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单剂量活性炭用于肠道去污:由医学非专业人员实施——关于可行性和实用性的前瞻性研究

Single dose activated charcoal for gut decontamination: Application by medical non-professionals -a prospective study on availability and practicability.

作者信息

Pfab Rudolf, Schmoll Sabrina, Dostal Gabriele, Stenzel Jochen, Hapfelmeier Alexander, Eyer Florian

机构信息

Division of Clinical Toxicology, Department of Internal Medicine 2, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675, Munich, Germany.

Department of Medical Statistics and Epidemiology, Klinikum rechts der Isar Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany.

出版信息

Toxicol Rep. 2016 Dec 31;4:49-54. doi: 10.1016/j.toxrep.2016.12.007. eCollection 2017.

Abstract

CONTEXT

Oral activated charcoal (AC) for toxin absorption should be applied as soon as possible. Extra-hospital AC-application on site by medical laypersons with pre-emptive obtained AC may save time, but may be inferior to AC-application by medical professionals.

OBJECTIVE

  1. Availability and incidence of pre-emptive stockpiling of AC on site in the German region Bavaria 2) time saved by AC-stockpiling and application on site, 3) quality of AC-application defined by completeness of the applied AC-dose, time needed, incidence of side-effects in lay-care and in professional-care, considering confounding variables: AC-formulation/powder/tablets, recommended AC-dose, patient's age.

METHOD

telephone-interviews in cases with AC-recommendation by a Poison Information Centre (PIC). Lay-care was suggested according to risk-assessment by PIC. Ingestion sites were classified as either apt for AC-stockpiling or not apt.

RESULTS

  1. availability: In Bavaria only 20%-22% of eligible cases had AC on-hand, 2) time-saving was at least 14 min. 3) Lay-care/professional-care or patient's age had no significant influence on the completeness of the applied AC-dose, which was higher with AC as powder but negatively correlated with the recommended AC-dose. No significant difference was seen with time needed for application and incidence of side-effects.

CONCLUSION

pre-emptive AC-stocking should be encouraged.

摘要

背景

用于毒素吸收的口服活性炭(AC)应尽快使用。由非专业医疗人员在现场使用预先获取的AC进行院外AC应用可能节省时间,但可能不如专业医疗人员进行的AC应用。

目的

1)德国巴伐利亚地区现场预先储备AC的可用性和发生率;2)AC储备和现场应用节省的时间;3)根据应用AC剂量的完整性、所需时间、非专业护理和专业护理中副作用的发生率来定义AC应用的质量,同时考虑混杂变量:AC制剂/粉末/片剂、推荐的AC剂量、患者年龄。

方法

对毒物信息中心(PIC)推荐使用AC的病例进行电话访谈。根据PIC的风险评估建议进行非专业护理。摄入地点分为适合AC储备或不适合。

结果

1)可用性:在巴伐利亚,只有20%-22%的符合条件的病例手头有AC;2)节省时间至少14分钟;3)非专业护理/专业护理或患者年龄对应用AC剂量的完整性没有显著影响,粉末状AC的应用剂量完整性更高,但与推荐的AC剂量呈负相关。在应用所需时间和副作用发生率方面没有显著差异。

结论

应鼓励预先储备AC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35a5/5615092/0c0142ca43f9/gr1.jpg

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