Doseeji cemmbinɗi (‘Overamping’) : Ɓooygol nguleeki, ɓuuɓri ɓernde, e ɓuuɓri ɓuuɓri¶

Ina wayi no doseeji opioid ɓurɗi heewde, ɗo neɗɗo ina ɓuuɓtoo seeɗa seeɗa, ina wayloo, ina woppa foofaango, doseeji cemmbinɗi, ganndiraaɗo no feewi e safaara ustude bonanndeeji e safaaraaji caɗtuɗi, ko "overamping", ko kiris bonɗo, ɓurɗo heewde metabolism e nder ɓernde, e ngaandi, e ƴiiƴam. So neɗɗo ñaamii dose tooke metamfetamin, kokayin pooɗal, kokayin crack, MDMA ("ekstaasi" / "molly"), pillitol amfetamin ngol haɗaani, walla katinon sintetik ("salteeji loowdi" / alfa-PVP / mefedron), walla ina ɓuuɓtoo balɗe e nder nervous e dow a wondude e dopamin, norepinefrin, e serotonin. Ɓernde ina ɓeydoo heewde haa ɓura 140 haa 180 fiyngo e nder hojomaaji, tansiyoŋ ina ɓeydoo haa yettoo toɓɓe baawɗe saabaade mboros (220/130 mmHg+), ƴiye koronaawiris ina udditoo e vasospasme acute, nguleeki ɓalndu ina waawi ɓeydaade yaawde haa ɓurta 40,0 haa 41,5 degere Celsius (104,0 haa 106,7 degere Fahrenheit).

So ɗum safraaka, tooke cemmbinɗe tiiɗɗe ina mbaawi warde e nder laabi nay jaawɗi : hipertermi bonɗo (defde terɗe ndernderiije e ustude ɓuuɓri nder ƴiiƴam), vasospasme ƴiiƴam koronaawiris e ɓuuɓri sodium-channel fatal e nder cellal miokardi walla ventrikulaar fatal akute Duuɓi 20), stroke ƴiiƴam nder hoore walla ɓuuɓri status epilepticus, e rabdomyolyse (ɓuuɓri ƴiiƴam mawndi bonndi ƴiiƴam). E oon sahaa gooto, nde tawnoo fentanil e nitazeen mo alaa ko bonnata hannde ina mbonna ko heewi e kokayin mbeddaaji, e karaŋ, e metamfetamin, e pillitol Adderall/MDMA ɓuuɓngol, kala kuutortooɗo ɓuuɓri, tawa ɗoon e ɗoon ina wonta ŋoŋɗi, ŋoŋɗi, walla ŋoŋɗi foofde, ina foti heɓde **exonemedicannasal.**nalo) Anndude no seerndirta overamping hakkille e emergency safaara baawɗo warde nguurndam, no coofnirta ñawɗo stimulant burning-hot e nder hojomaaji seeɗa, e ko waɗi a fotaani MEƊƊE pinnude ɓanndu ñawɗo stimulant delirious yeeso-dow e reedu mum ina hisna nguurndam.

Waɗde ɗum jooni¶

1. Ƴeewto fooftere e jaabawol mum ko adii : so tawii kuutortooɗo stimulant oo ina ŋakkiraa hakkille, ina ɓuuɓtoo, ina ɓuuɓtoo, walla ina foofa seeɗa seeɗa, waɗ Naloxone (Narcan) 4 mg e nofru, fuɗɗoo foofaango hisnude ɗoon e ɗoon. Kokayin mbeddaaji, metamfetamin, e pillitol stimulant ɓuuɓngol ina keewi cross-fenyl Hay so aɗa anndi ɓe njiɗnoo tan ko huutoraade stimulant, naloxone ina wayla fentanyl suuɗiiɗo kadi bonnataa neɗɗo jogiiɗo emergency stimulant laaɓɗo.
2. Noddu limoore emergency nokku maa (911 to Amerik e Kanadaa, 112 nder UE, 999 e nder leydi Angalteer) ɗoon e ɗoon so tawii neɗɗo oo ina jogii KALA bannge boɗeejo ɓanndu : ɓuuɓri ɓalndu walla ɓuuɓri, ɓalndu core ina nanndi e nguleeki, ɓuuɓri, ɓuuɓri hoore tiiɗndi ɗoon e ɗoon, yeeso ɓuuɓngo/juumre ɓuuɓnde, walla delirium mo alaa ɗo haaɗi. Ƴeewto men limooje caɗtuɗe regginorde.
3. So tawii ko ɓalndu neɗɗo oo ina wuli jaw, ina ɓuuɓna, walla ina ɓuuɓna, ina ɓuuɓna, fuɗɗoo coofgol ɓuuɓngol ƊOONI ƊOONI tawa aɗa fadi ambulance. Ɓoorno-ɗaa comci yaajɗi ɓurɗi heewde, pack **pack **ice packs walla saakuuji leɗɗe ɓuuɓɗe cuɗaaɗe e comci ɓuuɓɗi, e nder ar., e nder ar ɓalndu ɓuuɓndu e ndiyam ngulɗam tawa ina fuɗa heen fannu toowɗo, walla ina ɓuuɓna ɗum en e lootorde cooynde (jogaade hoore ina jokki e dow ndiyam). Kala minit nguleeki core ina heddii e dow 40,5 degere Celsius (105 degere Fahrenheit) ina addana ngaandi e terɗe bonɗe ɗe mbaylaaka.
4. WOTO MEƊƊU jogaade, pinnude, hog-tie, walla jooɗaade e dow ɓalndu walla e ɓanndu kuutortooɗo stimulant ɓuuɓɗo walla ɓuuɓɗo (restraint prone). Neɗɗo gonɗo e tooke stimulant ɓuuɓɗo ina jogii asidosis metabolik ɓurɗo heewde, ina ɗaɓɓi yaajde ɓalndu-wall mawɗo ngam fuɗde gaas karbonik (CO2). Pinnude ɗe yeeso les ina haɗa ɗe ɓuuɓde, ina ɓeyda asid e nder ƴiiƴam, ina addana ɗe ɓurtugol ɓernde e nder leƴƴanɗe 60.
5. **So tawii neɗɗo oo ina wondi e ɓuuɓri ɓalndu, ɓuuɓri jawdi/junngo nano, walla ɓuuɓri ɓuuɓri caggal nde huutorii kocaine walla met, jooɗo-ɗaa e dow ŋoral, resnda ɗum haa laaɓa cer, rokka ɗum 162 haa 325 mg Aspiriin ɓuuɓɗo (so wonaa tawa ina wondi e allergie walla ina jogii won e stroke/walround). tiiɗnaade, e anndinde safrooɓe ɗoon e ɗoon wonde kocaine walla metamfetamin ina woni e laana (safrooɓe safrooɓe ina poti reenaade won e mborosaaji beta-bloqueurs bonnooji ɓuuɓri ƴiiƴam).
6. So tawii neɗɗo oo ina wondi e "overamp" hakkille ɓurɗo hoybude (anxieux, jittery, paranoïde, walla exhausté tawa alaa ko nafata e ɓernde, alaa ko woni e mum so wonaa ɓuuɓri, e fooftere no woorunoo), nawtu ɗum to suudu cooyndu, niɓɓiɗndu, deeƴndu. Hokku ɗum njaram electrolyte cooyɗam, duɗal cooyngal walla non washcloth ofm woodgol haa stimulant oo ustoo.

Rapid Triage: Overamping hakkille ɓuuɓɗo vs tooke safaara kulɓiniiɗe nguurndam¶

E nder golle ustude bonanndeeji, helmere "overamping" ina soomi geɗe keewɗe : gila e ɓuuɓri gonndi e ɓuuɓri, jittery caggal nde neɗɗo ƴetti Adderall, meth, walla coke no feewi, haa e hipertermi, stroke, walla ɓuuɓri ɓernde. Huutoro ndee lekki pellital ngam seerndude ko waawi calminaade e nder galle e ko haani ICU safrirde jooni jooni.

flowchart TD
    A["Neɗɗo gonɗo e caɗeele Caggal Kokayin, Met, Crack, MDMA, walla Pills"] --> B{"Mbele Ɓe Jaabaaki walla Ɓe Foofa Seese / Ɓooytoo?"}
    B -->|YES: Limp, Blue Lips, Slow Breathing| C["TUUMƊO FENTANIL : Hokku Naloxone 4 mg Spray + Fooftere hisnude + Noddu 911"]
    B -->|NO: Awake, Fast Heartbeat, Sweating, Agitated, or In Pain| D{"Kala maandeeji kiriis simpatomimetik bannge boɗeejo?"}
    D -->|Hot Skin > 39.5C/103F, Chest Pain, Seizure, Stroke Signs, Dark Urine, or Violent Delirium| E["ƊAƊƊI CAAFORDE: Noddu 911 / 112 / 999 Ɗoon e ɗoon"]
    D -->|NO Physical Red Flags: Jittery, Anxious, Racing Thoughts, Exhausted, Mild Paranoia| F["Overamping ɓuuɓɗo/hakkunde: De-Escalate e nder suudu coofndu, deeƴndu"]
    E --> G["1. Ice-Pack jaawɗo / coofgol ɓuuɓngol 2. Aspiriin ɓuuɓɗo 325 mg so tawii ko ɓuuɓri ɓernde 3. Reentaade Zero Prone"]
    F --> H["1. Dim fitirlaaji & ɓuuɓnude jimɗi 2. Ndiyam cooyɗam / Elektrolit & Snack 3. Lowre cooynde 4. Monitor Kala Hojomaaji 15"]

Tablo Triage Clinique : Overamping ɓaleejo/oolo vs Emergency simpatomimetik boɗeejo¶

Emergency 1 : Hipertermie stimulant maligne ("Defde gila e nder")¶

Sabaabu gadano maayde yaawnde e nder metamfetamin, MDMA ("molly"), e katinon sintetik ("salt bath") ɓurtuɗo ko hipertermi dogdu.

1. Hol ko waɗi ɓuuɓri ina addana nguleeki ɓalndu ɓurde 41 degere Celsius (106 degere Fahrenheit) .¶

Stimulants e sahaa gooto ina ɓuuɓna ɓuuɓri nder ɓanndu tawa ina ɓuuɓna radiator mum :

• Peewnugol nguleeki mawki: Dopamin, serotonin, e norepinefriin ɓurtuɗo ina addana ɓalndu jokkude golle, ɓuuɓnude jawdi, ɓuuɓtude, e ɓuuɓnude mitokondriyeeji (UCP-3), ina addana nguleeki ɓalndu mawngu (haa teeŋti noon e nder cuuɗi jammaaji keewɗi yimɓe, ngulɗi, e nder pijirlooji ndunngu, walla e nder cuuɗi ɗi henndu mum en moƴƴaani).
• Bloqué de chaleur dissipation : E sahaa gooto, norepinefrin ina addana vasoconstriction periférique adrenergique alpha-1 tiiɗnde, ɓuuɓri ina uddita ƴiiƴam e nder ɓalndu haa ƴiiƴam ngulɗam waawa yettaade ɓalndu nduu ngam coofde.
• 40.5C (105F) Ɗatal ŋakkere terɗe keewɗe: So nguleeki ɓalndu ɓurii 40.5 degere Celsius (105 degere Fahrenheit) ko ɓuri hojomaaji 20 haa 30, poroteyiinuuji cellal ina mbayla, ina mbaɗta ɓuuɓri ɓalndu (barrière blooddumtox) ƴiiƴam ina ɓuuɓta (rabdomiolyse), ƴiiƴam ina yahra haywire (Coagulation intravasculaire diffuse / DIC), ina addana ƴiiƴam warde e kala tergal.

2. Porotokol coofgol jaawngol hade opitaal, Ɗatal e Ɗatal¶

Hoto waɗtu safrooɓe fuɗɗaade coofnude ñawɗo ɓuuɓɗo, kadi woto meeɗ rokkude asetaminofen (paracetamol / Tylenol) walla ibuprofen/aspiriin ngam ustude nguleeki ɓuuɓki. Pille ɓuuɓɗe ina ngolloo e hipotalamus e nder ɓuuɓol grippe/bakteriiji ɓuuɓɗi, ina mbaɗa zero ngam hipertermi ɓalndu baɗaaɗo e leɗɗe (ko ɓuri bonde, asetaminofen ina yaawi ŋakkere heeñere e sahaa hipertermi, AINE ina ɓeyda ŋakkere ƴiiƴam).

1. Moƴƴin to nokku ɓurɗo coofde: Addude neɗɗo oo e nder suudu ɓuuɓndu walla henndu ɓuuɓndu, ittu limce tedduɗe, limce, limce, e paɗe les haa les.
2. Waɗde ɓuuɓri ƴiiƴam e jokkondire ƴiiƴam mawɗe: Ɓoorno-ɗaa ɓuuɓri ƴiiƴam, saakuuji ɓuuɓri ƴiiƴam, walla ɓuuɓri nguura ɓuuɓndi e nder towel ɓuuɓɗo, ɓuuɓna ɗum no feewi e **wuddu (ƴiiƴam karotiid), ɓuuɓri (ƴiiƴam aksillaari), e ɓuuɓri gonndi e ɓalndu (femoral).
3. Coofgol ɓuuɓngol e fannu ɓuuɓngol (walla ɓuuɓnugol ndiyam ɓuuɓɗam):
   • Eponge walla ɓuuɓnude nokkuuji mawɗi e ɓalndu ɓuuɓndu e ndiyam ngulɗam (15 to 20 degrees Celsius / 60 to 68 degrees Fahrenheit) tawa ina toɗɗii fannu kuuraa ɓurɗo tiiɗde mo woodi (walla fannu semmbe e karton/towel) to bannge ɓalndu ɓuuɓndu nduu. Ɓooygol ina itta nguleeki laabi jeeɗiɗi ko ɓuri henndu yoorndu.
   • So tawii batte ina ngoodi ɗoon e ɗoon, neɗɗo oo ina ummoo (walla wallidiiɓe ɗiɗo tiiɗɓe ina mbaawi jogaade hoore ndee e dow jam), ɓuuɓna ɓalndu nduu e terɗe ɗee e ndiyam ɓuuɓɗam. (Ƴeew Ɓoornugol nguleeki vs ɓuuɓri ɓuuɓri.)

Emergency 2: Kokayin e Metamfetamin Naafigaagal ɓernde (Ɓernde & Vasospasm)¶

Kokayin e metamfetamin ina ngaddana infarctus miocardique (infarc cardiaque), dissection aortique, e arrêt cardiaque suffisant hay e nder huutortooɓe duuɓi 19 haa 35, tawi ina njogii ɓuuɓri kolesterol e nder ƴiiƴam mum en.

1. Hit ɓernde tatiire kocaine (e Cocaethylene e alkol)¶

• Vasospasme de l’artère coronaire + Surging de l’oxygène de la demande: Kokayin e met ina addana ɓalndu nduu fiyde no feewi e yaawde tawa e sahaa gooto spasm arterie coronaire ina uddita, ina weela ɓalndu ɓernde e oksijen.
• Blokaade sodium-channel direct (Kokayin tan): Kokayin ko anestetik nokkuyankeewo ("kayin") mo haɗata sodium yaawɗo ɓernde (Na+) laabi, yaajnude elektirik ɓernde QRS takikardiya ventrikulaar walla fibrilaasiyoŋ ventrikulaar (ko safrooɓe safrooɓe ɓee safrata e bikarbonaat sodium nder ƴiiƴam).
• Yaawde ɓuuɓde ƴiiƴam : Stimulants ina kuutoroo ƴiiƴam, ina addana ƴiiƴam ɓuuɓde no feewi e nder ƴiiƴam koronaawiris ɓuuɓɗam.
• Multiplier Cocaethylene (Cocaethylene + Alcohol): So neɗɗo yarii alkol tawa ina huutoroo kocaine pooɗal walla crack, heeñere neɗɗo ina wayla leɗɗe ɗiɗi ɗee, waɗta ɗum en mbaydi tataɓiri, ceertundi, ndi wiyetee ko kocaetilen. Kokaetilen ina jogii feccere nguurndam plasma laabi 3 haa 5 ko ɓuri kokayin tan, ina ɓeyda baasal maayde ɓernde ɗoon e ɗoon fotde laabi 18 haa 25.

2. Ballal gadanal ngam ɓuuɓri ɓalndu cemmbinndi (e jeertinaango Beta-Blocker Hospitaal)¶

1. Noddu 911 / 112 / 999 ɗoon e ɗoon ngam kala ɓuuɓri, teddundi, ɓuuɓri, walla ɓuuɓri ɓuuɓri, ɓuuɓri foofaango, ɓuuɓri ɓuuɓri, walla ɓuuɓri gonndi e ɓalndu, e wuddu, e wuttulo, walla e junngo.
2. Doole fooftere ɓanndu timmunde e deeƴre: Joɗɗin neɗɗo oo e nokku mo ɓuuɓri feccere (45 degrees) e koppi mum en ina njuuti. Kala ko ɓe njahrata ina ɓeyda katekolamin e ɗaɓɓaande oksijen miokardi.
3. Hokkude 162 haa 325 mg Aspiriin mo alaa ko waawi e nder reedu: So wonaa tawa neɗɗo oo ina jogii alerji aspiriin goonga walla ina hollita maale ƴiiƴam/stroke walla ɓuuɓri ɓalndu (dissection aortique), waɗde ɓe ƴamde e muñde bate mawɗo gooto 325 mg aspiriin (walla ɗiɗi haa fo nder ƴiiƴam korona. (Ƴeew Ballal gadanal ñawu ɓernde.)
4. Haalana Paramedics e Doctors ER Ɗoon e ɗoon Ko Kokayin walla Meth Huutoraama:
   • E nder ñawu ɓernde ngu alaa ko woni e mum, safrooɓe safrooɓe ina keewi rokkude beta-bloqueurs (hono metoprolol walla propranolol) e nder ƴiiƴam.
   • E nder doseeji kocaine walla metamfetamin ɓuuɓɗi, rokkude beta-bloqueur laaɓɗo (beta-1 / beta-2 blockade) ina waawi saabaade "stimulation alpha-adrenergique non opposée," ɗo ustude ƴiiƴam beta ina addana ƴiiƴam alfa udditaade, addana ƴiiƴam koronaawiris ɓuuɓde haa laaɓa cer, ƴiiƴam ɓeydoo haa laaɓa cer.
   • So a haalanii doktoor ER oo goonga wonde kocaine walla met ina woni e laana, ɓe safrata ñawu nguu e dow jam, ɓe kuutoroo benzodiazepines (lorazepam walla diazepam) ngam deeƴnude ƴiiƴam gonɗam e nder ɓalndu, nitroglycérine sublingual walla IV, e **kalsiyum/ver fentolamin.

Emergency 3 : MDMA ("Molly" / "Ecstasy") Ɓooygol ndiyam e ŋakkeende ndiyam¶

MDMA (3,4-methylenedioxymethamphetamine).

+-------------------------------------------------------------------------+
|       THE MDMA ("MOLLY") HYDRATION RULE: ELECTROLYTES, NEVER GALLONS    |
|                                                                         |
|  WHY PLAIN WATER CAN KILL ON MDMA:                                      |
|  MDMA stimulates the brain to release huge amounts of Antidiuretic      |
|  Hormone (ADH / Vasopressin), causing SIADH: your kidneys are           |
|  chemically LOCKED and CANNOT produce urine to excrete excess water.    |
|                                                                         |
|  If a dancing or overheating MDMA user chugs 3 to 5 liters of plain     |
|  tap or bottled water in 2 hours, blood sodium (Na+) plummets below     |
|  120 mEq/L (Acute Dilutional Hyponatremia). Water rushes into brain     |
|  cells, causing fatal CEREBRAL EDEMA (brain swelling, vomiting,         |
|  seizures, brain herniation, and death), disproportionately affecting   |
|  young women due to estrogen's effect on the brain sodium pump.         |
|                                                                         |
|  SAFE MDMA FLUID RULE:                                                  |
|  1. Drink ONLY isotonic ELECTROLYTE solutions (sports drinks, ORS       |
|     packets, or salty broth), NEVER large volumes of plain water.       |
|  2. Limit intake to roughly 250 to 500 mL (1 to 2 cups) per hour        |
|     while dancing or sweating, and 250 mL/hour when resting.            |
|  3. If someone on MDMA starts vomiting, has a headache, seems confused, |
|     or has not urinated despite drinking, STOP ALL FLUIDS and call 911  |
|     for emergency hypertonic saline (3% NaCl) treatment.                |
+-------------------------------------------------------------------------+

Emergency 4 : stroke stimulant, ƴiiƴam subaraknoid, e ɓuuɓri¶

Sabu metamfetamin, kokayin, crack, e katinon sintetik ina addana ƴiiƴam ɓuuɓde e nder ƴiiƴam (200/120 to 260/150 mmHg) e sara ɓuuɓri ƴiiƴam e ɓuuɓri ƴiiƴam, stroke iskemiik akut e ƴiiƴam ngaandi ƴiiƴam (ƴiiƴam nder ngaandi walla aneurisma ngaandi ruptur) ko caɗeele keewɗe bonɗe e stimulant overamping, hay e yimɓe e nder thiwerti mum en.

1. Anndude ƴiiƴam ngaandi walla mboros (BE-FAST)¶

Hoto meeɗ woppude ɓuuɓri hoore tiiɗndi, ɓuuɓri, walla haala ɓuuɓka e nder doggudu ɓuuɓndu, hono "toowde tan" walla waasde ɗaanaade :

• Naafigaagal "Thunderclap" (Aneurysm Rupturé / Hemorragie Subarachnoïde): So tawii neɗɗo mo ɓooyaani ko ɓuuɓti crack, ɓuuɓtii kokayin, walla huutoriima metamfetamin, ɗoon e ɗoon nanngi hoore mum, wulli e **naafigaagal ɓurngal bonde, ɓurngal ɓuuɓde e nguurndam mum6). wondude e wutte tiiɗɗo, ɓuuɓde, ɓuuɓde annoore, walla ɓuuɓde, ina gasa tawa ƴiiƴam gonɗam e les ngaandi ndii ina ɓuuɓtoo e les ɓuuɓri katekolamin ɓurndi heewde.
• BE-FAST Banngeeji boɗeeji stroke neurologique:
  • B (Balance): Ɓooygol ɓuuɓngol, ɓuuɓgol, walla waasde yahde no haanirta nii.
  • E (Gite): Ɓooygol ɓuuɓngol, ɗiɗi, walla majjugol gite goote walla ɗiɗi ɗee.
  • F (Yeeso): Bannge gooto e yeeso ina ɓuuɓtoo walla ina ɓuuɓtoo so naamnaama yo ɓuuɓto.
  • A (Juuɗe): Juuɗe walla koyngal gootal ina ɓuuɓtoo les walla ina ɓuuɓtoo so ina ɓuuɓtoo.
  • S (Haala): Haala ɓuuɓka, konnguɗi ɓuuɓɗi, walla waasde faamde konnguɗi koyɗi.
  • T (Wakkati): Noddaango 911 / 112 / 999 ɗoon e ɗoon e WOTO ndokku aspiriin so tawii neɗɗo oo ina wondi e ɓuuɓri hoore walla ina tuuma ƴiiƴam ngaandi (aspiriin ina bonna ƴiiƴam nder hoore).

2. Njuɓɓudi ɓuuɓri gonndi e stimulant tawa ina fadi safrooɓe¶

Ko ɓuuɓnata ina usta ɓuuɓri ngaandi ndii, tawa ko e batte sodium-kanaal (kokayin), vasospasm ngaandi, hipertermiya, e hiponatremiya (MDMA). Nandugol e ɓuuɓri ƴiiƴam ɓooyndi, ndi joofnata ko e hoore mum caggal leƴƴanɗe 60, ɓuuɓri ndi ñawu nguu addata ina heewi yahrude yeeso haa wonta ɓuuɓri jokkondirndi so wonaa tawa safraama e benzodiazepiin (midazolam, lorazepam, walla diyazepam):

1. Laɓɓin leydi e ɓuuɓnude hoore: Feewnitde neɗɗo oo e dow leydi, ɓuuɓna jacket walla pillow follaa les hoore mum, ɓuuɓna taabal kafe, ɓuuɓna, e geɗe gilaas ɗe mbaawataa yettaade.
2. Waɗde Ice Packs e Wuddu, e Ɓoggi, e Ɓoggi : Ñawɗo ɓuuɓɗo ina addana nguleeki ɓalndu mawki, baawki ustude nguleeki ɓalndu haa ɓura 41 degere Celsius (106 degere Fahrenheit) e nder hojomaaji seeɗa ; fuɗɗoo coofde wutte e wuttulo ɗoon e ɗoon nde ɓe njiylotoo.
3. Woto meeɗ waɗde hay huunde e hunuko maɓɓe kadi hoto meeɗ jogaade les terɗe maɓɓe ɓuuɓɗe: Doole ɓuuɓɗe, wallet, walla koppi hakkunde dente ɓuuɓɗe ina ɓuuɓna dente ina udda laawol henndu, kadi pinnude les terɗe ɓuuɓɗe ina ɓuuɓna ƴiye ina bonna ɓuuɓri ɓalndu (rhabdomyolysis).
4. Roll in the Side-Lying Recovery Position nde jerking oo dartotoo: Laɓɓin ƴiiƴam walla ɓuuɓri e hunuko, tawa aɗa ruttoo e bannge nano maɓɓe tawa aɗa ɓuuɓna seeɗa dow ngam ɓe mbaawa foofde e dow wellitaare haa safrooɓe ngara.

Ustugol bonanndeeji ko adii huutoraade e kisal hakkunde Binge: Haɗde Overamping e tooke fentanyl¶

Wonande yimɓe huutortooɓe hannde stimulants walla terɗe galleeji ballitooje neɗɗo wonɗo e baasal, laabi ustude bonanndeeji tuugiiɗi e hujjaaji ina taƴa no feewi baasal ɓurtungal warde :

De-Eskalaasiyoŋ ustude bonanndeeji ngam Overamping mo alaa ko woni e mum¶

So tawii a ƴeewtiima kala huunde e alluwal triage dow ngal, a tabitinii neɗɗo oo alaa ko ɓuuɓnata ɓalndu, alaa ko ɓuuɓnata ɓalndu, alaa ko ɓuuɓnata ɓalndu, alaa ko ɓuuɓnata, alaa ko ɓuuɓnata, e foofaango no woorunoo, ɓe ngoni ko e heɓde overamp psychologique/autonomique mo alaa ko bonnata (ina heewi ɓuuɓde e ƴettude stimulant be wakeffex no feewi, e mi slightly fotde waktuuji 36 haa 72).

1. Doggol ƴeewndorɗe de-eskalaasiyoŋ e nder nokkuuji e fijirde¶

1. Waylu nokku Senngo ɗoon e ɗoon:
   • Woɗɗito gimi bass mawɗi, cuuɗi keewɗi yimɓe, fitirlaaji jalbooji, walla ŋoral mbeddaaji mettuɗi, naata e suudu ɓuuɓndu, deeƴndu, tawa fitirlaaji mum ina ɓuuɓna.
2. Cool Nerve Vagus (Tawa aɗa sokla ɓanndu):
   • Waɗde lootgol ɓuuɓngol, ɓuuɓngol e dow tiinde maɓɓe, e gite maɓɓe, e caggal daande maɓɓe, walla ɓe ƴetta ɓuuɓri ɓuuɓndi (never freezing cold) tawa ina njooɗii walla ina ƴeewa.
3. Hidrat e Elektrolit e Karbohidrat Simple:
   • Binnge cemmbinɗe ina usta suukara e nder ƴiiƴam, sodium, potaasiyom, e magnesium tawa ina addana hunuko yoorde no feewi ("hunduko koton") e ɓuuɓde jawdi (bruxism).
   • Hokkude ɓuuɓri tokosiri, ɓuuɓri yarde elektorolit ɓuuɓnde, ndiyam ɓuuɓɗam, kosam, walla ɓuuɓri ɓiɓɓe leɗɗe, ɓeyda heen ɓuuɓri softundi, ndi weeɓaani ɓuuɓde (banaana, yogurt, applesauce, walla ɓuuɓri) e ɓuuɓri ɓuuɓri walla ɓuuɓri laaɓndi gila e ŋoral maɓɓe previllen crack.
4. Hirjinde Dille Leelɗe WALLA Fooftere (Ko ɓuri welde e maɓɓe):
   • Won e yimɓe ɓe overamping ina njiya ina nannga so ɓe mbiyii yo ɓe fenu haa laaɓa cer; yahde seeɗa e nder suudu kisal, ɓuuɓde, walla jooɗaade ina tiiɗi tawa ina waɗa foftere seeɗa 4-sekon / fooftere 6-sekon ina wuli semmbe kinetik nervous haa peccol ngol rewa.

2. No haaldirta e neɗɗo gonɗo e paranoia stimulant walla psychose ɗanngal¶

Caggal waktuuji 48 haa 96 tawa ɗaanaaki e metamfetamin walla crack cocaine, haa 40 haa 60 e nder teemedere huutortooɓe ɓee ina keɓa psychose gonɗo e ɓuuɓri gonndi e stimulant : ɓuuɓri gonndi e nanɗe (nanɗe ɓuuɓri walla rajooji polis e yaasi), ɓuuɓri yiytere-yimɓe e nder njiylawu periferik /hallucinations the mi"me." ɓalndu), walla paranoia tiiɗɗo wonde yimɓe ina ƴeewa windooji.

• Woto meeɗ luurdude walla ƴattaade majjere maɓɓe, kadi woto meeɗ waɗde ko njiy-ɗaa majjere ndee kadi:
  • Fooyre: "Aɗa ƴatto, hay gooto alaa e yaasi windo, jooɗo" (ina ummina tikkere, ina hollita ɓe aɗa jeyaa e fedde nde).
  • Wrong: "Oh yeah, mi yi'i spies'en yaasi boo" (escalates terreur maɓɓe).
  • Hakkunde (Validate the emotion, ground in safety): "Miɗo waawi yiyde no ɗum hulɓinirta jooni. Aɗa woni e kisal ɗoo e am e nder suudu nduu, damal ngal ina udditii, kadi miɗo yaha miɗo jooɗoo ɗoo tan miɗo reena ma nde njooɗiɗaa aɗa yara ndee ndiyam ngulɗam."
• Waɗde juuɗe maa ina njiyee, daraa e 45 degere ko famɗi fof meeteruuji 2 (6 feet), woto meeɗ uddude damal yaltirgal: Neɗɗo paranoid mo nanndaani e ŋoral e nder suudu tawa ina wondi e neɗɗo udduɗo damal, maa hulɓin, bolt walla haɓa. Yo ɓe njooɗto ɗo ɓe njiyata damal laaɓngal.
• Reento rokkude neɗɗo pillitol "landing gear" mbedda ngol yamiraaka: Hoto meeɗ rokkude neɗɗo mo overamping bar "Xanax" mbedda walla pillitol opioid ngam ɗaanaade ɗum; barmeeji alprazolam mbeddaaji fenaande ina njuɓɓinaa no feewi e fentanil, bromazolam, e xylazine, ina mbaɗta overamp stimulant wuurɗo e ɓuuɓri foofaango warngo tawa gooto fof ina ɗaanii.

(So tawii ko aan walla giɗo maa ina haɓa e metamfetamin, kokayin, crack, walla ñawu nguu, ƴeew Kuutoragol geɗe e mborosaaji: ballal ballal eɓɓoore, Haɗde ɓuuɓri e doseeji ɓurɗi heewde : ƴeewndorɗe fentanil/xilazine e nalokson, e Wallude tergal galle mo addiction. Hiisaade ƴettude janngirde ballal gadanal e CPR jaɓaangal to Croix-Rouge, St John Ambulance, walla dokkoowo nokku.)

Naamne keewɗe naamneede¶

Fuɗɗoode ƴeewtaama¶

• Fedde Ameriknaare Ɓernde (AHA, Amerik): Bayyinaango ganndal ko faati e njuɓɓudi ñawu nguu e ɓuuɓri ɓalndu jokkondirndi e kocaine (Patofisiyoloji vasospasm koronaawiris, uddugol laabi sodium, uddugol benzodiazepine e nitrogliserin gonngol e laawol gadanol ngol, e reentaade).
• Njuɓɓudi toppitiindi ko fayti e ñawu nguu e cellal hakkille (SAMHSA) & Duɗal ngenndiwal ko faati e ñawu nguu (NIDA / NIH, leyɗeele dentuɗe Amerik): Safrude ñawuuji kuutoragol dorog (TIP 33 / Ardorde safaara), ƴeewndo tooke simpatomimetik, e jokkondire cemmbinɗe fentanil.
• Koldaa Ameriknaajo tookeeji safaara (ACMT) e Koldaa Ameriknaajo tookeeji cafrirɗi (ACEP): Njuɓɓudi safaara tookeeji simpatomimetik tiiɗɗi, delirium ɓuuɓɗo / agitaasiyoŋ tiiɗɗo, e hipertermiiji baɗɗi e leɗɗe (Rapid conductive/evaporative avophyne of njuɓɓudi rabdomiolisis).
• Koolol ngenndiwal ngam ustude bonanndeeji (Dowlaaji Dentuɗi) & Fedde politik dorog: Anndude e jaabaade stimulant Overamping (Seerndude overamping hakkille e emergency safaara e golle de-escalation kisal).
• Nokku Orop toppitiiɗo ko fayti e ñawuuji e mborosaaji (EMCDDA / EUDA) & Sarwiis toppitiiɗo ko fayti e tooke e nder leydi Angalteer (TOXBASE): Ardorde safaara ko faati e MDMA-induced Sindrome de secretion hormone antidiuretique inpropriée (SIADH / hiponadiyotoksiye dilusionnelle acuteeponatremia).

Ardiiɓe jokkondirɓe¶

• Ballal gadanal ɓurngal opioid
• Haɗde ɓuuɓri e doseeji ɓurɗi heewde : ƴeewndorɗe fentanil/xilazine e nalokson
• Kuutoragol geɗe e mborosaaji: ballal ballal eɓɓoore
• Wallude tergal galle mo addiction
• Ballal gadanal ñawu ɓernde
• Ɓoornugol nguleeki vs ɓuuɓri ɓuuɓri
• Gaññeeje ƴiiƴam tiiɗɗe, rabdomiolisis, e triage eɓɓoore ƴiiƴam ɓalejam
• Limooje emergency