We got toned out about 8 in the evening for a teen with ALOC. When we got there we were let in the house by the parents. The 14 year old came into the front room really amped up, pacing and talking fast. He said that he was walking on the park when a white guy came up and offered him a drink of something that looked like apple juice. He then changed the story subtly and said that he was offered a "shot" of something like apple juice. The story was then altered one more time. He said he was offered a "chunk" of what he thought was apple juice. My patient then quickly added that he didn't want his parents to know because he didn't want them to think he was a drunk (my thought, "Yeah, right. It's much better that your parents think your a blithering idiot for taking "chunks" from strangers in the park."). Everything checked out on my patient except his heart rate, which was cranking along at 145 beats a minute. at one point my patient startd talking in Spanish to his parents. The other firefighter I work with flash me a knowing look. I'm fluent in Spanish so I just eaves dropped on the conversation to see if his story stayed the same. It did. After calming him down we sent him to the hospital.
Since the was the second patient with similar presentation (a little amped up with a fast heart rate but no other medical complaint) in a month we followed up. We were informed that Kaiser diagnosed him with acute alcohol ingestion and nothing else. I think either the kid had something else in his "chunk" or Kaiser didn't want to test him for anything else and went with the simplest of explanations.
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