Risk ɓurɗo heewde doseeji caggal muñal, sedaasiyoŋ xylazine, e doseeji naloxone¶

Winndannde wootere ɓurnde maayde e nguurndam neɗɗo mo ñawu nguu huutortoo ko opioid, balɗe 14, ina waɗa ko ɗoon e ɗoon caggal nde o yalti e nokku ɗo o rewrata tan, e nokku ɗo o reentortoo, o naati e opitaal, walla o kasoo walla kasoo. Dowlaaji epidemiyoloji ummoriiɗi e Fedde Adunaare Cellal (OMS), e nokkuuji toppitiiɗi ko fayti e ñawuuji e nder leyɗeele dentuɗe Amerik (CDC), e Biro toppitiiɗo ko fayti e moƴƴitingol cellal e ŋakkeende cellal e nder leydi Angalteer ina kollita wonde e nder yontereeji ɗiɗi gadani caggal nde neɗɗo yalti e kasoo walla e detox e nder safrirde, baasal neɗɗo maayde e doseeji opioid ɓurɗi heewde ina ɓeydoo to0fo-fold to14fo-ld huutortooɓe ñalnde kala. So tawii yiɗdeeji hakkille ina keddii ina tiiɗi, balɗe 3 haa 7 tan e reentaade opioid ina itta desensitization biologique receptor e nder ɓalndu, ina artira muñal fooftere feewde e neɗɗo mo opioid alaa. So tawii oon neɗɗo heɓiino sahaa e sahaa fof mette, artii e ballal mum ɓooyngal, ƴetti hay feccere e doseeji mum ganndaaɗi ko adii detox, ɓe keɓata ko ɗoon e ɗoon, ɓe keɓata ko ɓuuɓri foofaango, ko ɗum addanta ɓe warde.

Ko ɓuri saɗtinde ndeeɗoo bonannde caggal muñal ko ñamri mbeddaaji ndi rewaani laawol, ɓeydotoondi huutoreede e fentanil peewnaaɗi e laawol, opioiduuji benzimidazol baawɗi sanne (nitazenes), ñawbuuli alfa-2 adrenerjik daabaaji (ksilazine edezopidiyanes), silazine edesindiyan". (bromazolam). E nder doseeji fentanil-e-xilazine jillondirɗi, ƴeewooɓe ɓe ɓuuɓnata keesuuji tati walla nayi Naloxone (Narcan) e nder doggol jaawngol ina ɗaminii neɗɗo oo jooɗoo e haalde ina mbaɗa majjere mawnde : sibu nalokson ina wayla tan ko ina wona opioid, tee waawaa waylude trixonester violation, seminilozine ƴettugol ɓuuɓngol tawa ina waasa ƴeewtaade ko hisnata ngaandi tigi rigi, woni fooftere hisnude jokkondire (fooftere 1 kala leƴƴanɗe 5) tawa ina yahdi e doseeji naloxone waktuuji 2 haa 3 tawa ina tiiɗi ngam wartirde fooftere.

Waɗde ɗum jooni¶

1. Ƴeewto foofaango e jaabawol ko adii, caggal ɗuum noddu limoore emergency nokku maa ɗoon e ɗoon. Diwtu juuɗe neɗɗo oo no feewi, ɓuuɓna juuɗe maa no feewi e dow cakkital ɓalndu maɓɓe (sternum rub), ƴeewto-ɗaa ɓalndu makko fotde leƴƴanɗe 5. So tawii ɗe njaabaaki, ɗe poofaani, walla ɗe mbaɗata tan ko daande leelnde, ɓuuɓnde, ɓuuɓnde, walla ɓuuɓnde ("death rattle", ko famɗi fof foofaango 8 e nder hojomaaji) e gite daneeje, ɓuuɓɗe, walla ɓuuɓɗe, noddu 911 e nder leyɗeele dentuɗe Amerik e Kanadaa, 112 e nder leyɗeele dentuɗe Amerik, e nder leydi Orop9, 112 e nder Orop men9 limooje caɗtuɗe regginorde.
2. Waɗde dose 1 Naloxone (4 mg Narcan e nder nofru walla 0,4 mg e nder ɓalndu) ɗoon e ɗoon. Naatde e nofru naloxone nofru haa timma e nder nofru wooturu, ɓuuɓna plunger oo no feewi e junngo maa. Hoto test-spray kaɓirgal ngal e nder weeyo ko adii, sibu kala yuɓɓo ina jogii dose gooto tan.
3. Fuɗɗoode Rescue Fooftere ɗoon e ɗoon (fooftere 1 kala leƴƴanɗe 5 haa 6) e WOTO darto tawa aɗa ɗaminii naloxone ina golla. Tiltin hoore neɗɗo oo caggal, ƴetta wuttulo mum ngam udditaade laawol fooftere, pinndi nofru mum uddaa, siimtu hunduko maa dow barrier mum (huutoraade pocket recue or availd). 2 foofaango leelngo, ƴeewde ɓalndu nduu ina ummoo, rewa heen poofaango 1 kala leƴƴanɗe 5 haa 6 (poofaango 10 haa 12 e nder hojomaaji). So ɓe ngalaa pulse, puɗɗo-ɗee CPR timmuɗo (30 ɓuuɓri ɓalndu haa 2 fooftere hisnude; ƴeew men opioid ɓurɗo heewde be CPR ardotooɓe).
4. Ƴeewto fooftere e maande hojomaaji 2 haa 3 : so tawii neɗɗo oo HAA JOONI foofaani no haanirta nii (ko famɗi fof foofaango 10/hoore), rokku ɗum dose 2 Naloxone e nder nofru woɗndu nduu. Jokku foofaango hisnude hakkunde kala dose.
5. WOPPIT hokkude Naloxone ɓeydiiɗo so neɗɗo oo fuɗɗiima foofde e hoore mum (10+ foofaango/hoore), hay so tawii ɓe ngoni ko e ŋakkere hakkille e Xylazine ("tranq"). So tawii lekki kii e nder mbeddaaji ina waɗi xylazine, medetomidine, walla bromazolam e bannge neɗɗo oo, caggal nde o foofti fentanyl, naloxone wayliima no feewi e ustude fooftere opioid. So tawii ɓernde maɓɓe ina ummoo ina ustoo laabi 10 haa 16 e nder hojomaaji 10, tawa noon mbaydi leppi maɓɓe ina ɓuuɓtoo, woto njokku e ɓuuɓnude keesuuji Narcan ɓeydaaɗi e nder hunuko maɓɓe, ɗum noon ina addana ɓe ɓuuɓri ɓuuɓndi e ɓuuɓri ƴiiƴam. Rokkude ɓe e bannge maɓɓe e nder Recovery Position e jokkude ƴeewtaade foofaango maɓɓe haa safrooɓe ngara.
6. Reento "Renarcotization" leeltuɗo (fawde e doseeji ɓurtuɗi) ko famɗi fof waktuuji 3 haa 4. Nalokson ina ɓooya e nder 30 haa 90 minit, kono fentanil, nitazenes, walla metadone toowɗe ina keddii e ɓanndu fotde 4 haa 12+ waktuuji. Hoto meeɗ accude neɗɗo wuurɗo tan ngam "ɗaanaade ɗum."

Lekki kuulal : Waylude huunde hesere (Fentanil + Silazin / Nitazene) ɓurnde heewde¶

Huutoro ndeeɗoo mbaydi hisnude safaara e nder safaara so tawii aɗa jaabo neɗɗo mo jaabaaki so tawii opioid sintetik walla "tranq dope" (fentanyl + xylazine) ina waawi jeyeede heen.

flowchart TD
    A["Neɗɗo mo jaabaaki + Leelɗo, ɓuuɓɗo, ɓuuɓɗo, walla fooftere nde alaa (<8 fooftere/min)"] --> B["Noddu 911 / 112 / 999 Ɗoon e ɗoon + Hokku Dose Nalokson 1re (4 mg ɓuuɓri nofru e nder nofru 1)"]
    B --> C["ƊOONI Fuɗɗoode Fooftere Hisnude : Ƴeewto hoore, ƴetta wuttulo, pinna nofru, hokka foofaango 1 kala leƴƴanɗe 5"]
    C --> D{"Waɗde Hojomaaji 2 haa 3 nde ndokkata foofaango hisnude : Mbele neɗɗo oo ina foofa e hoore mum jooni (>=10 foofaango/min)?"}
    D -->|"NO: Haa jooni foofaani walla ɓuuɓnaaki (<8 fooftere/min)"| E["Waɗde Dose Naloxone 2 (e nder Nofru 2) + Jokkude Fooftere Hisnude (pooftere 1 kala leƴƴanɗe 5)"]
    E --> F{"Waɗde Hojomaaji 2 haa 3 goɗɗi: Fooftere artii?"}
    F -->|"ALAA (Tuumaaɗo wonde ko fentanil, karfentanil, walla nitazene toowɗo)"| G["Waɗde Dose Naloxone 3/4 kala 2-3 mins + Fooftere Hisnude nde taƴaaka / CPR haa EMS ari"]
    D -->|"EEY: Foofde e ɓuuɓde (10-16 fooftere/min) e leppi ina mbaɗta pinndi, KONO neɗɗo ina ŋakkiraa hakkille/ɗaaniima haa jooni"| H["TUUMDE XYLAZINE / BENZO : WOPPUDE rokkude Naloxone ɓeydaaɗo ; roll e nder Position Recovery e jogaade laawol henndu udditiingol"]
    F -->|"EEY: Fooftere artii"| H
    H --> I["Heddo e ñawɗo fotde waktuuji 3 haa 4+ ; ƴeew Renarkotisaasiyoŋ nde Nalokson ɓooyi e hojomaaji 30 haa 90"]

Feccere 1: Neurobiyoloji mbayliigu caggal muñal (Ko waɗi balɗe 5 abstinence ina ustoo muñal)¶

Iwdiiji e yimɓe wonɓe e cellal ina keewi hulde so nganndii wonde jaɓde balɗe 7 detox walla balɗe 28 abstinence-only rehab tawa alaa leɗɗe toppitiiɗe ina jeyaa e sahaaji ɓurɗi heewde baasal e maayde ɗoon e ɗoon. Famde no desensibilisaasiyoŋ jaɓɓotooɗo mu-opioid (\(\mu\)-OR) gollortoo ina hollita ko waɗi ɗum:

1. No muñal ɓuuɓngal mahirta: E nder kuutortooɗo opioid ñalnde kala, nokkuuji fooftere ngaandi (kompleks pre-Bötzinger, jogorɗo ƴellitde fooftere otomatik e jaabtaade ɓeydagol gaas karbonik e nder ƴiiƴam \(\text{CO}_2\)) ina jokki e ɓuuɓde e opioid. Ngam haɗude neɗɗo oo woppude foofaango, neeruuji ɗii ina fosforila e nder kemikal (chemical) e ina ustoo jokkere enɗam mum en mu-opioid, ina ɗaɓɓi laabi 10 haa 50 opioid ngam saabaade ustaare foofaango, so wonaa e neɗɗo kuutortooɗo ɗum ko adii.
2. No muñal foofaango yaawrata majjude: Ina wayi no muñal e batte euphoric opioid (ko heddii e ɓuuɓri fotde lebbi), muñal e ɓuuɓri fooftere nde opioid addata ina wayloo e yaawre e nder balɗe 3 haa 7 tan caggal nde neɗɗo woppitaa.
3. The Post-Detox Trap: So neɗɗo timminii detox balɗe 5, jooɗii e safrirde yontere e ñawu nguu, walla jooɗii balɗe 10 e nder kasoo diiwaan tawa alaa Buprenorphine (Suboxone) walla Methadone, receptoruuji foofaango ngaandi mum ina ustoo hakkille mum haa timma (limbic dopamine mismatch) ina ngoni e tolno ɓurɗo mawnude e sahaa kala.
4. "Taariindi ganndiraandi" ŋakkere muñal : Ko ɓuri haawnaade heen, wiɗtooji neurofarmakoloji Pavlovian ina kollita wonde so neɗɗo huutoriima opioid e nder nokku keso, mo anndaaka (hono suudu otel, suudu lootorde gaas, walla suudu sehil mum trigger do usual than, than jaabawol homeostatik teskinngol, ustude tolno doseeji maɓɓe ɓurɗi warde ɗii haa ɓurti.

No Lekki ngam ñawu huutoraade opioid (MOUD) ndeenirta e maayde ɓuuɓnde¶

Ndee ɗoo ŋakkeende muñal yaawnde ko ɗum addani Fedde Adunaare Cellal (OMS), Fedde Ngenndiire toppitiinde ko fayti e ñawu nguu (NIDA), e Fedde Ameriknaare toppitiinde ko fayti e ñawu nguu (ASAM) ina wasiyoo no feewi nde neɗɗo waɗata ñawu nguu tawa ina jokki Lekki ngam ustude ñawu nguu (DisordMOUD) Use

• Buprenorfin (Subokson, Sublocade, Brixadi) e Metadon ina njogii jokkere enɗam e jogaade muñal foofaango toowngal waktuuji 24 e ñalawma.
• Sabu buprenorfin ina jogii affiniteer jokkondirɗo no feewi e jaɓɓotooɗo mu-opioid, so tawii ñawɗo ƴettuɗo Suboxone ñalnde kala (walla injection Sublocade lewru kala) ina jogii sahaa mo alaa ko waawi, ina ɓuuɓtoo laawol gootol, buprenorfin ina jogori jogaade ko ɓuri heewde e jaɓɓotooɗe bitan e ɓanndu mum en doseeji ɓurɗi heewde warngooji e taƴde maayɗeele baɗɗe sabaabu fof e 50 haa 70 e nder teemedere.
• Ko wayno ɗuum, so ñawɗo suɓiima Naltrexone Extended-Release (Vivitrol) mo alaa opioid, ɓe ndeenaama tawa balɗe 28 ɗee ina ngolloo, kono ina haani ɓe jeertinee wonde so ɓe ŋakkii balɗe maɓɓe lewru arooru nduu, muñal maɓɓe e opioid ko zero.

Feccere ɗiɗmere : Silasin ("Tranq"), Medetomidin, e Nitazen e nder Dowlaaji Laabi¶

E nder duuɓi keewɗi jawtuɗi ɗii, dokkal dorog mo alaa ko bonnata e nder Amerik worgo e nokkuuji Orop, wayliima gila e heroin laaɓɗo walla fentanil, fayti e mixtures polysubstances caɗtuɗi, baylotooɗi no doseeji ɓurɗi heewde ɗii njiyrata e no ɗi njaaborii e ballal gadanal.

Tablo nannditiiɗo: Adulterants laabi e no ɓe mbaylirta ballal gadanal ɓurngal heewde¶

No toppitirtee ñawanɗe ɓalndu nekrotik ɗe Xylazine ("Tranq").¶

Nandugol e ɓuuɓri bakteriiji (ko waɗata tan ko e nokku ɗo ƴiiƴam ɗam ƴiiƴam ɗam ɓuuɓnata ɓalndu nduu), xylazine ina addana ɓalndu nduu ɓuuɓde no feewi, ina ɓuuɓna ƴiiƴam tokosam ɗam e nder ɓalndu nduu fof, ina addana ɓalndu nduu ɓuuɓde ƴiiƴam tokosam e nder ɓalndu nduu fof, ina addana ɓalndu nduu ɓuuɓde e weelo, puncheu-black-out, eschar ulcers e dow koyɗe, e koyɗe, e juuɗe hay e yimɓe ɓuuɓɓe tan walla ɓuuɓooɓe dorog:

• Hoto meeɗ ɓuuɓnude gaañanɗe xylazine e peroksiid hidrojen, alkol ɓuuɓɗo, walla ɓuuɓri, ko ɗum warata ƴiiƴam kesam ɓuuɓɗam ɗam etaade sellinde ɓuuɓri ndii.
• Lootde no feewi ñalnde kala laawol gootol e ndiyam ngulɗam laaɓɗam e saabunde ɓuuɓnde walla saline sterile, waɗde heen ɓuuɓri nebam njuumri, gaas Xeroform petrolatum, walla vaseline daneejo laaɓɗo (Vaseline) ngam haɗde leeso ñawu nguu ɓuuɓde e pa-dTelfa) e ɓuuɓri gaas loowdi.
• Ƴeewto safaara yaawɗo so tawii boɗewol ngol ina yaawi yaajde e yaasi ummoraade e ɓuuɓri ndii, ɓuuɓri boɗeeri ina ƴetta e tergal ngal, nguleeki ina ƴellitoo, walla ƴiyal/tendon ina yiyee e les ɓuuɓri ndii (risk osteomyelitis e sepsis; ƴeew men sepsis e ɓuuɓri septik ardotooɗo).

Feccere 3: "Fayndaare ko foofde, wonaa umminde" Porotokol Redosing Naloxone¶

E jamaanu xylazine e mbaydiiji nalokson nofru toowɗi (hono 4 mg Narcan, 8 mg Kloxxado, walla 5 mg Zimhi), juɓɓule cellal renndo e annduɓe safaara addiction ina teeŋtina waylo-waylo tiiɗngo e heblooji doseeji ɓurɗi heewde : Fayndaare ustude doseeji Nakson 16 foofaango e nder hojomaaji), WONAA umminde neɗɗo oo haa timma hakkille mum.

Ko waɗi Naloxone ɓurde heewde ina addana neɗɗo bonnude (Retraction précipitée & Edema pulmonaire)¶

So neɗɗo ƴeewoowo yiytii neɗɗo mo anndaaka sabu "tranq dope" (fentanyl + xylazine), o fiyi Narcan miligaram 4 (16 mg fof) e nder hunuko mum e nder leƴƴanɗe 60 sabu neɗɗo oo udditaaki gite mum tawo :

1. Naloxone ina ƴetta hojomaaji 2 haa 3 timmuɗi ngam ɓuuɓde e nder ƴiiƴam, taƴa ƴiiƴam-ngaandi. Fiyde dose ɗiɗmere walla tataɓere caggal leƴƴanɗe 30 tan ina bonna lekki kii hade dose gadano oo hay yettaade ngaandi.
2. So fentanil oo yanii e ƴiiƴam ɓalndu (ko heewi ko caggal dose 1 walla 2), neɗɗo oo fuɗɗotoo foofde kadi, kono heddotoo ko e ŋoŋɗi gila e xylazine.
3. So aɗa jokki e fiyde doseeji 3, 4, walla 5 goɗɗi naloxone e nder neɗɗo foofoowo mo xylazine seerndi ɗum, aɗa ɓuuɓna 100 e nder teemedere opioid background e kala jaɓɓotooɗo e ɓanndu mum, ɗum addana Recipitated Opioid Withdrawal:
   • Ɓuuɓri e ɓuuɓri ƴiiƴam tawi neɗɗo oo ina semi-conscience e xylazine, ina addana ɓe aspiraade ɓuuɓri e nder ɓuuɓri maɓɓe, ɓe ɓuuɓtoo.
   • Ɓooygol katekolamin (adrenalin) mawngol baawngol saabaade ɓuuɓri ƴiiƴam ndi alaa ko bonnata ɓernde (ndiyam keewɗam ƴiiƴam) e ɓuuɓri ɓernde.
   • Nafoore ɓalndu mawnde e ɓuuɓri addanndi neɗɗo oo dogde e nokku hee, oon ɗoon e ɗoon huutoraade doosgal mawngal fentanil mbeddaaji caggal hojomaaji 20 ngam haɗde ñawu nguu, ɗum addanta neɗɗo oo doseeji ɗiɗaɓiri bonɗi so nalokson oo ɓooyii.

Ko foti waɗeede so tawii neɗɗo oo ina jogii "Syndrome de la pet en bois" (Rigidité de la mur du pet fentanyl)¶

So neɗɗo ina ɓuuɓna walla ina foofa ɓuuɓri jaawndi, toowndi, fentanil walla nitazenes sintetik, ina waawi sahaa e sahaa fof saabaade Rigidité de la mur du thorax induit par le fentanil ("Syndrome du thorax en bois") e nder leƴƴanɗe 60 : - Koɗorɗe daande neɗɗo oo (glottis) e ƴiye hakkunde-leyɗeeje/diaphragme ina njuɓɓina tiiɗde no alluwal nii. - So a ƴettii hoore maɓɓe caggal, aɗa etoo fawde heen foofaango hisnude e nder hunuko maɓɓe, henndu naatataa, ɓernde salii umminde, hay so tawii alaa ko woni e hunuko maɓɓe ko nguura walla ko wonaa huunde. - Golle ɗoon e ɗoon: Waɗde Naloxone (Narcan) ɗoon e ɗoon. Ina wayi no ɓuuɓri gonndi e laawol henndu, Sindoron ɓernde leɗɗe ko ɓuuɓri gonndi e ɓalndu, ndi ɓuuɓri mu-opioid e nder ɓalndu (locus coeruleus) kadi ko Naloxone udditi ɗum e yaawre. Jokku etaade foofde hisnude no feewi e saraaji ɓuuɓri ɓalndu tawa nalokson ina sooma ko ɓuri leƴƴanɗe 90 haa 120 ; so naloxone oo yanii e ɓalndu, ƴiye daande e ɓalndu ina ɓuuɓtoo, fooftere maa hisnude ina ɓuuɓtoo no feewi.

Feccere 4: No kuutorto-ɗen no moƴƴi mbaydiiji jarribooji fentanil, xilazin e nitazene¶

Ɗaɗi jarribooji immunoassay jaawɗi (Ɗaɗi jarriborɗi Fentanil / FTS, Ɗaɗi jarribooji Xylazine / XTS, e Ɗaɗi jarribooji Benzodiazepine / Nitazene) ko mbaydiiji kaayitaaji ɗi ngalaa njoɓdi, ɗi nganndu-ɗaa ina njiytoo mborosaaji baawɗi warde haa e pecce-in-2. Kono, ƴeewde pillol walla poɗɗe ɗe moƴƴaani ina rokka negatif fenaande sabu majjere ɗiɗi kuutortooɗo : "Effet cookie chip chocolat" e fenaande fenaande ɓurnde heewde e metamfetamin/MDMA.

Rewrude e ndeeɗoo Porotokol ƴeewndo leɗɗe hoolkisaaɗe e laboratuwaaruuji 5 (ummoraade e CDC, DanceSafe, e Duɗal Cellal Jaaynde Johns Hopkins Bloomberg) :

Ɗatal 1: Foolde "Effet Cookie Chip Chocolat" (Ƴeewndo Dose oo fof)¶

So pressinguuji pillitol ɗi ngalaa sariya walla yeeyooɓe laabi ina njillondira e miligaram 1 fentanil e nder powle filler ngam pressinguuji pillitol oksikodon ("M30"), Xanax, walla Adderall fenaande, fentanil oo jillondirtaa no feewi. Feccere e pillol ɓuuɓngol ina waawi wonde e fentanil zero (fotde cookirɗe), tawi noon ɓuuɓri tokosiri bannge goɗɗo oo e pillol gootol tigi rigi ina waɗi hotspot fentanil laaɓɗo (fotde sokola) baawɗo warde, mo miligaramuuji 2. - So a ɓuuɓtii tan ko ŋoral tokosal milimeeteer 1 e dow pillol ɓuuɓngol ngam ƴeewndaade ngol, aɗa waawi waasde ɓuuɓde nokku fentanyl oo, keɓaa njeñtudi kisal fenaande. - Ko ɓuri moƴƴude: Ɓoorno-ɗaa pillo oo fof walla dose oo fof mo njiɗ-ɗaa ñaamde e nder poɗɗe laaɓtuɗe, ɓuuɓɗe no feewi e nder cooyngal laaɓngal, gilaas shot, walla baggie plastic tokooso mbele kala hotspot ina renndinee e nder sample oo fof.

Ɗatal 2: Ɓeydude limre ndiyam laaɓtunde (Kuulal dilution critique)¶

1. So aɗa jarriboo Opioid Injectable (Fuɗɗude ƴiiƴam ɗam fof e nder cooyngal): Caggal nde ƴettu-ɗaa dose maa ɓuuɓɗo oo dow e nder siriŋ maa, ɓeydu heen 5 mililiter (1 kaas / 1 ampoule ndiyam sterile standard) ndiyam laaɓɗam e nder cooyngal ngal,f
2. So aɗa jarriboo Pill Crushed walla Residue Powder: Waɗtu ko ina tolnoo e 10 miligaram powder ɓuuɓɗo (ina heewi ngam suɗaade gaasa e hoore Abraham Lincoln e dow penny Amerik, walla e tip coktirgal galle) e nder koppi tokoosi:
   • Wonande Heroin, Oksikodon, Xanax, walla Kokayin: Ɓeydu heen 5 mililiter (1 kaas) ndiyam laaɓɗam walla ndiyam ɓuuɓɗam, ɓuuɓna ɗum fotde leƴƴanɗe 15.
   • KO ƁURI TEŊKUDE E ƊEMNGAL: Ngam Metamfetamin, MDMA (Ekstaasi/Molly), walla Difenhidramin: Aɗa foti ɓuuɓnude metamfetamin walla MDMA e nder 30 mililiiteer (2 cukalel / 1 ons ndiyam / gilaas timmuɗo e kala mg0wter) ndiyam So a ɓuuɓnii metamfetamin walla MDMA e nder toɓɓe ndiyam seeɗa tan, ɓuuɓnoowo ɓuuɓɗo oo ina jokkondiri e antibiotik oo e dow strip jarriborɗo Fentanyl, ina waɗa positif fenaande (e ɓuuɓri toowndi lidokayin walla difenhidramin taƴaaɗo e leɗɗe mbeddaaji ina waawi haɗde Xylazine perL to5 mg).

Ɗatal 3: Dip Strip fotde 15 Sekon e Lay Flat¶

1. E jogaade jokkol junngo colour Batte Test Fentanyl (e Batte Test Xylazine ceertuɗe), ɓuuɓna tip absorbant les ɓuuɓɗo oo e nder ndiyam tan haa e laylaytol ɓurngol heewde fotde 15 leƴƴannde.
2. Lelnu strip oo e dow leydi laaɓndi, ɗaɓɓu 2 haa 5 minit hade maa janngude e les annoore moƴƴere.

Ɗatal 4: Janngu Diidi ɗii no haanirta nii (Ko luutndii jarribo COVID walla jarribo reedu)¶

Batte teskuyaaji leɗɗe cafrorteeɗe ina njannga KO LUUTƊI e teskuyaaji reedu galle walla teskuyaaji COVID-19:

• Diidi gooti boɗeeji/pink (diidi Top Control tan) = POSITIIF (HAKKOL: Fentanyl walla Xylazine INA WONI). Hay so diidi ɗiɗaɓi zero ina ngoodi hay dara, diidi 1 = POSITIIF.
• Laabi ɗiɗi boɗeeji/pinki (Hay so laabi jarriborɗi les ɗii ko super faint no ɓuuɓri nii) = NEGATIF (Fentanyl/Xylazine yiytaaka e ndeen sample).
• Diidi zero (walla diidi les tan ɗi ngalaa diidi toppitiiɗi dow) = INVALID TEST (Test e strip keso).

Feccere 5: Toppitagol caggal ummital, njuɓɓudi ƴettugol ɓuuɓri, e ƴeewndo renarkotization waktuuji 4¶

So neɗɗo fuɗɗiima foofde no feewi kadi (foofde 10 haa 16 e nder hojomaaji) caggal Naloxone e foofde hisnude, emergency joofaani. Ko mbaɗata e nder hojomaaji 60 gadani caggal ummital ina hollita so tawii neɗɗo oo ina wuuri ñalnde heen walla ina wondi e mboros bonɗo (dose secondaire) bonɗo.

1. No njuɓɓinirtee neɗɗo mo ummii e ɓuuɓri gonndi e ɓuuɓri gonndi e ɓuuɓri¶

So tawii doseeji keewɗi Naloxone ina ndokkee (walla so tawii neɗɗo oo ina jogii fentanil teeŋtuɗo ñalnde kala), ina waawi ummitaade ina ɓuuɓtoo, ina ɓuuɓtoo, ina ɓuuɓtoo, ina ɓuuɓtoo no feewi, ina ɗaɓɓa yaltude ɗoon e ɗoon ngam huutoraade leɗɗe goɗɗe ngam haɗde mette ɗee :

• De-escalate e calminaali e faamnude ko waɗi e nder leƴƴanɗe 10: Darto caggal meeteer 1 (3 feet) mbele ɓe njiyataa corned, haaldu e daande deeƴnde, nde ñaawataa, mbiyaa: "A woppii foofde e doseeji ɓurtuɗi.min ndokki ma Narcan noright so feel maa Narcan ina haɗa jaɓɓotooɗe maa Narcan ina fuɗɗoo ɓoornaade e nder hojomaaji 30 haa 45, ñawu nguu ina ustoo e hoore mum."
• Ko waɗi aɗa foti ñaagaade ɓe yo ɓe kuutoro fentanyl ko ɓuri jooni jooni: Fammina laaɓndal: "Jooni noon, Narcan ina waɗa no gartirgol wakkatiyel e dow receptors ngaandi maa. So a ƴettii hit fentanyl goɗɗo jooni jooni ngam etaade fiyde Narcan, a nanataa ɗum hay dara nde wear off minutes, kono hay dara fentanyl maa ɓuuɓtu e ngaandi maa e sahaa gooto, wara ma."
• Positioning pour Xylazine / Benzodiazepine Co-Sedation: So tawii neɗɗo oo ina foofa no haanirta nii (12 fooftere e nder hojomaaji) tawa ina jogii leppi/koppi pinɗi, kono ina heddii e ɗaanaade no feewi gila e xylazine, ɓuuɓna ɗum en e bannge nano mum en e nder nokku mum en ɓuuɓri ɓuuɓndi e dow maɓɓe, e jooɗaade e sara maɓɓe ina ndaara kala fooftere haa safrooɓe ƴetta laamu.

2. Ñalnde wootere waylude buprenorfin caggal ummital nalokson¶

Departemaaji cafrirɗi e EMS "Bridge Clinics" ina ndokka jooni Induction buprenorphine post-overdose e nder suudu safrirdu caggal nde doseeji ɗii mbayli, kam e Induction Buprenorphine Micro-Dose Low (Laawol Bernese) wonande yimɓe huutortooɓe fraid a street: - E nder nokkuuji 36 e nder mette, Laawol Bernese fuɗɗotoo ko e doseeji tokoosi buprenorfin (0.25 mg to 0.5 mg laabi ɗiɗi e ñalawma) tawi ñawɗo oo ina jokki e ustude agonisteeji timmuɗi, seeɗa-seeɗa ina maha laylaytol buprenorfin e dow reentorde ngaandi e nder balɗe 5 haa 7 haa timma 12 mg to 16 mg dose ñalnde kala ina yettoo e zero ɓuuɓɗo.

Naamne keewɗe naamneede¶

Fuɗɗoode ƴeewtaama¶

• Centres de contrôle et de prévention des maladies (CDC) e njuɓɓudi toppitiindi cellal hakkille (SAMHSA, leyɗeele dentuɗe Amerik): Kuutorgal ngam haɓaade ñawuuji ɓurɗi heewde opioid, ardorde safaara e dow fentanyl e xylazine ("tranq") peewnaaɗi e laawol ngol rewaani laawol, e dow mg nalokson.
• Fedde Adunaare Cellal (OMS, hakkunde leyɗeele): Njuɓɓudi renndo ngam haɓaade ɓurtugol opioid (Protokolle ventilaasiyoŋ hisnude, tiitoonde naloxone, baasal maayde caggal kasoo / caggal detox, e toppitagol nokkuuji cellal).
• Koldaa Ameriknaajo tookeeji safaara (ACMT) e Akademi Ameriknaajo tookeeji safaara (AACT): Bayyinaango darnde jokkondire ngam haɗde fentanil e analog fentanil e nder golle e nder jaabtiiɓe caɗeele (Refuting myths overdose fentanyl passif dermal/airborne).
• Duɗal ngenndiwal ko faati e ñawu nguu (NIDA / NIH) e Duɗal Cellal Jaayndewal Johns Hopkins Bloomberg : Ƴeewndo laboratuwaaruuji ƴeewndorɗe fentanil (FTS) e ƴeewndorɗe xilazine (XTS), kuule dillugol ngam haɗde metamfetamin/MDMA fenaande, e neurobiyoloji rapidiraasiyoŋ toɓɓugol ƴiiƴam.
• Ofis ngam moƴƴitingol cellal e ŋakkeende cellal (OHID) e Sarwiis ngenndiijo cellal (NHS, Angalteer): Jeertinaango ngenndiijo ngam kisal ñawɓe e dow opioid sintetik benzimidazole (nitazenes) baawɗo huutoreede e njuɓɓudi ñawanɗe xylazine.

Ardiiɓe jokkondirɓe¶

• Ballal gadanal ɓurngal opioid
• CPR (Uurtinde ɓernde e ɓuuɓri)
• Kuutoragol geɗe e mborosaaji: ballal ballal eɓɓoore
• Uddugol alkol no feewi, ɓuuɓri ƴiiƴam (DTs), e ƴeewndo safaara
• Woppude benzodiazepine e sahaa gooto e baasal ɓuuɓngal
• Wallude tergal galle mo addiction
• Sepsis e ɓuuɓri septik
• Limooje emergency