Furthermore, the dosage-response curve for GHB is steep, and exceeding the intoxicating dose can result in severe adverse effects. If concomitant ingestion is suspected, consider gastric lavage and activated charcoal. Rule out other possible causes for the patient's altered mental status. Coma reversal agents are of little or no use. Recovery of consciousness generally takes two to six hours.
Supportive management includes aspiration precautions and pulse oximetry.
If concomitant ingestion is suspected, consideration should be given to gastric lavage and activated charcoal. Without confirmatory evidence of GHB ingestion, the clinician must rule out other causes for the patient's altered mental status. Physicians should be aware of the possible co-ingestion of other drugs or alcohol and treat these accordingly. In the presence of severe respiratory depression, hypoxia, or a combination toxic exposure, rapid sequence intubation is generally indicated for airway protection during lavage and during the treatment of hypoxia. However, a conservative approach to intubation is considered prudent, especially when the history of GHB ingestion is reliable.