Te Whakatairanga Whakatairanga ('Overamping'): Hyperthermia, Te mamae o te uma, me te Agitation Triage¶

Kaore i rite ki te mate nui o te opioid, inaa ka tuohu te tangata, ka puru, ka mutu te manawa, ko te whakaongaonga whakaihiihi, e mohiotia whānuitia ana i roto i te rongoa whakaheke-kino me te ohotata hei "overamping", he raruraru kino, hyper-metabolic o te ngakau, roro, oko toto, me te pāmahana tinana. Ki te pau te tangata i te horopeta paitini o te methamphetamine, paura cocaine, crack cocaine, MDMA ("ecstasy" / "molly"), pire amphetamine kino, cathinones waihanga ranei ("te pati pati" / alpha-PVP / mephedrone), kua oho ranei mo nga ra i runga i te oma whakahihiko, kei te puku o ratou puku, me te ngakau aroha. serotonin**. Ka piki ake te reiti o te ngakau i mua 140 ki te 180 patiki ia meneti, ka piki te pehanga toto ki nga taumata e pa ana ki te whiu (220/130 mmHg+), ka tutakina nga arai coronary i roto i te vasospasm acute, a ka tere te piki o te mahana o te tinana ki mua 40.0 ki te 41.5 nekehanga Celsius (104.0 ki te 106.7 nekehanga Fahrenheit).

Ki te kore e rongoatia, ka mate te paitini whakaihiihi kino na roto i nga tikanga tere e wha: ** hyperthermia kino (te tunu i nga whekau o roto me te whakaoho i te whakahiatotanga i roto i te toto), te uaua o te ngakau korokoro me te arai arai konutai (e hua ai te infarction myocardial acute or arrhythmia ventricular fatal ventricular arrhythmia ahakoa i roto i te 20-tau te mate hemorrhoea) epilepticus seizures, me te rhabdomyolysis (te pakaru o nga uaua koiwi nui e whakangaro ana i nga whatukuhu). I taua wa ano, na te mea kei te whakakinohia e te **fentanyl me nga nitazenes he nui te paheketanga o te cocaine tiriti, kapiti, methamphetamine, me nga pire Adderall/MDMA kua pehia , ko nga kaiwhakamahi whakaihiihi ka moe ohorere, ka ngohe, ka puhoi ranei ki te manawa me whiwhi ** naloxone intranasal (Narcan) i taua wa tonu. Ma te mohio me pehea te wehewehe i te kaha o te hinengaro mai i te mate whawhati tata hauora, me pehea te whakamatao i te manawanui whakaoho wera-wera i roto i nga meneti, me te aha KORE rawa koe e tii tinana i tetahi turoro whakaihiihi nanakia te kanohi ki raro i tona puku ka ora.

Mahia tenei inaianei¶

1. Tirohia te manawa me te urupare i te tuatahi: ki te kore te mohio o te tangata whakaihiihi, ka ngongo, ka ngongo, ka manawa puhoi ranei, tukuna te Naloxone (Narcan) 4 mg nasal spray ka timata tonu te whakaora manawa. Ko te cocaine tiriti, methamphetamine, me nga pire whakaihiihi kua pehia he maha nga wa ka paheke ki te fentanyl. Ahakoa e mohio ana koe i whakaaro noa ratou ki te whakamahi i te mea whakaihiihi, ka huri te naloxone i te fentanyl huna, ka kaore e pa ki te tangata he ohorere whakaohooho parakore.
2. Waea atu ki to nama whawhati tata (911 i te US me Kanata, 112 i roto i te EU, 999 i te UK) inaa tonu he haki whero tinana te tangata: te mamae o te uma, te pehanga ranei, te kiri o te kiri ka wera te wera, te maru, te mahunga ohorere, te kanohi heke/ngoikore te ringa, te weriweri kore e taea te whakahaere. Tirohia to maatau tau ohorere whaiaronga.
3. Mehemea kei te wera te kiri o te tangata, kei te pupuhi, kei te porangi ranei, kei te wera rawa ranei, me timata tonu te whakamatao kaha i te wa e tatari ana mo te waka tūroro. Wewetehia nga kakahu o waho o te taikaha, takai peke tio, he peke huawhenua tio ranei kua hipokina ki te kakahu angiangi ki roto i nga kee, i te hiku, me nga taha o te kaki, whakamataohia te wai i te wa e pupuhi ana i te kiri, ka whakamatao ki te kiri, ka pupuhi i te kiri. he pati hauhautanga (kia tautokohia te upoko ki runga ake i te wai). I ia meneti ka noho te pāmahana matua ki runga ake i te 40.5 nga nekehanga Celsius (105 nga nekehanga Fahrenheit) ka kore e taea te huri te roro me te okana.
4. KAWA rawa e mau, titi, here poaka, noho ranei i runga i te tuara o te kai whakahihiko, i te pohehe ranei o te kai whakaihiihi i te pouaka (ka taea te pupuri)CO2). Ma te pine ki raro ka aukati i te rewharewha, ka piki ake te taumata o te waikawa o te toto, ka pa te ** ka mau te ngakau mate ohorere ("Kati te asphyxia") i roto i te 60 hēkona.
5. Ki te mamae te uma o te tangata, te mamae o te kauae/ringa maui, te werawera matao ranei i muri i te whakamahi cocaine me te meth ranei, noho pai ki te takoto, kia ata noho, ka hoatu 162 ki te 325 mg o te Aspirin ngaungau (ki te kore e mate mate mate, kua mate ranei te toto). poari (me karo nga taote hōhipera i etahi momo beta-aukati e whakararu ake ana i te mokowhiti o te arai coronary).
6. Mena kei te kaha ake te "overamp" o te hinengaro o te tangata (he awangawanga, he ohooho, he paranoia, he ngenge ranei kaore he mamae o te uma, KORE he wera nui, me te manawa noa), nekehia ki tetahi ruma hauhautanga, pouri, ata noho. Homai he inu hiko makariri, he kaukau makariri, he kakahu horoi ranei, he ngau iti o te kai, me te noho marino, karekau he whakawakanga tae noa ki te pau o te mea whakaongaonga.

Te Whakatairanga Tere: Te Hinengaro Hinengaro Maamaa ki te Whakamatea Te Hauora Hauora¶

I roto i nga mahi whakaheke kino, ka kapi te kupu "overamping" i te whanui whanui: mai i te whakaraerae, i te whakaeke ohorere i muri i te tango nui rawa atu o Adderall, meth, coke ranei, tae noa ki te mate hyperthermia, te whiu, te mate ngakau ranei. Whakamahia tenei rakau whakatau hei wehe i nga mea ka taea te whakamaarama i te kainga mai i nga mea e hiahiatia ana e te hohipera ICU inaianei.

flowchart TD
    A["Tangata i roto i te mamae i muri i te Cocaine, Meth, Crack, MDMA, Pills ranei"] --> B{"He Karekau ranei ratou i te aro, he manawa puhoi ranei / ngongoro?"}
    B -->|YES: Limp, Blue Lips, Slow Breathing| C["KAUPAPA KAUPAPA FENTANYL: Homai Naloxone 4 mg Rehu + Whakaoranga Manawa + Waea 911"]
    B -->|NO: Awake, Fast Heartbeat, Sweating, Agitated, or In Pain| D{"Tetahi Tohu Whero-Flag Sympathomimetic Crisis?"}
    D -->|Hot Skin > 39.5C/103F, Chest Pain, Seizure, Stroke Signs, Dark Urine, or Violent Delirium| E["MEDICAL EMERGENCY: Waea wawetia 911 / 112 / 999"]
    D -->|NO Physical Red Flags: Jittery, Anxious, Racing Thoughts, Exhausted, Mild Paranoia| F["Maama/Moderate Overamping: De-Escalate i roto i te Matao, Roa Ataahua"]
    E --> G["1. Puka Tio Tere / Whakamaoho Whakaeto 2. Aspirin Ngaungau 325 mg ki te mamae o te uma 3. Kore te aukati"]
    F --> H["1. Nga Raiti Ataahua & Whakawetohia te Waiata 2. Te Wai Matao / Te Hiko me te Paramanawa 3. Te Taera horoi Matao 4. Aroturuki Ia 15 Minuti"]

Ripanga Triage Haumanu: Kakariki/Kowhai Overamping vs. Whero Sympathomimetic Emergency¶

Ohotata Whakamate 1: Hiperthermia Whakatairanga kino ("Te tunu kai mai i roto")¶

Ko te take tuatahi o te mate tere i roto i te methamphetamine whakapeka, MDMA ("molly"), me te cathinone synthetic ("tote pati") he nui te horopeta o te rewerawera.

1. He aha te take ka pahemo te pāmahana tinana matua ki te 41 nga nekehanga Celsius (106 nga nekehanga Fahrenheit)¶

Ko nga mea whakaoho i te wa kotahi ka huri i te oumu o roto o te tinana i te wa e pakaru ana tana radiator:

• Te Hanga Wera Nui: Ko te taikaha o te dopamine, te serotonin, me te norepinephrine ka pa ki te whakakorikori haere tonu o nga uaua kohiwi, te mau o te kauae, te ohooho, me te wetewete o te mitochondrial (UCP-3), ka whakaputa i te wera o te tinana o roto (ina koa i roto i nga tini, i nga karapu po wera, i nga huihuinga raumati, i nga ruuma ngoikore ranei).
• Kua Katia te Weratanga: I te wa kotahi, ka whakaoho te norepinephrine i te alpha-1 adrenergic peripheral vasoconstriction, ma te awhi ka tutakina nga oko toto i roto i te kiri kia kore ai e tae te toto wera ki te mata kiri kia whakamatao.
• Ko te 40.5C (105F) Paepae Rahunga-Maama: Kia neke ake te pāmahana matua 40.5 nga nekehanga Celsius (105 nga nekehanga Fahrenheit) neke atu i te 20 ki te 30 meneti, ka whakahekehia nga pūmua pūtau, ka pakaru te arai intestinal (te tuku i nga endotoxins gut ki roto i te toto), te koiwiti () me te koiwiti () ka mate (Disseminated Intravascular Coagulation / DIC), ka mate te toto mai i ia okana.

2. Taahiraa-i-te-mua-mua-Hospital Rapid Cooling Protocol¶

Kaua ** kaua e tatari mo nga kaiparapara kia timata ki te whakamatao i te manawanui whakaihiihi wera, kaua hoki e hoatu te acetaminophen (paracetamol / Tylenol) me te ibuprofen/aspirin hei whakaheke i te kirika whakaongaonga**. Ka mahi nga pire kirika antipyretic ki te hypothalamus i te wa o te rewharewha / huakita kirikaa me te mahi kore mo te hyperthermia uaua na te raau taero (he kino rawa atu, ko te acetaminophen te whakatere i te ngoikore o te ate i te wa hyperthermia, me nga NSAID ka kino te mate whatukuhu).

1. Neke ki te Taiao Tino Pai: Kawea mai te tangata ki roto i te ruuma hau, te hau marumaru ranei, ka tango i nga koti taumaha, nga hootiti, nga potae me nga hu ki raro.
2. Hoatu nga Pokai Huo ki nga Hunga Arota Nui: Takaia nga putea tio, nga peke tio, nga kete kai tio ranei ki roto i te tauera maku angiangi, ka mau ki runga i te kaki (carotid arteries), te kerekere (axillary arteries), me te riu nuku (arteri femoral).
3. Rehu-me-te-Pana whakamahana (te Ruku-Wai Matao ranei):
   • Te hautai, te rehu ranei i nga waahi nui o te kiri kau ki te wai matao (15 to 20 degrees Celsius / 60 to 68 degrees Fahrenheit) me te tohu i te powhiriwhiri hiko tino kaha e waatea ana (me te powhiri kaha ranei ki te kaata/tauera) puta noa i te kiri maku. Ko te whakaetonga ka tango i te wera e whitu nga wa tere atu i te hau maroke.
   • Mēnā kei te wātea tonu he tāpu kaukau, ā, kei te oho te tangata (ka taea e te tokorua ngā kaiawhina kaha te pupuri i te mahunga ki waho o te wai), whakauruhia te rama me nga peka ki te wai paipa matao. (Tirohia Te wera wera me te wera wera.)

Ohotata 2: Cocaine me te Methamphetamine Te Mamae o te Uma (Paea Manawa & Vasospasm)¶

Ko te cocaine me te methamphetamine te paheketanga ** myocardial infarction (whakaekea ngakau)**, aortic dissection, me te mate ngakau ohorere ahakoa i roto i nga kaiwhakamahi 19-ki-35-tau te pakeke kaore he tohu cholesterol i roto i o ratou uaua.

1. Ko te toru o te mate ngakau o te cocaine (me te Cocaethylene me te waipiro)¶

• Ko te Koronary Artery Vasospasm + Te Whakanuia o te Oxygen Demand: Ko te cocaine me te meth ka kaha ake te patu o te uaua ngakau me te tere ake i te wa ano ** ka kati nga uaua korokoro**, ka matekai te uaua o te ngakau o te hāora.
• Ko te Waenga-Sodium Blockade (Ko te Cocaine anake): Ko te Cocaine he rongoa a-rohe ("caine") ka aukati tika ** te konutai tere ngakau (Na+) nga hongere**, te whakawhanui i te hiko o te ngakau QRS he uaua me te whakaoho i te mate tachycardia ventricular or ventricular fibrillation (e rongoatia ana e nga taote hōhipera ki te konutai konutai urunga-roto).
• Ka Whakaterehia te Toto Toto: Ka whakahoahohia e te hunga whakaihiihi nga platelets, ka puta ohorere te toto i roto i te arai coronary momi.
• Ko te Cocaethylene Multiplier (Cocaine + Alcohol): Ki te inu waipiro te tangata i a ia e whakamahi ana i te paura, i te kapiti cocaine ranei, ka whakawhitia e te ate o te tangata nga raau taero ki te tuatoru, te puhui hinengaro motuhake e kiia nei ko cocaethylene. Ko te Cocaethylene he haurua ora o te plasma 3 ki te 5 nga wa roa atu i te cocaine anake me te whakanui ake i te tupono o te mate mate ngakau ohorere ma te 18- ki te 25 nga wa.

2. Awhina tuatahi mo te mamae mamae o te uma (me te Whakatupato Whakatupato Beta-Aukati a te Hospital)¶

1. Waea atu ki a 911 / 112 / 999 tonu mo te pehi, te taumaha, te wera, te mamae mamae o te uma, te poto o te manawa, te werawera makariri, te mamae ranei e pa ana ki muri, kaki, kauae, ringa ranei.
2. Whakauhia te okiokinga tinana me te ata noho: Whakanohoia te tangata ki tetahi tuunga haurua-whakapapa (45 degrees) me nga turi piko. Ia hikoinga ka piki ake nga catecholamine me te hiahia o te hāora myocardial.
3. Hoatu te 162 ki te 325 mg o Aspirin Ngaungau Kore-Enteric: Ki te kore te tangata e mate mate mate aspirini pono, ka whakaatu ranei i nga tohu o te roro ka toto/te whiu, te mamae hoki o te tuara (aortic dissection), me tono ** ngaungau me te horomia tetahi pakeke 325 mg aspirini (e rua ranei ki te wha 81 mg peepi aspirini i roto i te pereti coronary)** (Tirohia Ko te mate o te ngakau awhina tuatahi.)
4. Me kii atu ki nga Paramedics me nga Takuta ER i te wa i whakamahia te Cocaine me te Meth ranei:
   • I roto i te whakaeke ngakau kore i te raau taero, ka tukuna e nga taote ohorere nga beta-aukati (penei i te metoprolol, propranolol ranei).
   • ** I roto i te mate huka, me te methamphetamine, ka hoatu he beta-aukati parakore (beta-1 / beta-2 te aukati) ka taea te "whakaongaonga alpha-adrenergic kaore i te aukati,"** i te aukati i nga kaiwhakawhiwhi beta ka tuwhera whanui nga kaiwhakawhiwhi alpha, na te mea ka tutakina nga uaua o te korokoro ki te kati rawa, ka piki te pehanga toto.
   • Ina korero pono koe ki te taote ER kei runga te cocaine me te meth ranei, ka rongoa ratou i te mamae o te uma ma te whakamahi i te ** benzodiazepines intravenous (lorazepam, diazepam ranei)** hei whakamaarama i te puku pukuaroha, sublingual, IV nitroglycerin ranei, me parapara-calcium-channel (diltiazem/verapamil) ranei **phentolamine.

Ohotata ki te ora 3: MDMA ("Molly" / "Ecstasy") Te waipiro wai vs.¶

MDMA (3,4-methylenedioxymethamphetamine) e mau ana i te mate whakamomori takirua kua mate i te hunga taiohi me te hunga i tae mai ki te karapu i ngana ki te "mahi tika" ma te tuku karani wai mania.

+-------------------------------------------------------------------------+
|       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.                |
+-------------------------------------------------------------------------+

Ohotata 4: Te Huringa Whakatairanga, Te whakaheke toto o te Subarachnoid, me te hopu.¶

Na te mea ko te methamphetamine, cocaine, crack, me nga cathinones waihanga ka puta ohorere, ka kaha te paheketanga o te toto toto (200/120 to 260/150 mmHg) i te taha o te paheketanga o nga oko toto roro me te kopiri o te pereti, ** te whiu ischemic whakapeka me te whakaheke toto o te roro (te whakaheke toto i roto i te cerebral, te pakaru o te aneurysm cerebral ranei)** he raruraru kino i te nuinga o te waa o te whakaihiihi i te nui o te whakaihiihi, tae noa ki nga tangata kei te rua tekau me te toru tekau o ratou tau.

1. Te mohio ki te whakaheke toto o te roro, te whiu ranei (BE-FAST)¶

Kaua rawa e whakakore i te mahunga nui, te tutukitanga, te korero pohehe ranei i te wa e oma whakaihiihi ana "he tiketike noa iho" he moe kore ranei:

• Ko te "Thunderclap" Headache (Ruptured Aneurysm / Subarachnoid Hemorrhage): Ki te kapohia e te tangata katahi ka puhipuhi kapiti, ka hongi cocaine, ka whakamahi ranei i te methamphetamine i to ratou mahunga ka tangi me te ** tino kino, tino pahū o te upoko o to ratau oranga** (ka tae ki te mamae nui i roto i te 60 hēkona, ka pa te mamae ki te kaki), katahi ka pa te mamae ki roto i te 60 hēkona. kua marama, kua tiango ranei, he oko toto kei te takenga o te roro kua pakaru i raro i te kaha o te toto catecholamine.
• BE-FAST Nga Kara Whero Neurological Stroke:
  • B (Tautika): Ka mate ohorere te toenga, te mangere, te kore e taea te hikoi tika.
  • E (Kakano): He karumaru, rua, ngaro ranei te tirohanga ki tetahi, e rua ranei nga kanohi.
  • F (Mata): Ka totohu tetahi taha o te kanohi, ka pohehe ranei ina tono kia ataata.
  • A (Arms): Kotahi te ringa, waewae ranei ka heke whakararo, ka ngoikore ranei te wa e mau ana.
  • S (Speech): He korero pohehe, he kupu pohehe, he kore ranei e mohio ki nga rerenga korero ngawari.
  • T (Wā): Waea 911 / 112 / 999 me Kaua e hoatu ahipirini ki te mea he mahunga whatitiri te tangata, e whakapaetia ana kua toto te roro (he kaha ake te toto i roto i te roro).

2. Te whakahaere i te hopu i te whakaihiihi i te wa e tatari ana mo nga paramedic¶

Ko nga mea whakaihiihi ka whakaheke tika i te paepae hopu o te roro na roto i nga paanga o te konutai (cocaine), te vasospasm cerebral, te hyperthermia, me te hyponatremia (MDMA). Kaore i te rite ki te mapu mate urutomo ka mutu i muri i te 60 hēkona, ka ahu whakamua te hopu i nga raau taero ki te mate epilepticus tonu ki te kore e rongoatia me te benzodiazepines intravenous, intramuscular benzodiazepines (midazolam, lorazepam, diazepam ranei):

1. Whakamamahia te papa me te awhi i te mahunga: Whakangawari te tangata ki runga i te papa, paheke he koti takai, urunga ranei ki raro i tona mahunga, ka pana nga tepu kawhe, whakamahana me nga taonga karaihe kia kore e taea.
2. Whakanohoia he Pokai Tio ki te Kaki, ki nga Wae, ki te Rae: Ko te manawanui whakaihiihi e wiri ana ka whakaputa i te wera uaua nui ka taea te pana i te pāmahana matua ki mua i te 41 nga nekehanga Celsius (106 nga nekehanga Fahrenheit) i roto i nga meneti; Me timata tonu te whakamatao i te kaki me nga kaokao i a ratou e hopu ana.
3. Kaua rawa e kuhua tetahi mea ki roto i o ratou waha, kaua hoki e pupuri i o ratou peka e wiri ana: Ko te kaha o te koko, te pukoro, te maihao ranei i waenga i nga niho katoka ka pakaru nga niho me te aukati i te huarahi hau, me te titi ki raro o nga peka e wiri ana ka whati nga wheua ka kino te pakaru o te uaua (rhabdomyolysis).
4. ** Hurihia ki roto i te Turanga Whakaora Takoto i te wa e mutu ai te pupuhi:** Maamaa te huware, te ruaki ranei mai i te waha ma te huri ki to taha maui me te kauae e titaha paku ana ki runga kia taea ai e ratou te manawa noa kia tae ra ano nga kaiparapara.

Whakamahi-Whakaitihia i mua i te Whakamahi me te Haumaru Waenganui: Te Aukati i te Whakanuia me te Pahana Fentanyl¶

Mo nga tangata e whakamahi ana i nga mea whakaihiihi, i nga mema o te whanau e tautoko ana i te tangata kei te tupono, ko nga mahi whakaheke kino i runga i nga taunakitanga ka tino whakaiti i te tupono o te horopeta mate:

Hipanga-i-te-Taahi-Whakaiti-Whakaitihia te Whakanuia mo te Whakanui-kore¶

Mena kua tirohia e koe nga mea katoa o te ripanga whakamatautau i runga ake nei ka whakau i te tangata kare he mamae o te uma, karekau he kirika/kiri wera, karekau he paopao, karekau he tohu whiu, me te manawa noa, kei te pa ki a ia he karekau he tino taumahatanga o te hinengaro/aunoa (he maha ka puta ma te tango i nga mea whakaihiihi, te whakaranu i nga mea whakaihiihi ki te kawhe, ki te oho mo nga haora726).

1. Te rarangi arowhai mo te whakaheke i te taiao me te tinana¶

1. Hurihia te Taiao Taiao Inamata:
   • Neke atu i nga puoro bass nui, nga ruma e kikii ana, nga rama kanapa, nga koki huarahi taumaha ranei ki roto i te whare moenga hauhautanga, ata noho me te rama atarua.
2. Me whakamatao i te Nerve Vagus (Kare e Oho te Tinana):
   • Whakanohoia he kakahu horoi makuku ki runga i o ratou rae, kanohi me te tuara o te kaki, me tango ranei i te maamaa-ki-te-matao (kaore i tino makariri) i te wa e noho ana, e tirotirohia ana ranei.
3. Hawai ki nga Hiko me nga Waahanga Maamaa:
   • Ka pau te huka toto, te konutai, te pāhare pāporo, me te konupora i te wa e paheke ai te waha o te waha ("cottonmouth") me te huri o kauae (bruxism).
   • Homai he iti, he inu totika o te inu hiko, te wai kokonati, te waiu, te maene huarākau ranei, me nga paramanawa ngawari, ngawari ki te horomia (panana, miraka pē, aporo, hupa ranei) me tetahi wahi ngaungau kapia, he kokonga kakahu horoi ma ranei kia kore ai e pakaru o ratou niho i te mau o te kauae.
4. Akiakihia te Neketere Ataahua RĀNEI Okioki (Ko tehea e pai ana ki a ratou):
   • Ko etahi o nga tangata e eke ana ki te eke ki runga ka pohehe ki te kii kia takoto marie; te hikoi haere i roto i te ruma haumaru, te totoro, te noho tika ranei i te wa e whakangungu ana puturi 4-hekona te manawa o te manawa / 6-hekona te manawa o te manawa ka wera i te kaha o te pukuriri kia pahemo te tihi.

2. Me pehea te korero ki te tangata e pa ana ki te paranoia whakahihiko, ki te kore moe ranei¶

I muri i te 48 ki te 96 haora karekau he moe i runga i te methamphetamine, crack cocaine ranei, tae atu ki te 40 ki te 60 ōrau o nga kaiwhakamahi ka wheako i te hinengaro whakaihiihi-whakaongaonga noa: te pohehe o te whakarongo (rongo muhumuhu, i nga reo irirangi pirihimana ranei i waho), te atarangi-nga tangata i roto i te tirohanga peripheral, te pohehe tactile ("meth paranos" / he ahua kino te tangata i raro i te kiri.

• Kaua rawa e totohe, e tawai ranei ki a raatau pohehe, kaua hoki e kii kei te kite koe i te pohehe:
  • He: "Kei te porangi koe, karekau he tangata i waho o te matapihi, noho mai" (ka whakapataritari i te riri me te whakaae kei roto koe i te kaupapa).
  • He: "Aue, kei te kite hoki au i nga tutei kei waho" (ka piki te wehi).
  • Tau (Whakamanahia te kare-a-roto, kia noho haumaru): "Kei te kite au i te wehi o tera i tenei wa. Kei te ora koe i konei me ahau i roto i tenei ruma, kua raka te tatau, ka noho tonu ahau ki konei kia mataara koe i a koe e noho ana ki te inu i tenei wai matao."
• Kia kitea o ringaringa, tu ki te koki 45-tohu neke atu i te 2 mita (6 putu) te tawhiti, kaua rawa e araia te kuaha puta: Ko te tangata paranoia ka pohehe i roto i tetahi ruuma me te tangata e arai ana i te kuaha ka mataku, ka tutakina, ka whawhai ranei. Tukua kia noho ki te wahi e kite marama ai ratou i te tatau.
• A ape i te tuku pire "tikanga taunga" ki te huarahi kaore i tohua: Kaua rawa e hoatu ki te tangata e takahi ana i te tiriti "Xanax", pire opioid ranei hei whakamoe i a ia; Ko nga tutaki alprazolam tiriti tinihanga kua tino herea ki te fentanyl, bromazolam, me te xylazine, ka huri i te overamp whakaihiihi ora ki te hopu manawa mate i te wa e moe ana te katoa.

(Mena kei te tohe koe, he hoa aroha ranei ki te methamphetamine, cocaine, kapiti, he waranga whakaongaonga whakahaunga ranei, tirohia. Te whakamahi matū me te mooni tarukino: aratohu awhina ohorere, Ko te hokinga mai me te aukati i te horopeta nui: ko nga takai whakamatautau fentanyl/xylazine me te naloxone, a Te tautoko i tetahi mema o te whanau e mate ana i te waranga. Whakaarohia te tango i tetahi akoranga awhina tuatahi me te CPR kua whakamanahia mai i te Ripeka Whero, St John Ambulance, tetahi kaiwhakarato rohe ranei.)

Pātai auau¶

Kua tirohia nga puna¶

• American Heart Association (AHA, United States): Whakaahua Putaiao mo te Whakahaere i te mamae o te uma e pa ana ki te Cocaine me te Infarction Myocardial (Coronary vasospasm pathophysiology, te aukati konutai-waahanga, te benzodiazepine me te nitroglycerin te rongoa tuatahi, me te karo i te aukati-beta kaore i te whakaekehia).
• ** Te Tukino Taonga me te Whakahaere Ratonga Hauora Hinengaro (SAMHSA) & National Institute on Drug Abuse (NIDA / NIH, United States):** Te Maimoatanga o te Whakaoho Whakaoho Whakaoho (TIP 33 / Aratohu Hauora), te triage toxidrome sympathomimetic, me te whakauru tahi o te fentanyl ki nga mahi whakaihiihi kino.
• ** American College of Medical Toxicology (ACMT) me te American College of Emergency Physicians (ACEP):** Te Whakahaere Haumanu o te Severe Sympathomimetic Toxicity, Excited Delirium / Severe Agitation, and Drug-Induced Hyperthermia (Rapid conductive/evaporative cooling, karo i te whakahaeretanga o te rhabdomyolysis, me te rhabdomyolysis).
• National Harm Reduction Coalition (United States) & Drug Policy Alliance: Te Moohio me te Whakautu ki te Whakatairanga Whakatairanga (Te rerekee i te kaha o te hinengaro mai i nga ohorere hauora me nga tikanga whakaheke haumaru).
• ** Te Whare Aroturuki a te Pakeha mo nga Taaka me te Taakaro (EMCDDA / EUDA) & UK National Poisons Information Service (TOXBASE):** Arataki haumanu i runga i te MDMA-whakauru ** Syndrome o te Hunga Hormone Antidiuretic Kore (SIADH / acute dilutional hyponatremia)** me te cocaethylene cardiotoxicity.

Nga kaiarahi e pa ana¶

• Opioid overdose tuatahi awhina
• Ko te hokinga mai me te aukati i te horopeta nui: ko nga takai whakamatautau fentanyl/xylazine me te naloxone
• Te whakamahi matū me te mooni tarukino: aratohu awhina ohorere
• Te tautoko i tetahi mema o te whanau e mate ana i te waranga
• Ko te mate o te ngakau awhina tuatahi
• Te wera wera me te wera wera
• Ko te whara o te whatukuhu, te rhabdomyolysis, me te whakamatautau mimi pouri
• Nga tau ohorere