被毒害的病人意识发生了变化. 关于使用"昏迷尾酒"的争议
1New York University Medical Center, Bellevue Hospital Center 10016, USA.
JAMA
|August 16, 1995
概括
经验性地给出德克斯特和胺用于改变意识. 储备纳洛用于阿片类药物中毒和弗卢马泽尼尔用于二二胺过量服用或镇静逆转.
科学领域:
- 紧急医疗 紧急医疗
- 临床毒理学 临床毒理学
背景情况:
- 受毒患者的意识变化需要进行关键的早期干预.
- 标准的诊断和治疗方法带有风险和好处.
研究的目的:
- 审查标准干预措施的风险和益处,对潜在的中毒患者有意识改变.
- 为了指导临床医生在关键的决策在最初的5分钟的护理.
主要方法:
- 在MEDLINE (1966-1994) 的文献搜索中,使用了以下术语:中毒,过量服用,毒性,纳洛,葡萄糖,胺,弗鲁马泽尼尔.
- 对诊断实用性和疗效的大型试验的分析.
- 对较小的副作用研究进行了广泛的审查.
主要成果:
- 对意识变化而言,偏好实验性地给予高性德克斯特和胺化物.
- 快速葡萄糖测试条是有用的,但并非不可错误的,用于检测低血糖.
- 纳洛酸适用于阿片类药物中毒.
- 弗卢马泽尼尔推用于治疗意识的镇静逆转和选择二二类药物的过量服用.
结论:
- 早期的经验性治疗用乳糖和胺对改变意识是有益的.
- 根据特定的临床表现,对纳洛和弗鲁马塞尼尔的明智使用至关重要.
- 临床医生必须在初始管理阶段权衡干预措施的风险和益处.
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