抗毒剂的实际延迟:患者,蛇或医院的因素 (ASP-33)
Geoffrey K Isbister1,2,3, Angela L Chiew3,4, Nicholas A Buckley2,3,5
1Clinical Toxicology Research Group, University of Newcastle, Newcastle, Australia.
Clinical toxicology (Philadelphia, Pa.)
|December 9, 2024
概括
对于蛇咬伤的抗毒剂的延迟,特别是等待血液结果,长时间的治疗. 即使在诊断测试之前,早期管理对于有效的毒蛇咬伤管理至关重要.
科学领域:
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
- 临床研究 临床研究
背景情况:
- 早期使用抗毒药对于成功治疗蛇咬伤至关重要.
- 了解抗毒药剂的延迟对于改善患者的治疗结果至关重要.
研究的目的:
- 调查导致蛇咬后抗毒剂施用延迟的因素.
- 确定优化抗毒治疗时间的潜在策略.
主要方法:
- 来自澳大利亚蛇咬项目 (2006-2021) 的蛇咬病例的回顾性审查.
- 分析患者的人口统计,蛇类型,咬伤时间,入院,血液采集和抗毒剂的使用情况.
- 基于医院转移状态的抗毒药的时间比较.
主要成果:
- 抗毒剂的中位时间是咬后的235分钟,到达医院后的中位延迟是147分钟.
- 等待血液检测结果是延迟抗毒药剂的首要原因.
- 与转移后接受治疗的患者相比,在转移前接受抗毒剂的患者经历了显著更短的注射时间.
结论:
- 抗毒剂的使用发生显著的延迟,通常是由于等待实验室结果.
- 早期服用抗毒药,可能以临床症状为指导,而不是仅仅依赖测试结果,可以提高治疗疗效.
- 务实的临床决策,特别是在转移病例中,可以加快抗毒药的输送.
相关概念视频
Prevention of Further Absorption of Poison
782
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
782
Factors Affecting Drug Response: Overview
1.9K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
1.9K
Anticholinesterase Agents: Poisoning and Treatment
790
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
790
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
359
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
359
Local Anesthetics: Adverse Effects
388
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
388
Local Anesthetics: Pharmacokinetics
731
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
731


