Kretzschmar M
Klinik für Anästhesiologie und Intensivtherapie am Waldklinikum Gera gGmbH, Gera.
Z Arztl Fortbild Qualitatssich. 2001 Jan;95(1):45-9.
Emergencies caused by acute poisoning amount to 3-5% of the actions carried out by the emergency medical service. Sleep supporting drugs have a 35% part in the acute drug-induced poisoning, primarily within the framework of suicidal or parasuicidal actions. In this case, benzodiazepines occupy a top position, followed by H1-antihistaminic agents with strong sedative effects, and the so-called anxiolytic agents of the "second generation". In general, intoxication with sleep supporting drugs lead to disturbances of consciousness with different degrees of seriousness. Careful (external) anamnesis, inspection of the environment and clinical investigations could be helpful to evaluate the diagnosis. Hypoglycemia and neurological illnesses are to be excluded differential diagnostically. Preclinical therapy follows the "five finger rule" (stabilization of the vital functions, detoxification, antidote therapy, asservation, transportation). Specific procedures (preclinical stomach lavage, antidote therapy) are indicated in rare cases, only (mainly mixed intoxication with ethanol). Subsequent therapeutic procedures under clinical conditions are demonstrated using selected examples.
急性中毒导致的紧急情况占紧急医疗服务行动的3%至5%。助眠药物在急性药物中毒中占35%,主要发生在自杀或准自杀行为的情况下。在这种情况下,苯二氮䓬类药物位居榜首,其次是具有强烈镇静作用的H1抗组胺药,以及所谓的“第二代”抗焦虑药。一般来说,助眠药物中毒会导致不同程度的意识障碍。仔细的(外部)问诊、对环境的检查和临床检查有助于评估诊断。需要通过鉴别诊断排除低血糖和神经系统疾病。院前治疗遵循“五指规则”(维持生命功能稳定、解毒、解毒剂治疗、护理、转运)。仅在极少数情况下(主要是与乙醇混合中毒)才需要采取特定程序(院前洗胃、解毒剂治疗)。下面通过具体实例展示临床条件下的后续治疗程序。