Avtor/Urednik | Poplas-Susič, Tonka; Klemenc-Ketiš, Zalika; Komericki-Grzinic, M; Kersnik, Janko | |
Naslov | Glasgow Coma Scale in acute poisonings before and after use of antidote in patients with history of use of psychotropic agents | |
Tip | članek | |
Vir | Srp Arh Celok Lek | |
Vol. in št. | Letnik 138, št. 3-4 | |
Leto izdaje | 2010 | |
Obseg | str. 210-3 | |
Jezik | eng | |
Abstrakt | Introduction: Data on emergency interventions in poisonings are scarce. Objective To determine the effectiveness of antidote therapy in acute poisoning-related emergency medical services (EMS) interventions. Methods: A prospective observational study included all poisoning-related intervention cases over 3 years (1999-2001) in the Celje region, Slovenia, covering 125,000 inhabitants. Data were recorded on an EMS form. Results: Psychoactive agents were present in 56.5% out of 244 poisoning-related EMS interventions. Prescription drugs were a cause of intoxication in 93 (39.2%) cases alone or in combination with alcohol or illegal drugs. More than one fifth of poisonings were due to the use of illegal drugs in 52 (21.9%) cases, 43 (18.1%) out of them heroin related. At the time of EMS arrival, more patients who ingested illegal drugs were in coma or comatose than the rest. 24 (45.3%) vs. 32 (17.3%) of poisoned patients were in coma (p < 0.001). Glasgow Coma Scale (GCS) at the first contact was lower in patients who ingested illegal drugs than in the remaining patients (9.0 vs. 11.6, p = 0.001). In 23.2% of the cases, an antidote was administered. In 29 (12.2%) naloxone and in 16 (6.7%) flumazenil was administered. Mean GCS after intervention was higher in all cases but significantly higher in illegal drug cases, 13.4 vs. 12.2 (p = 0.001), with a mean positive change in GCS of 4.5 vs. 0.6 (p < 0.001). In illegal drug users, mean change after antidote administration was 8.2 vs. 0.5 without antidote administration (p < 0.001). Conclusion: High rate of successful antidote use during the intervention indicated the importance of good EMS protocols and the presence of a skilled doctor in the EMS team. | |
Deskriptorji | UNCONSCIOUSNESS GLASGOW COMA SCALE POISONING ANTIDOTES EMERGENCY MEDICAL SERVICES PSYCHOTROPIC DRUGS STREET DRUGS NALOXONE FLUMAZENIL TREATMENT OUTCOME |