Situations in which<unk>  packers present to the ED:
Asymptomatic but in custody
Signs of toxidromes from a ruptured packet
Signs of bowel obstruction or perforation
History and physical
Type of drug
Type of packet wrapping (more likely to rupture or leak if home made)
Number of packets ingested
GI symptoms (pain, distention, obstipation)
Other drug use
Asymptomatic but in custody
Signs of toxidromes from a ruptured packet
Signs of bowel obstruction or perforation
Type of drug
Type of packet wrapping (more likely to rupture or leak if home made)
Number of packets ingested
GI symptoms (pain, distention, obstipation)
Other drug use
Body packing
25C-NBOMe‎
Hematoma block
Alcohol
Procedural sedation
Amphetamines
Procedural sedation 
Bath salts