24/07/2025
🚑 EMS Case Study: Acute Caffeine Overdose in a Young Adult
🔹 Dispatch Info:
21-year-old male, found agitated and vomiting at a college dorm. Bystanders report he consumed multiple energy drinks and caffeine pills for exam prep.
🔹 Initial Assessment (Primary Survey):
• Airway: Patent
• Breathing: Tachypnea (RR 26/min)
• Circulation: Tachycardia (HR 142 bpm), BP 178/100 mmHg
• Disability: Alert but restless, GCS 15
• Exposure: Diaphoretic, tremors, no trauma
🔹 Focused History (SAMPLE):
• S: Nausea, palpitations, tremors, chest tightness
• A: No known allergies
• M: Recently took over-the-counter caffeine pills
• P: No prior medical history
• L: Multiple energy drinks + caffeine pills in last 4 hours
• E: Studying for exams, trying to stay awake
🔹 On-Scene Management:
• High-flow oxygen via NRB
• Cardiac monitor: Sinus tachycardia
• IV access established, 0.9% NS bolus
• BZD - Midazolam 2 mg IV for agitation/ seizure prevention
•Antiemetics – nausea/vomiting
• Cooling measures – if hyperthermic
For Hypertensive Crisis:
• Use Nitroglycerin
• Avoid beta-blockers – may cause unopposed alpha stimulation
• Reassurance, supportive care
• Transported to ED with continuous cardiac monitoring
🔹 Emergency Department Outcome:
• Diagnosed with acute caffeine intoxication
• Recovered with supportive care; discharged in stable condition with counseling on stimulant use
⸻
🧠 Takeaway for EMS Providers:
👉
👉Always consider caffeine overdose in young, otherwise healthy patients presenting with hyperadrenergic signs—especially when Recreational drug use is denied.
👉 Acute caffeine intoxication can mimic many conditions including
mania excited delirium and thyroid storm.
👉Rapid assessment and early symptom management can prevent escalation to seizures or arrhythmias.
