Muɲuli kɔfɛ fura tata hakɛ cayalenba farati, Silazini lafiyali, ani Nalokɔni tata hakɛ seginni¶

Opioid tali bana bɛ mɔgɔ min na, o tigi ka ɲɛnamaya kɔnɔ, tile 14 finɛtiri kelen min bɛ mɔgɔ faga ka tɛmɛ tɔw bɛɛ kan, o bɛ kɛ o yɔrɔnin bɛɛ, a bɔlen kɔ detox yɔrɔ la, min bɛ kɛ ka a yɛrɛ tanga dɔrɔn, sigida la, kɛnɛyaso la, dɔgɔtɔrɔso la, walima kaso walima kaso la. Banakisɛfagalanw ka kunnafoniw minnu bɔra diɲɛ kɛnɛyatɔnba fɛ (OMS), Ameriki ka banaw kɛlɛli ni u kunbɛnni baaradaw (CDC), ani Angletɛri ka kɛnɛya sabatili ni danfarako biro fɛ, olu b’a jira ko dɔgɔkun fila fɔlɔw kɔnɔ, a bɔlen kɔ kaso la walima ka bɔ dɔgɔtɔrɔso la, o tigi ka saya farati bɛ bonya opioid tali kojugu fɛ kasaara la, o bɛ bonya siɲɛ 10 ka se siɲɛ 40 ma ni i ye a suma ni don o don baarakɛlaw ye minnu bɛ baara kɛ kosɛbɛ. Hali ni hakili nege bɛ to ka bonya, opioid tali tile tile 3 fo tile 7 dɔrɔn, o bɛ biologique receptor desensitisation bɔ hakili la, ka ninakili muɲuni segin ka taa opioid tɛ mɔgɔ min na. Ni o tigi ye degun sɔrɔ waati dɔɔnin kɔnɔ, ka segin a ka fura kɔrɔ la, ka sɔrɔ ka hali a ka fura hakɛ dɔnta hakɛ dɔ ta ka kɔn detox ɲɛ, a bɛ ninakili jɔ joona, min bɛ se ka mɔgɔ faga.

Min bɛ nin farati in gɛlɛya muɲuni kɔfɛ, o ye nbɛdaw la furaw sɔrɔli ye min ma labɛn, min bɛ ka caya ka taa a fɛ ni fentanili ye min dilannen don cogo jugu la, bɛnzimidazɔli opioyidi fangamaba (nitazenes), baganw ka alfa-2 adɛrɛnɛji lawulili furaw (zilazini / "tranq" ani mɛdetomidini), ani bɛnzodiazepiniw dilanbagaw (bɔrɔmazɔlamu). Fentanili ni zilazini tata hakɛ cayalenba ɲagaminen na, mɔgɔ minnu bɛ Naloxone (Narcan) kɛsu saba walima naani fiyɛ teliya la ka tugu ɲɔgɔn na ka a tigi makɔnɔ a ka sigi ka kuma, olu bɛ filiba kɛ: barisa nalokɔni bɛ opioid yɔrɔ dɔrɔn de kɔsegin, wa a tɛ se ka sililazini lafiyali kɔsegin, nalokzɔni tali kojugu bɛ farinya ** teliya lase mɔgɔ ma bɔli** k’a sɔrɔ a ma se ka fɛn ɲɛnabɔ min bɛ hakili kisi tiɲɛ na, o ye ninakili kisili ye min bɛ to senna (ninakili 1 segin 5 o segin 5) ka fara nalokɔni tali kan min bɛ kɛ waati kɔnɔ miniti 2 fo miniti 3 kɔnɔ ka ɲɛ ninakili seginni.

Aw bɛ o kɛ sisan¶

1. Aw bɛ fɔlɔ ka ninakili ni a jaabi lajɛ, o kɔ aw bɛ aw ka sigida kɔrɔtɔko nimɔrɔ wele joona. Aw bɛ a tigi kamankunw lamaga kosɛbɛ, ka aw senkɔniw magaya teliya la a barajuru cɛmancɛ la (sternum rub), ka sɔrɔ ka a disi kɔlɔsi fo sekɔndi 5. N’u tɛ jaabi di, n’u tɛ ninakili, walima n’u bɛ mankan dɔɔni dɔɔni dɔrɔn bɔ, n’u bɛ sɔgɔsɔgɔ, n’u bɛ sɔgɔsɔgɔ, walima n’u bɛ mankanw bɔ dɔɔnin dɔɔnin, n’u bɛ mankanw bɔ dɔɔnin dɔɔnin, n’u bɛ mankanw bɔ dɔɔnin dɔɔnin, n’u bɛ ninakili 8 bɔ miniti kɔnɔ) ni u dawolo ni u bolokɔnincininw ye bulu, bulama, walima nɛrɛmuguma-bilen ye, aw bɛ 911 wele Ameriki ani Kanada, 112 Erɔpu tɔnba bɛɛ kɔnɔ, 999 Angletɛri, walima aw k’an ka kɔrɔtɔko nimɔrɔw ɲɛbilasɛbɛn.
2. Aw bɛ Naloxone hakɛ 1 kɛ (Narcan nugulafura miligaramu 4 walima farikolojidɛsɛ pikiri miligaramu 0,4) o yɔrɔnin bɛɛ. Aw bɛ naloxone nugulafura fiyɛlan dawolo bɛɛ don nugu kelen kɔnɔ ka sɔrɔ ka pikirijikɛlan digi ka ɲɛ ni aw bolokɔnincinin ye. Aw kana minɛn in fiyɛ fiɲɛ na fɔlɔ, barisa a kelen kelen bɛɛ bɛ furakisɛ kelen dɔrɔn de minɛ.
3. Aw bɛ kisi ninakili daminɛ joona (aw bɛ ninakili 1 kɛ segin 5 fo 6 o sekɔndi 6) ani aw kana a jɔ ka a sɔrɔ aw bɛ nalokɔni makɔnɔ a ka baara kɛ. Aw bɛ a tigi kun kɔrɔta ka segin kɔfɛ, ka a dawolo kɔrɔta walasa ka fiɲɛbɔyɔrɔ da, ka a nuguw sɔgɔ ka u da, ka aw da datugu u ta kan (aw bɛ baara kɛ ni bɔrɔ kisi masike ye walima ni a bɛ sɔrɔ), ka 2 di a ma dɔɔni dɔɔni ninakiliw, ka disi wulicogo lajɛ, o kɔfɛ finakili 1 segin 5 fo 6 o segin 5 (fiɲɛ 10 fo 12 miniti kelen kɔnɔ). Ni u dusukun tantanni tɛ, aw bɛ CPR dafalen daminɛ (disidimi 30 fo ka se kisi ninakili 2 ma; aw ye an ka opioid tata hakɛ caya kojugu ani CPR (CPR) ye ɲɛminɛbagaw).
4. Aw bɛ ninakili lajɛ miniti 2 fo miniti 3 taamasiɲɛ na: ni a tigi tɛ ninakili ka ɲɛ hali bi (a ka dɔgɔ ni ninakili 10 ye miniti kɔnɔ), aw bɛ Naloxone pikiri 2nan kɛ nugu tɔ kelen na. Aw bɛ tɛmɛ ni kisi ninakiliw ye a tata hakɛ bɛɛ ni ɲɔgɔn cɛ.
5. AW KA Naloxone wɛrɛ dili dabila ni a tigi ye ninakili daminɛ ka ɲɛ a yɛrɛ ma (fiɲɛ 10+/miniti), hali ni a tora a yɛrɛ la ka bɔ Xylazine ("tranq") la. Ni xylazine, médetomidine, walima bromazolam tun bɛ nbɛda fura la fentanili kɛrɛfɛ, a tigi bɛna a lafiya kosɛbɛ ani ka sunɔgɔ hali o kɔfɛ nalokɔni ye opioid ninakilidegun kɔsegin pewu. Ni u disi bɛ wuli ka jigin ka taa a fɛ siɲɛ 10 fo siɲɛ 16 miniti kɔnɔ ani ni u dawolo kulɛri bɛ ka pinɛ, aw kana to ka Narcan kɛsu wɛrɛw pɔnpe u nugu la, o bɛ fɔɔnɔ teliyalen tɔɔrɔlen ni fogonfogonlabana bila mɔgɔ la. Aw bɛ u kuru u kɛrɛ fɛ ka don Recovery Position kɔnɔ ani ka to ka u ninakili kɔlɔsi fo dɔgɔtɔrɔso baarakɛlaw ka se.
6. Aw bɛ aw janto "Renarcotization" (ka segin ka bin a tata hakɛ cayalenba la) fo lɛri 3 fo lɛri 4 ni kɔ. Naloxone bɛ sɛgɛn miniti 30 fo miniti 90 kɔnɔ, k’a sɔrɔ fentanili, nitazɛni walima mɛtadɔni hakɛ caman bɛ to farikolo la fo lɛri lɛrɛ 4 fo 12+. Aw kana mɔgɔ lakunulen to a kelen na abada walasa a ka "sunɔgɔ a la."

Desizɔn jiri : Ka bi fɛn caman (Fentanyl + Xylazine / Nitazene) tata hakɛ cayalenba kɔsegin¶

Aw bɛ baara kɛ ni nin kɛnɛyaso kisicogo jateminɛ ye min bɛ kɛ senfɛ-senfɛ ni aw bɛ jaabi di mɔgɔ ma min tɛ jaabi di ni opioid sintetiki walima "tranq dope" (fentanyl + xylazine) bɛ se ka kɛ a la.

flowchart TD
    A["Mɔgɔ min tɛ jaabi di + A bɛ ninakili dɔɔni dɔɔni, a bɛ sɔgɔsɔgɔ, a bɛ sɔgɔsɔgɔ, walima a tɛ kɛ (<8 ninakili/min) ."] --> B["Aw bɛ telefɔni 911 / 112 / 999 wele joona + Aw bɛ Nalokɔni tata hakɛ fɔlɔ di a ma (Nu fiyɛli miligaramu 4 nugu la 1) ."]
    B --> C["Aw bɛ kisi ninakili daminɛ o yɔrɔnin bɛɛ: Aw bɛ kunkolo kɔrɔta, ka aw dawolo kɔrɔta, ka nugu digidigi, ka ninakili 1 kɛ segin 5 o segin 5"]
    C --> D{"Aw bɛ miniti 2 fo miniti 3 makɔnɔ ka aw to kisi ninakiliw dili la: Yala a tigi bɛ ninakili a yɛrɛ ma sisan (>=10 ninakili/min) wa?"}
    D -->|"AYI: Hali bi, a tɛ ninakili walima ka fiɲɛ bila (<8 ninakili/min) ."| E["Aw bɛ Naloxone hakɛ 2nan kɛ (nugu 2 kɔnɔ) + Aw bɛ tɛmɛ ni kisi ninakili ye (ninakili 1 sekɔndi 5 o sekɔndi 5) ."]
    E --> F{"Aw bɛ miniti 2 fo 3 wɛrɛ makɔnɔ: Ninakili bɛ segin a cogo kɔrɔ la wa?"}
    F -->|"AYI (Fentanyl, Carfentanil walima Nitazene hakɛ caman bɛ siga a la) ."| G["Aw bɛ Naloxone hakɛ 3nan/4nan kɛ miniti 2-3 o miniti 2-3 + Kisili ninakili min tɛ tigɛ / CPR fo EMS ka se"]
    D -->|"ƆWƆ: Ninakili bɛ to sen na (ninakili 10-16/miniti) ani dawolo bɛ kɛ pinɛ ye, NK’A SƆRƆ a tigi hakili tɛ a la hali bi/a bɛ sunɔgɔ la"| H["XYLAZINE / BENZO ƝƐNABƆLI ƝƐNABƆLI MIN BƐ SƆRƆ: Aw bɛ Naloxone wɛrɛ dili dabila; aw bɛ a wuli ka don Recovery Position kɔnɔ ani ka fiɲɛbɔyɔrɔ da wuli"]
    F -->|"ƆWƆ: Ninakili bɛ segin a cogo kɔrɔ la"| H
    H --> I["Aw bɛ to banabagatɔ fɛ fo lɛri 3 fo lɛri 4+; aw ye Renarcotization kɔlɔsi ni Naloxone bɛ sɛgɛn miniti 30 fo 90 la"]

Yɔrɔ fɔlɔ: Muɲuli kɔfɛ seginkanni (Mun na tile 5 muɲuli bɛ muɲuli segin a cogo kɔrɔ la)¶

Denbayaw ni mɔgɔ minnu bɛ kɛnɛya la, olu ka teli ka kabakoya k’a dɔn ko ka bɔ tile 7 detox la walima ka tile 28 kɛ ka i yɛrɛ tanga dɔrɔn, k’a sɔrɔ furakɛli fura tɛ u la, o ye waati dɔ ye min farati ka bon kosɛbɛ saya barikama la. mu-opioid receptor (\(\mu\)-OR) desensitization bɛ baara kɛ cogo min na, o faamuyali bɛ a ɲɛfɔ mun na:

1. Muɲuli basigilen bɛ bonya cogo min na: Don o don opioid talikɛla min bɛ baara kɛ kosɛbɛ, opioid talikɛla min bɛ baara kɛ kosɛbɛ, o la, hakili la ninakiliyɔrɔw (pre-Bötzinger complex, min bɛ ninakili hakɛ otomatiki kɔlɔsi ani ka jaabi di joli la gazi ɲuman \(\text{CO}_2\) jiginni ma) bɛ to ka fa opioidw la. Walasa a tigi kana ninakili jɔ, senfagabana bɛ fosforilasi kɛ ni kemikɛli ye ani k’u ka mu-opioïde sɔrɔyɔrɔw lajɔ, o bɛ opioid caman de wajibiya siɲɛ 10 fo siɲɛ 50 walasa ka ninakili dabila ka tɛmɛ a siɲɛ fɔlɔ ta kan.
2. Ni ninakili muɲuli bɛ ban joona cogo min na: A tɛ i n’a fɔ opioidw ka nisɔndiya nɔ muɲuni (min bɛ to kalo caman kɔnɔ), ninakilidegun min bɛ sɔrɔ opioid fɛ, o muɲuni bɛ kɔsegin joona tile 3 fo tile 7 dɔrɔn kɔnɔ, a tali kɔfɛ.
3. The Post-Detox Trap: Ni mɔgɔ ye tile 5 detox kɛ ka ban, ni a tora dɔgɔtɔrɔso la dɔgɔkun kelen kɔnɔ ni banakisɛ ye, walima ni a ye tile 10 kɛ mara kasobon kɔnɔ ni Buprenorphine (Suboxone) walima Methadone tɛ a la, u hakili la ninakiliminɛnw bɛ u yɛrɛ tanga pewu k’a sɔrɔ u hakili nege bɛ u la (limbic dopamine mismatch) bɛ waati bɛɛ la.
4. The "Familiar Environment" Conditioned Tolerance Loss: Min ka bon kosɛbɛ, Pavlovian neuropharmacology ka sɛgɛsɛgɛliw y’a jira ko ni mɔgɔ bɛ opioidw ta yɔrɔ kura la, a ma deli min na (i n’a fɔ lotɛli so, gaziso sanuyaso, walima a terikɛ ka so) sanni ka kɛ a ka so sabatilen ye, a hakili tɛ a ka anticipatory homeostatic daminɛ jaabi kɔfɛ, o bɛ u ka fura tata hakɛ cayalenba hakɛ dɔgɔya ka tɛmɛ fɔlɔ kan.

Opioid tali bana (MOUD) fura bɛ mɔgɔ tanga cogo min na saya ma min bɛ segin kɔ¶

Nin muɲuli bɔnɛ teliya in de ye sababu tigitigi ye min b’a to Diɲɛ kɛnɛyatɔn (OMS), Jamana ka dɔrɔguta baarada (NIDA), ani Amerika ka dɔrɔguta furakɛli tɔnba (ASAM) bɛ ladilikan di kosɛbɛ ko aw kana baga bɔli kɛ ka sɔrɔ a ma taa ɲɛ Opioid tali bana (MOUD):

• Buprenorphine (Suboxone, Sublocade, Brixadi) ani Methadone bɛ mu-opioïde sɔrɔyɔrɔw minɛ ani ka ninakili muɲuni caman mara sanga 24 kɔnɔ.
• Ikomi buprenorphine ni mu-opioïde minɛbaga sirili ka bon kosɛbɛ kɛrɛnkɛrɛnnenya la, ni banabagatɔ min bɛ Suboxone ta don o don (walima kalo o kalo Sublocade pikiri) o waati barika ka dɔgɔn ani ka sɛgɛn siɲɛ kelen, buprenorphine min sirilen don u hakili minɛyɔrɔw la kaban, o bɛ nbɛda la fentanili fanba bali farikolo la ka a siri, o bɛ a bali ka a tali kojugu ani ka a tigɛ min bɛ se ka mɔgɔ faga sababu bɛɛ ka saya bɛ se ka kɛ kɛmɛsarada la 50 fo 70.
• O cogo kelen na, ni banabagatɔ ye opioid balilan min tɛ opioid balilan ye Extended-Release Naltrexone (Vivitrol) sugandi, u bɛ lakana ka a sɔrɔ tile 28 pikiri bɛ baara la, nka u ka kan ka lasɔmi ko ni u ma u ka kalo nata pikiri kɛ, u ka opioid muɲuni ye zeru ye.

Yɔrɔ 2nan : Silazini ("Tranq"), Mɛdetomidini ani Nitazɛni minnu bɛ nbɛdaw la¶

San damadɔ tɛmɛnenw na, dɔrɔgu jalakibali sɔrɔli Ameriki Woroduguyanfan bɛɛ la ani Erɔpu yɔrɔ dɔw la, o jiginna ka bɔ eroyini walima fentanili saniyalen na ka taa fɛn caman ɲagaminenw gɛlɛnw na minnu bɛ fura tata hakɛ cayalenba cogoya Changer ani ka dɛmɛ fɔlɔ jaabi cogo Changer.

Tablo min bɛ tali kɛ ɲɔgɔn na: Nbɛdaw la jatɔyakɛlaw ani u bɛ Dɛmɛ fɔlɔ fura tata hakɛ caya caman Changer cogo min na¶

Xylazine ("Tranq") fari joginda minnu bɛ mɔgɔ faga, olu ladoncogo¶

A tɛ i n’a fɔ banakisɛ pikiri kurulenw (minnu bɛ kɛ yɔrɔ tigitigi dɔrɔn de la, pikirijikɛlan min tɛ sterile ye fari sɔgɔ yɔrɔ min na), zilazini bɛ kɛ sababu ye ka farikolo lamini joli siraw sɔgɔsɔgɔ kosɛbɛ, ka joli sira misɛnninw datugu fari fan bɛɛ la ani ka oksizɛni kɔngɔ la, ka kɛ sababu ye ka punched-out, purple-to-black necrotic eschar ulcers bila a la bolokɔniw, senkɔniw, ani bolow hali mɔgɔ minnu bɛ sɔgɔsɔgɔ walima dɔrɔgu min dɔrɔn:

• Aw kana zilazini joginda ko abada ni perokisidi idɔrɔzi ye, ni dɔlɔ mugumugu ye, walima ni bleach ye, o bɛ granulasiyɔn kura nɔgɔlen faga min b’a ɲini ka kirinni kɛnɛya.
• Aw bɛ a ko dɔɔni dɔɔni don o don ni ji sanuman sanuman ye ani safinɛ nɔgɔlen walima saline sterili, ka furakisɛ tulu, Xeroform petrolatum gaze, walima vaseline finman gansan (Vaseline) kɛ a la walasa ka joginda dilan ka to ka mɔ, ka a datugu ni sterili ye min tɛ nɔrɔ (Telfa) ani gaze sirilan lafiyalen.
• Aw bɛ dɔgɔtɔrɔso la joona ni bilenni jɛnsɛnna teliya la kɛnɛma ka bɔ kirinni na, ni kuru bilenmanw bɛ yele senkɔni na, ni sumaya bɛ don a la, walima ni kolo/sɔgɔsɔgɔninjɛ bɛ ye joginda da la (farati min bɛ kolotugudaw ni jolidɛsɛ la; aw ye anw lajɛ sepsis ni septic shock (banakisɛfagalanw sɔgɔsɔgɔninjɛ). guide).

Yɔrɔ 3nan : "Laɲini ye ninakili ye, a tɛ kunun" Naloxone Redosing Protocol¶

Zilazini ni nugula nalokɔni hakɛ caman tali waati la (i n’a fɔ Narcan miligaramu 4**, Kloxxado miligaramu 8**, walima Zimhi miligaramu 5), foroba kɛnɛyasow ni dɔlɔmin furakɛli kɛrɛnkɛrɛnnenw bɛ sinsin fɛnba dɔ kan min bɛ kɛ ka caya kojugu degeliw la: Nalokɔni tali kun ye ka ninakilicogo ɲuman segin a cogo kɔrɔ la (10 ka se 16 ma ninakiliw miniti kelen kɔnɔ), ka a tigi lawuli fo a hakili ka to a la.

Mun na Naloxone tali kojugu bɛ tiɲɛni kɛ (Precipitated Withdrawal & Pulmonary Edema) .¶

Ni kɔlɔsilikɛla dɔ ye mɔgɔ sɔrɔ min hakili tɛ "tranq dope" (fentanyl + xylazine) fɛ, ka Narcan furakisɛ miligaramu 4 (miligaramu 16 bɛɛ lajɛlen) naani fiyɛ a nugu la segin 60 kɔnɔ barisa a tigi ma a ɲɛ da fɔlɔ:

1. Nalokɔni bɛ miniti 2 fo miniti 3 dafalen ta walasa ka a minɛ nugulatumu fɛ ani ka joli ni kunsɛmɛ sira tigɛ. Ni aw ye a tata hakɛ filanan walima sabanan fiyɛ sekɔndi 30 dɔrɔn kɔfɛ, o bɛ fura tiɲɛ sani a tata hakɛ fɔlɔ ka se hali kunsɛmɛ na.
2. Ni fentanili bɔra kunsɛmɛnasumaya la (a ka ca a la a tata hakɛ 1 walima 2 kɔfɛ), a tigi bɛ ninakili daminɛ tuguni, nka a bɛ to a yɛrɛ la ka bɔ zilazini na.
3. Ni aw tora ka nalokɔni hakɛ 3, 4 walima 5 wɛrɛ fiyɛ ninakilibaga la min lafiyalen don ni zilazini ye, aw bɛ kɔkan opioid kɛmɛsarada la 100 bɔ u farikolo minɛbaga bɛɛ la, ka Opioid bɔli teliya fariman bila mɔgɔ la:
   • Fɔɔnɔ ni kɔnɔboli teliya la k’a sɔrɔ a tigi hakili bɛ a yɛrɛ la hali bi ka bɔ xylazine fɛ, o bɛ kɛ sababu ye a ka fɔɔnɔ bila a fogonfogon la ka a sɔgɔsɔgɔ.
   • Katekolamini (adrénaline) wulicogo belebele minnu bɛ se ka kɛ sababu ye ka naloxone-induite non-cardiogenic pulmonary edema (ji min bɛ fogonfogon fa) ani dusukun tantannibaliya.
   • Farikoloɲɛnajɛ ni jɔrɔnanko jugumanba min bɛ kɛ sababu ye ka a tigi boli ka bɔ yɔrɔ la ani ka o yɔrɔnin bɛɛ ka nbɛda la fentanili hakɛba dɔ ta miniti 20 o kɔfɛ walasa ka bana in jɔ, o bɛ kɛ sababu ye ka a tata hakɛ cayalenba filanan kɛ min bɛ mɔgɔ faga ni nalokɔni sɛgɛnna.

Aw ka kan ka min kɛ ni "Syndrome de la chest de bois" (Fentanyl Chest Wall Rigidity) bɛ a tigi la .¶

Ni mɔgɔ dɔ ye fentanili walima nitazɛni sintetiki bololanɛgɛ teliyalenba dɔ pikiri walima ka a fiyɛ, o bɛ se ka Fentanyl-Induced Chest Wall Rigidity ("Wooden Chest Syndrome") bila mɔgɔ la tuma dɔw la segin 60 kɔnɔ: - A tigi kan siraw (glottis) ani a kɔkiliw ni a kɔkiliw/kɔnɔnakolo fasaw bɛ datugu ka gɛlɛya i n’a fɔ pankurun. - Ni aw y’u kun kɔrɔta ka segin kɔfɛ k’a ɲini ka kisi ninakili dɔ fiyɛ u da kɔnɔ, fiɲɛ tɛna don ani disi bɛ ban ka wuli, hali ni dumuni walima dunan fɛn tɛ u da kɔnɔ. - Tɔni: Aw bɛ Naloxone (Narcan) di joona. A tɛ i n’a fɔ fiɲɛbɔyɔrɔw balili cogoya la, Wooden Chest Syndrome ye farikolojidɛsɛ ye min bɛ sɔrɔ mu-opioid minɛbagaw fɛ kunsɛmɛ na (locus coeruleus) ani a bɛ da wuli joona Naloxone fɛ. Aw bɛ to ka kisi ninakili nɔgɔmanw kɛ disi degun kɛrɛfɛ ka a sɔrɔ nalokɔni bɛ a minɛ sekɔndi 90 fo 120 ni kɔ; ni nalokɔni ye kunsɛmɛnasumaya dɔrɔn, kanw ni disi kogo bɛ lafiya ani aw ka kisi ninakiliw bɛna don ka ɲɛ.

Yɔrɔ 4nan : Fentanili, sililazini ani nitazɛni sɛgɛsɛgɛli furakisɛw tali ka ɲɛ¶

Farikolo tangalan minnu bɛ taa teliya la kɛrɛfɛ (Fentanyl Test Strips / FTS, Xylazine Test Strips / XTS, ani Benzodiazepine / Nitazene Test Strips) ye papiyew ye minnu sɔngɔ man gɛlɛn, minnu bɛ jatɔya fagalenw dɔn fo ka se tilayɔrɔba miliyari kelen ma miniti 2 kɔnɔ. Nka, ni aw ye furakisɛ walima mugu sɛgɛsɛgɛ cogo jugu la, o bɛ nɛgɛjuru nkalonma di ka da a kan baarakɛlaw ka fili fila bɛ kɛ minnu ka teli ka kɛ: "Chocolate Chip Cookie Effect" ani Metanfetamini/MDMA Over-Concentration False Positive.

Aw bɛ nin tigitigi 5-Step Laboratory-Verified Drug Checking Protocol labato (ka bɔ CDC, DanceSafe, ani Johns Hopkins Bloomberg foroba kɛnɛya kalanso la):

Taabolo fɔlɔ : Aw bɛ se sɔrɔ "Chocolate Chip Cookie Effect" kan (Aw bɛ a tata hakɛ bɛɛ kɔrɔbɔ) .¶

Ni furakisɛw digicogo juguw walima nbɛdaw la feerekɛlaw ye fentanili miligaramu 1 ɲagami fasa mugu la walasa ka ɔkisikodɔni ("M30"), Xanax, walima Adderall furakisɛ nkalonmaw digi, fentanili tɛ ɲagami ɲɔgɔn na. Furakisɛ digilen tilancɛ kelen bɛ se ka kɛ ni fentanili zeru ye (kukisɛ mugu), ka sɔrɔ furakisɛ kelen tigitigi fan dɔ fɛ, fentanili saniyalen (sokolamugu) yɔrɔ min bɛ mɔgɔ faga, o bɛ se ka kɛ miligaramu 2 ye. - Ni aw ye milimɛtɛrɛ 1 nɔngɔn fitinin dɔ dɔrɔn sɔgɔ furakisɛ digilen dɔ kan walasa k’a sɛgɛsɛgɛ, aw bɛ se ka fentanili funteni yɔrɔ tiɲɛ nɔgɔya la, ka sɔrɔ ka jaabi nkalonma sɔrɔ min tɛ mɔgɔ tɔɔrɔ. - Fɛɛrɛ ɲuman: Aw bɛ furakisɛ bɛɛ walima aw b’a fɛ ka a tata hakɛ bɛɛ min mugumugu ka kɛ mugu ɲuman ye min ɲagaminen don kosɛbɛ tobilikɛminɛn sanuman kɔnɔ, galasi min bɛ kɛ ni marifa ye, walima plastiki foroko fitinin dɔ kɔnɔ walasa yɔrɔ min ka suma, o ka tila ka tila sɛgɛsɛgɛli bɛɛ la.

2nan : Aw bɛ ji hakɛ tigitigi fara a kan (Critical Dilution Rule) .¶

1. Ni aw bɛ Opioid pikirikɛlan dɔ sɛgɛsɛgɛ (Ka pikirijikɛlan bɛɛ wuli tobilikɛminɛn kɔnɔ): Aw kɛlen kɔ ka aw ka furakisɛ wulilen sama ka taa sanfɛ aw ka pikirijikɛlan kɔnɔ, aw bɛ ji sanuman mililitiri 5 (te kuuru 1 / ji sterili anpulu 1 standard) kɛ tobilikɛminɛn lankolon na walasa ka tobilikɛminɛn tolenw ko, ka o ko ji tolenw sɛgɛsɛgɛ.
2. Ni aw bɛ furakisɛ walima mugu tolen dɔ sɛgɛsɛgɛ: Aw bɛ mugu ɲagaminen ɲuman miligaramu 10 ɲɔgɔn kɛ (min bɛ se ka Abraham Lincoln kunsigi datugu Ameriki warijɛ kan, walima so konnɛgɛ kun) ka o kɛ tasa fitinin dɔ kɔnɔ:
   • Eroyini, Oksikodɔni, Xanax, walima Kokayini ta la: Aw bɛ ** mililitiri 5 (te kutu ɲɛ 1)** kɛ pɔnpe gansan walima buteli kɔnɔ ji la ka a wuli fo sekɔndi 15.
   • ƝƐFƆLI KƆRƆBƆLI MIN BƐ ƝƐSIN ƝƐNABƆLI LA: Metanfetamini, MDMA (Ecstasy/Molly), walima Diphenhydramine: Aw AW KA KAN ka metanfetamini walima MDMA kɛ ji mililitiri 30 (ji kutu ɲɛ 2 / onsi jilama 1 / galasi dafalen) la kristalɛ/mugu miligaramu 10 o miligaramu 10 na. Ni aw ye metanfetamini walima MDMA wuli ji dɔɔni dɔrɔn na, o fɛnɲɛnamafagalan min bɛ mɔgɔ bila ka wuli, o bɛ ɲɔgɔn sɔrɔ ni banakisɛfagalan ye min bɛ Fentanili sɛgɛsɛgɛlikɛlan kan, ka false positive bɔ (ani lidokayini walima difenhidramini hakɛ caman minnu tigɛra ka kɛ nbɛdaw la furaw ye, olu bɛ se ka Xylazine Test Strips bali ni a ma wuli ka se mililitiri 5 ma miligaramu 10 o miligaramu 10 kɔnɔ).

Taabolo 3nan : Aw bɛ Strip su ji la fo Sekɔndi 15 ka sɔrɔ ka a da fla la¶

1. Aw bɛ Fentanyl Test Strip bololanɛgɛ kunkolo kulɛrilen minɛ (ani Xylazine Test Strip danfaralen), aw bɛ duguma minɛn min bɛ kɛ ni ji ye, aw bɛ o su ji la dɔrɔn fo ka se fasa hakɛ danma ma fo seginkanni 15.
2. Aw bɛ sɛbɛnfura da yɔrɔ saniyalen kan ka sɔrɔ ka miniti 2 fo miniti 5 makɔnɔ sani aw ka kalan kɛ yeelen ɲuman na.

Taabolo 4nan : Layiniw kalan ka ɲɛ (COVID walima kɔnɔmaya sɛgɛsɛgɛli kɛrɛfɛ) .¶

Dɔrɔgu sɛgɛsɛgɛli sɛbɛnw minnu bɛ ɲɔgɔn sɔrɔ, olu bɛ kalan KƆLƆSI TIƝƐN du kɔnɔ kɔnɔmaya walima COVID-19 sɛgɛsɛgɛli la:

• Layini bilenman/pinki kelen kelen (Top Control layini dɔrɔn) = POSITIF (FARAKƐRƐ: Fentanili walima Xylazine BƐ KƐ). Hali ni layini filanan zeru tɛ yen hali dɔɔnin, layini 1 = POSITIVE.
• Layidu bilenman/pink fila (Hali ni duguma sɛgɛsɛgɛli layini ye super faint ye i n’a fɔ sɔgɔsɔgɔ) = NEGATIVE (Fentanyl/Xylazine ma sɔrɔ o misali la).
• Zero layiniw (walima duguma layini dɔrɔn min tɛ sanfɛla kunkanko layini ye) = INVALID TEST (Sɛbɛnni segin ni strip kura ye).

Yɔrɔ 5nan: Lakununni kɔfɛ ladonni, Lakununni teliyalen ɲɛnabɔli, ani Lɛrɛ 4 Renarcotisation Watch¶

Ni mɔgɔ ye ninakili daminɛ ka ɲɛ tuguni (ninakili 10 fo 16 miniti kɔnɔ) Naloxone ni kisi ninakili kɔfɛ, kɔrɔtɔko bɛ a ban. Aw bɛ min kɛ miniti 60 fɔlɔ lakununni kɔfɛ o de b’a jira ni a tigi bɛ kisi wulada fɛ walima ni a tata hakɛ filanan filanan bɛ a faga.

1. Mɔgɔ min bɛ kunun ni a ka bɔli teliya la, aw bɛ se ka o ɲɛnabɔ cogo min¶

Ni Naloxone hakɛ caman kɛra a la (walima ni fentanili degunba bɛ a tigi la don o don), a bɛ se ka kunun ni hakili ɲagaminen don, ka sumaya, ka fɔɔnɔ, ka yɛrɛyɛrɛ kosɛbɛ, ka a ɲini ka bɔ joona walasa ka fura caman ta walasa ka dimi dabila:

• Aw ka de-escalate hakili sigi ani ka min kɛra segin 10 kɔnɔ, o ɲɛfɔ: Aw bɛ aw jɔ kɔfɛ mɛtɛrɛ 1 (sen 3) walasa u kana a ye ko aw bɛ nkɔni na, ka kuma ni kan ye min hakili sigilen don, min tɛ kiri tigɛ, ka a fɔ ko: "I ye ninakili dabila ka bɔ fura tata hakɛ cayalenba la ani an ye Narcan di i ma walasa k'i ka ɲɛnamaya kisi. I bɛ bana jugu min sɔrɔ sisan, o bɛ bɔ Narcan dɔrɔn de la min bɛ i ka minɛbagaw bali. The Narcan bɛna daminɛ ka sɛgɛn miniti 30 fo 45 kɔnɔ ani bana bɛna nɔgɔya a yɛrɛma."
• Mun na aw ka kan ka u deli ko u kana fentanili caman ta sisan: Aw bɛ a ɲɛfɔ ka jɛya: "Sisan yɛrɛ, Narcan bɛ kɛ i n'a fɔ waati kunkurunnin kɔnɔ lakanani aw hakili la. Ni aw ye fentanili gosi wɛrɛ ta sisan yɛrɛ walasa k'a ɲini ka Narcan gosi, aw tɛna a ye hali a daminɛ na, nka miniti 45 kɔnɔ ni Narcan sɛgɛnna, fentanili hakɛ fila bɛɛ bɛna kɛ i ka sɔgɔsɔgɔ i hakili la o waati kelen na tigitigi k'i faga."
• Sylazine / Benzodiazepine Co-Sedation (Xylazine / Benzodiazepine Co-Sedation) jɔyɔrɔfalen: Ni a tigi bɛ ninakili ka ɲɛ (fiɲɛ 12 miniti kelen kɔnɔ) ani ni a dawolo/bolokɔniw ɲɛ ye bulama ye, nka a tora sunɔgɔ la kosɛbɛ ka bɔ xylazine la, aw bɛ u wuli ka u kininbolo kɛ Recovery Position la, aw bɛ a dawolo kɔrɔta dɔɔni ka taa ɲɛfɛ walasa nɔgɔ ka bɔ ka bɔ, ka fini sumalen dɔ bila u kan, ka to u kɛrɛfɛ ka ninakili bɛɛ kɔlɔsi fo dɔgɔtɔrɔso baarakɛlaw ka u ta.

2. Don kelen jiginni Buprenorphine la Naloxone lakununni kɔfɛ¶

Dɔgɔtɔrɔso kɔrɔtɔko ɲɛmɔgɔsow ani EMS "Bridge Clinics" bɛ Post-Overdose Buprenorphine Induction di sisan kɛnɛyaso kɔnɔ yɛrɛ, a tata hakɛ tɛmɛnen kɔfɛ, ka fara Low-Dose Buprenorphine Micro-Induction (Bernese Method) kan, mɔgɔ minnu bɛ nbɛdaw la fentanili ta minnu bɛ siran ka a tali teliya la: - Sani aw ka lɛri 36 makɔnɔ dimi na, Bernese Method bɛ daminɛ ni buprenorphine hakɛ fitinin misɛnninw ye (0.25 mg to 0.5 mg siɲɛ kelen walima siɲɛ fila tile kɔnɔ) ka a sɔrɔ banabagatɔ bɛ ka agoniste dafalenw dɔgɔya hali bi, ka buprenorphine tangalan dɔ jɔ dɔɔni dɔɔni a kunkolo minɛyɔrɔw kan tile 5 fo tile 7 kɔnɔ fo ka se a falen ma 12 mg to 16 mg don o don fura tata hakɛ bɛ se ni zeru ye ni a tali teliyalen don.

Ɲininkali minnu bɛ kɛ tuma caman na¶

Sosow sɛgɛsɛgɛra¶

• Banaw kɛlɛli ni u kunbɛnni baaradaw (CDC) ani dɔrɔguta ni hakili kɛnɛya baarakɛlaw ka ɲɛmɔgɔso (SAMHSA, Etazuni): Opioid tata hakɛ caya kunbɛnni baarakɛminɛn, kɛnɛyaso ka laadilikanw fentanili ni zilazini ("tranq") minnu dilannen don cogo la min tɛ sariya kɔnɔ, ani foro kunnafoniw minnu bɛ tali kɛ nalokzɔni miligaramu 4 ni miligaramu 8 nugu la.
• Diɲɛ kɛnɛyatɔn (OMS, Dugukolo kan): Opioid tata hakɛ cayalenba sigida la (Kisi fiɲɛbɔcogo, nalokɔni titirili, kaso kɔfɛ / detox kɔfɛ saya farati, ani kɛnɛya jɔyɔrɔ ladonni).
• Amerika ka dɔgɔtɔrɔso toxicologie kalanso (ACMT) ani Ameriki ka toxicologie clinique (AACT): Jɛkulu ka jɔyɔrɔfalen fɔlen min bɛ baarakɛyɔrɔ la fentanili ni fentanili analozi tali kunbɛnni kan kɔrɔtɔko jaabiw la (Ka fentanili tali cayalenba nsiirinw sɔsɔ farikolo la/fiɲɛ fɛ).
• Jamana ka dɔrɔguta baarada (NIDA / NIH) ani Johns Hopkins Bloomberg foroba kɛnɛya kalanso: Fentanili sɛgɛsɛgɛli sɛbɛnw (FTS) ni Xylazine sɛgɛsɛgɛli sɛbɛnw (XTS) sɛgɛsɛgɛli laboratuwari la, dilancogo sariyaw walasa ka metanfetamini/MDMA nkalontigɛbanaw bali, ani ninakili muɲuni teliya la farikolojidɛsɛ furakɛli.
• Kɛnɛya sabatili ni danfara biro (OHID) ani jamana ka kɛnɛyako baarada (NHS, Angletɛri): Jamana ka banabagatɔw lakanani lasɔminiw bɛnkansɛbɛnw kan minnu bɛ se ka kɛ bɛnzimidazɔli opioid (nitazenes) ni zilazini joginda furakɛli barikamaw kan.

Gafe minnu bɛ tali kɛ o ko la¶

• Opioid tata hakɛ cayalenba dɛmɛ fɔlɔ
• CPR (Dusukun ni fogonfogon lakununni) .
• Dɔrɔguta ni dɔrɔguta: dɛmɛni kɔrɔtɔlen
• Dɔlɔmin jugumanba, Delirium Tremens (DTs), ani furakɛli detox triage
• Benzodiazepine tali dabila yɔrɔnin kelen ani kirinni farati
• Ka denbaya kɔnɔmɔgɔ dɔ dɛmɛ min bɛ ni dɔlɔmin ye
• Sepsis ni septic shock (banakisɛfagalanw).
• Kɔrɔtɔko nimɔrɔw