Roessler Markus, Müller Sarah Anja, Schaper Andreas
Medizinische Fakultät und Universitätsklinikum OWL, Klinikum Bielefeld, Universitätszentrum für Anästhesiologie und Notfallmedizin, Universität Bielefeld, Teutoburger Straße 50, 33604, Bielefeld, Deutschland.
Zentrale Notaufnahme, Klinikum Wolfsburg, Wolfsburg, Deutschland.
Anaesthesiologie. 2025 Jul;74(7):429-438. doi: 10.1007/s00101-025-01544-3. Epub 2025 Jun 13.
Cases of poisoning account for 3-7% of all emergency medical services (EMS) calls. At present it is not known which toxins are responsible for severe and fatal poisoning in Germany.
In this study, all cases of poisoning with a severe or fatal course reported to the Poisoning Information Center (GIZ) North by the emergency services over a 5-year period were analyzed. The severity of poisoning was classified using the poisoning severity score (PSS) [4] and the causative noxious agents were assigned according to the anatomical therapeutic chemical (ATC) classification system [6].
In 259 cases out of 8528 consultations by the EMS the poisoning was severe and in 14 cases it was fatal. Most commonly involved were patients between 20 and 49 years. In 221 (81%) of these cases the poisoning was with suicidal intent and most often at home. In 199 cases the cause was pharmaceuticals, mostly taken by women (60.8%). Most substances were pharmaceuticals with effects on the central nervous system, the second most frequent but only in 16 cases were drugs with effects on the cardiovascular system. Chemical products accounted for 29 (10.6%) and drugs for 14 (5.1%) of the cases. The outcome was fatal in 14 (5.1%) patients. Most of these patients were already dead when found and resuscitation efforts were unsuccessful. Of the patients three were transported to hospital but were dead on arrival. In fatal intoxications suitable specific antidotes were principally available only in three cases but resuscitation efforts were either no longer indicated or were unsuccessful.
This study shows that most severe and fatal poisonings occur at home with suicidal intent using pharmaceuticals. Due to the possible number of different substances and the possible combinations, it is not possible for EMS personnel to assess all effects and substance interactions. If contacted early, due to their access to large data banks poisoning information centers are able to provide important recommendations with respect to symptomatic and further treatment as well as to suitable target hospitals.
中毒病例占所有紧急医疗服务（EMS）呼叫的3%至7%。目前尚不清楚在德国哪些毒素会导致严重和致命中毒。
在本研究中，分析了紧急服务部门在5年期间向北方中毒信息中心（GIZ）报告的所有严重或致命中毒病例。使用中毒严重程度评分（PSS）[4]对中毒严重程度进行分类，并根据解剖治疗化学（ATC）分类系统[6]确定致病有害物质。
在EMS的8528次咨询中，有259例中毒严重，14例致命。最常见的是20至49岁的患者。在这些病例中，221例（81%）中毒是出于自杀意图，且大多在家中发生。199例中毒原因是药物，大多由女性服用（60.8%）。大多数物质是对中枢神经系统有影响的药物，其次是对心血管系统有影响的药物，但仅16例。化学产品占病例的29例（10.6%），药物占14例（5.1%）。14例（5.1%）患者死亡。这些患者中的大多数在被发现时已经死亡，复苏努力未成功。3例患者被送往医院，但到达时已死亡。在致命中毒中，仅3例主要有合适的特效解毒剂，但复苏努力要么不再适用，要么未成功。
本研究表明，大多数严重和致命中毒发生在家中，出于自杀意图使用药物。由于可能涉及的不同物质数量和可能的组合，EMS人员无法评估所有影响和物质相互作用。如果尽早联系，中毒信息中心由于可以访问大型数据库，能够就对症治疗和进一步治疗以及合适的目标医院提供重要建议。
