MacNamara A F, Riyat M S, Quinton D N
Accident and Emergency Department, Leicester Royal Infirmary NHS Trust, England.
J R Soc Med. 1996 Nov;89(11):608-10. doi: 10.1177/014107689608901104.
To identify changes in treatment methods and types of drugs taken in overdoses over a 10-year period we conducted a retrospective study in the accident and emergency department of a large teaching hospital. The influence of a protocol to direct medical management was also studied. Results were compared with those of a 1984 survey at the same institution. 409 cases of accidental and deliberate poisoning were reviewed. In deliberate poisoning 52% of drugs taken were prescription drugs, 41.6% over-the-counter medications and the remaining 6.4% illicit drugs. Only 13% of patients had a stomach emptying procedure compared with 75.2% of patients in the previous survey. Charcoal was administered or offered in over 95% of cases. Medical management of overdoses in this centre changed drastically over 10 years. A department protocol had been adhered to in the great majority of cases, and we recommend that all accident and emergency departments as well as medical and paediatric teams establish similar protocols. Over-the-counter drugs are increasingly troublesome, especially paracetamol, which accounts for 28.8% of drugs taken in deliberate overdose.
为了确定10年间过量用药的治疗方法和所服用药物类型的变化，我们在一家大型教学医院的急诊科进行了一项回顾性研究。我们还研究了指导医疗管理的方案的影响。将结果与该机构1984年的一项调查结果进行了比较。回顾了409例意外和故意中毒病例。在故意中毒中，所服用药物的52%为处方药，41.6%为非处方药，其余6.4%为非法药物。只有13%的患者进行了胃排空程序，而在前一次调查中这一比例为75.2%。超过95%的病例使用或提供了活性炭。该中心对过量用药的医疗管理在10年间发生了巨大变化。绝大多数病例都遵循了科室方案，我们建议所有急诊科以及医疗和儿科团队都制定类似的方案。非处方药越来越麻烦，尤其是对乙酰氨基酚，它占故意过量服用药物的28.8%。
