Continuing
Medical
Education
NYP/Weill Cornell
Tuesday, December 1, 2009 4:00-8:00 pm
NYP/Weill Cornell Campus
Room M-107
Four Hour Call Review
4:00-5:20 pm Adult Medical Call Review with Dr.Carter
5:20-5:30 pm Break
5:30-6:45 pm Trauma Call Review with Dr.Eachempati
6:45-6:55 pm Break
6:55-8:00 pm Pediatric Call Review with Dr.Lupica
Please RSVP if you plan on attending
ANY QUESTIONS OR IDEAS
PLEASE CONTACT CME COORDINATOR
STEVE SAMUELS EMT-P 516-383-7248
cocaine overdose by a medical examiner surveillance study?
a. Suicides
b. Age over 50
c. Ambient temperature > 31.1° C (88° F)
d. Concomitant opioid use
e. HIV status
Hyperthermia is the vital sign abnormality that correlates most with
fatality in cocaine users. There are numerous case reports of hyperthermia-related deaths with or
without rhabdomyolysis after cocaine use. Cocaine causes hyperthermia in several ways.
Cocaine increases heat production through psychomotor agitation via its CNS effects. Cocaine also controls
the dopamine-modulated heat-regulatory centers of the hypothalamus.94 Peripherally, cocaine hampers
heat dissipation by vasoconstriction of the vasculature. In addition, high ambient temperatures are
associated with an increase in mortality from cocaine overdose. In a medical examiner surveillance study
in New York City, it was found that significantly more deaths were due to cocaine overdoses on hot days
than on other days. The mean daily mortality began to increase when maximum temperature equaled or
exceeded 31.1° C (88° F). These findings are consistent with data demonstrating that the survival rate of
cocaine-poisoned dogs fell from 100% to 57% when ambient temperature was increased from –5° C to
5° C.
Answer: C
