Recently, the ambulance team from the Dongcheng Emergency Station of Beijing Emergency Medical Center received an urgent call: an elderly patient had become restless and unresponsive, showing no reaction to questions from bystanders. The situation was critical and required immediate medical intervention.
Upon receiving the dispatch order, the team activated an emergency response and sped to the scene. On the way, Dr. Lu Shuchun promptly contacted the patient’s family to gather detailed information about the on-site situation and the patient’s medical background. Drawing on clinical experience, Dr. Lu also provided targeted first-aid guidance to help stabilize the condition before arrival, saving time for first aid. Meanwhile, Nurse Wu Tong carefully checked and prepared all necessary emergency medications and equipment to ensure seamless cooperation with the doctor upon arrival. As the patient’s home was located deep inside a narrow alley, the ambulance could not drive directly to the door. Driver Wu Hongtao, demonstrating excellent driving skills and familiarity with local roads, coordinated with the family to identify a more accessible pick-up point, ensuring the ambulance reached the scene swiftly and safely.
Upon arrival, Dr. Lu learned from the family that the patient had recently been under emotional stress after losing a close relative. A rapid physical examination showed blood pressure 140/80 mmHg, heart rate 85 bpm, respiration 16 bpm, and normal temperature. However, the patient was clearly delirious. His eyes wandered aimlessly, and he gave no verbal response to others’ questions, displaying a frightened expression, dry lips and skin, dilated pupils (about 5 mm), and episodic muscle rigidity in both upper limbs. ECG and blood glucose tests revealed no significant abnormalities.
Recognizing the urgency, Dr. Lu immediately instructed Nurse Wu to administer oxygen therapy, establish intravenous access, and set up ECG monitoring to observe vital signs in real time. Despite these measures, the cause of the patient’s sudden delirium remained unclear. Hypoglycemia had been ruled out by examination. Could it be an acute cerebrovascular disease, or a stress-induced psychogenic reaction? Dr. Lu noticed certain contradictions between the symptoms and the vital signs that could not explained by the initial assumptions.
To identify the key clue, he carefully questioned the family again about the patient’s activities before onset. Finally, the family recalled that the patient had consumed homemade medicinal liquor infused with Datura seeds about an hour earlier to help with insomnia. This information immediately pointed to a possible diagnosis. Datura poisoning may cause the disorders of consciousness. Dr. Lu explained his reasoning to the family, collected a sample of the herbal liquor for toxicological testing, and led the team to transfer the patient promptly to a hospital equipped for specialized toxicology treatment for precise treatment. Follow-up confirmed that toxicological analysis verified Datura poisoning, and the patient was admitted for systematic medical care.
Beijing 120 reminds you:
The Datura plant contains several tropane alkaloids, including atropine, scopolamine, and hyoscyamine. These compounds competitively inhibit acetylcholine by reversibly binding to muscarinic (M) cholinergic receptors, thereby blocking parasympathetic nerve activity. This leads to a cluster of symptoms collectively known as anticholinergic syndrome, characterized by dry mouth, dilated pupils, rapid heartbeat, elevated body temperature, and hallucinations. In severe cases, patients may develop delirium, coma, and convulsions, even fatal symptoms including respiratory failure, or fatal cardiac arrhythmias.
Most Datura poisoning cases occur through accidental ingestion, such as eating Datura seeds, leaves, or flowers, or consuming food or herbal products containing Datura components. Because the primary symptoms involve the nervous and mental systems, it is easy to misdiagnose the condition as stroke, encephalitis, or methanol poisoning if the patients or family cannot recall any Datura exposure, which can delay timely treatment.