过量服用患者的输管治疗:是时候从格拉斯哥昏迷量表继续前进了
Richard Af Pellatt1,2,3,4, Katherine Isoardi5,6, Gerben Keijzers1,3,4
1Emergency Department, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
Emergency medicine Australasia : EMA
|May 29, 2023
概括
大多数药物过量和意识受损的患者不需要输管治疗,仅仅是为了保护呼吸道. 建议进行个性化风险评估和观察,挑战过时的做法.
科学领域:
- 紧急医疗 紧急医疗
- 毒理学 毒理学 毒理学
- 关键的护理关键的护理
背景情况:
- 药物过量服用往往导致意识丧失和昏迷在急诊室 (EDs).
- 在这些患者的输管实践中存在显著的差异.
- 目前用于输管的指示包括呼吸衰竭,促进治疗和呼吸道保护.
研究的目的:
- 挑战过时的实践,即仅为过量服用药物的呼吸道保护而输管患者.
- 倡导对昏迷过量患者进行个性化风险评估和观察.
- 提供一种临床工具,以指导这些患者的安全观察.
主要方法:
- 审查当前的文献和临床实践指南关于药物过量输管.
- 批评现有的输管指示,特别是用于呼吸道保护.
- 建议风险评估和观察战略.
主要成果:
- 有证据表明,对于昏迷过量患者,单独用于呼吸道保护的输入管往往是不必要的和过时的.
- 低质量的研究表明,观察对于许多患者来说是一种安全的替代方案.
- 建议采用个性化风险评估方法.
结论:
- 临床医生应该重新考虑在药物过量患者的常规输液管道保护呼吸道的意识下降.
- 个性化风险评估和观察可以安全地管理大多数昏迷过量患者.
- 拟议的流程图可以帮助临床医生为这些复杂的病例做出决策.
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