• David Fitzpatrick, Patrick O'Meara, and Andrew Cunningham.
• Paramedic Clinical Research Specialist, Scottish Ambulance Service, NMAHP Research Unit, University of Stirling, UK david.fitzpatrick@nhs.net.
• Scot Med J. 2016 Nov 1; 61 (4): 192-194.

AbstractThis short report describes the case of a young adult male who had smoked a synthetic cannabinoid legal high product called 'Exodus Damnation'. The patient's presentation was atypical from that described in the literature, with hypotension and hypoxaemia. Of note was the rapid recovery after pre-hospital intervention with high-flow oxygen therapy and intravenous fluids. The patient refused on-going care, despite repeated advice to attend the Emergency Department. The distinct lack of specialist support and referral to drug treatment for this patient population, with whom ambulance services are coming into contact with increasing frequency, is reported. For those patients with the capacity to refuse on-going care, ambulance services may be in an opportune position to actively promote referral to support services for these vulnerable individuals.© The Author(s) 2016.

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