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<p>A comatose 5‑year-old girl with respiratory insufficiency was admitted to the emergency department with marked miosis and severe hypokalemia. After a&#xa0;trial administration of naloxone, the child immediately regained consciousness and the potassium level normalized following parenteral substitution. The child’s grandfather, who was receiving palliative care at home, was treated with fentanyl patches and the child had played with such a patch. The standard drug rapid test in urine and serum was negative and the detection of a&#xa0;toxic fentanyl level in the serum was only achieved with targeted analysis.</p><p>Fentanyl patches pose a&#xa0;high risk for intoxication and are not detected by routine drug/opiate screening tests. Therefore, in cases with corresponding symptoms and negative opiate screening, fentanyl should also be considered.</p>

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Akute Intoxikation durch Fentanylpflaster

  • 期刊论文

  • 发表日期：

    2025年5月5日

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  • Thomas Bruhns,
  • Ansgar Thimm

摘要

A comatose 5‑year-old girl with respiratory insufficiency was admitted to the emergency department with marked miosis and severe hypokalemia. After a trial administration of naloxone, the child immediately regained consciousness and the potassium level normalized following parenteral substitution. The child’s grandfather, who was receiving palliative care at home, was treated with fentanyl patches and the child had played with such a patch. The standard drug rapid test in urine and serum was negative and the detection of a toxic fentanyl level in the serum was only achieved with targeted analysis.

Fentanyl patches pose a high risk for intoxication and are not detected by routine drug/opiate screening tests. Therefore, in cases with corresponding symptoms and negative opiate screening, fentanyl should also be considered.