reflecting this intense sympathetic drive. The vital signs that align with that pattern show a very high blood pressure (around 200/100) along with a rapid pulse (about 150 beats per minute), which is why that option is the best fit for an acute cocaine overdose. The other sets describe scenarios with slowed pulse or low blood pressure, which aren’t the typical dominant features of acute cocaine toxicity. In the field, manage airway, breathing, and circulation; calm the patient and treat agitation with benzodiazepines. If chest pain is present, address it appropriately and avoid using beta-blockers alone due to the risk of unopposed alpha stimulation.

Acute cocaine overdose triggers a surge of sympathetic activity, causing a sharp rise in blood pressure and a fast heart rate. The most characteristic finding is hypertension with tachycardia, reflecting this intense sympathetic drive. The vital signs that align with that pattern show a very high blood pressure (around 200/100) along with a rapid pulse (about 150 beats per minute), which is why that option is the best fit for an acute cocaine overdose.

The other sets describe scenarios with slowed pulse or low blood pressure, which aren’t the typical dominant features of acute cocaine toxicity. In the field, manage airway, breathing, and circulation; calm the patient and treat agitation with benzodiazepines. If chest pain is present, address it appropriately and avoid using beta-blockers alone due to the risk of unopposed alpha stimulation.