Irbad Laga Shakisan Yahay Inay Ku Tuftay ama Cabbid Ku Tuftay Baarka ama Naadiga: Daaqadda Tijaabada Kaadida ee 12-Saacadood ee GHB iyo Soo Bixinta Saaxiibka Badbaadada ah¶

La kulma dawakhaad lama filaan ah, dawakhaad aan la garanayn, curyaan cufan oo cufan, aragga tunnel-ka, hadalka qallafsan, ama dareen fiiqan oo ku jira baar saxan, goob lagu caweeyo, xaflad, ama xaflad guri ka dib markaad cabto wax yar ama khamri waa xaalad degdeg ah oo caafimaad iyo badbaado shaqsiyadeed. Haddii dembiilaha uu simbiriirixiyey habdhiska neerfayaasha dhexe ee aan ur lahayn galaas aan la joogin ama uu isticmaalo irbad heer sare ah oo hypodermic ah ama qalin insulin ah oo lagu burburiyo qoob-ka-ciyaarka qoob-ka-ciyaarka ah, labada khatarood ee aasaasiga ah ayaa isku mar wada dhacaya: Niyad-jabka neef-mareenka oo degdeg ah ama hammi haddii dhibbanuhu lumiyo miyir-beel, iyo afduub ugaadhsi ah oo uu geystay gacan-ku-dhiigluhu isagoo isu ekeysiiyay inuu qof wax u qabto. baabuur ama wadaag. Lixdankii ilbiriqsi ee ugu horeyay in adiga ama saaxiibkaa aad ku aragtaan sakhraan aan dheeli tirnayn ama aad ku aragtaan nabar cusub oo dalool ah cudud, garab, dhabarka hoose, ama bowdada, xidh saaxiib aad aaminsantahay, diido inaad bannaanka u baxdo meel baabuurta la dhigto oo mugdi ah ama luuq mugdi ah oo aad la jirto qof kasta oo qalaad, digtoonow maamulka goobta iyo amniga albaabka shatiga leh isla markiiba, wac degaankaaga nambarada degdega ah haddii neefsashadu hoos u dhacdo ama miyirku hoos u dhaco, oo la tasho annaga hagaha kala soocida mukhaadaraadka cabbitaanka iyo kufsiga timirta, annaga daloolin saliingaha la tuuray iyo hagaha PEP-ga cudur-sidaha dhiiga, iyo annaga ka bixida taariikhda xun si badbaado leh hage.

Dhakhaatiirta toxicologists ee shaybaadhka FBI-da, Xeer-ilaalinta Sayniska Forensic ee Boqortooyada Ingiriiska, iyo Ururka Dhakhaatiirta Dabiiciga ah (SOFT) waxay xooga saarayaan xaqiiqda bayoolojiga ah in qof kasta oo nolosha cawayska ah iyo goob joogayaashu ay tahay inay fahmaan: wakiilada firfircoon ee degdega ah sida ** gamma-hydroxybutyrate (GHlac) (GHlac)) - **, ** 1,4-butanediol (1,4-BD) waxaa dheefshiidka beerka ka dhiga kaarboon laba ogsaydh iyo biyo si degdeg ah oo ay uga baaba'aan dhiigga bini'aadamka gudaha 4 ilaa 8 saacadood waxayna noqonayaan kuwo aan lagu ogaan karin kaadida gudaha 10 ilaa 12 saacadood ka dib marka la nuugo. Haddii dhibbanuhu uu sugo ilaa galabka xiga si uu u booqdo rugta caafimaadka, ama uu iska daayo kaadida ugu horraysa ee habeenkii ka hor inta aanu iman qaybta gargaarka degdegga ah, caddaynta baadhista ee soo gudbinta kiimikaad si joogto ah ayaa loo lumay. Ogaanshaha sida loo sameeyo soo saarista saaxiibka cududda gacanta xidhan, ilaali galaaska cabitaanka ee laga shakisan yahay, soo qaado muunada kaadida ee ugu horraysa weel nadiif ah oo xidhan ka hor inta aanu xidhmin daaqadda dheef-shiid kiimikaadka 12-saacadood ah, oo bilaw 72-saac HIV ka-hortagga-soo-gaadhista ka dib (PEP) saacad ka dib markii la tuhunsan yahay irbad-ku-tujin caddayntaada labadaba.

Hadda samee tan¶

1. Isku xidh jir ahaan saaxiib aad aaminsan tahay oo isla markiiba u dhaqaaq meel nabdoon oo ay shaqaaluhu gacanta ku hayaan oo ku dhex jira goobta. in si toos ah loo taageero ** miiska baarka ugu weyn, xafiiska maareeyaha goobta, teendhada daryeelka caafimaadka, ama goobta hore ee amniga halkaas oo ay joogaan kamaradaha CCTV ee heersare ah iyo shaqaale lebisan. Weligaa keligaa ha dib ugu noqon meel musqul ah oo xidhan halkaas oo aad kaga gudbi karto albaabka xidhan oo aanay gaadhin dhakhaatiirta caafimaadka.
2. ** Ka ilaali qof kasta oo qalaad, is yaqaan, ama qof kasta oo aan la hubin inuu "caawinayo" inuu qaado ama kaxeeyo qofka dhibaataysan dibadda albaabka laga baxo. Samee meel adag oo af iyo adinba ah agagaarka saaxiibkaa, u sheeg amaanka goobta haddii qof uu dul heehaabayo ama ku adkaysanayo inuu dhibbanaha u kaxeeyo gaadhi, waligaa ha u ogolaan dhibbanaha inuu ka baxo goobta marka laga reebo saaxiibo gudaha ah oo la xaqiijiyay ama shaqaalaha gurmadka degdega ah ee ambalaasta.
3. Wac 911, 112, ama 999 isla markiiba haddii qofku muujiyo arday go'an, neefsasho gaabis ah ama khuuraya, maqaarka qabow, matag marka hurdo la'aan, ama awoodin inuu soo jeedo. gag reflex. Dhig qof lulmoonaya ama matagaya dhinaciisa ** booska soo kabashada bidix ee bidix** iyagoo gadhkoodu hore u yara janjeero si ay mataggu afka uga soo baxaan halkii ay u hanqal taagi lahaayeen sambabada, oo la soco neef kasta ilaa ay ka imanayaan dhakhaatiirta caafimaadka.
4. ** Qabo oo xidh muunadda kaadida ee ugu horraysa ee faaruq ah haddi aanad cisbitaal ama shaqaale booliisku ku baari karin 60 daqiiqo gudahood. Haddii aad ku sugayso safka kala-soocidda cusbitaalka dheer ama aanad isla markiiba gaadhi karin baaraha dambiilaha kufsiga, si toos ah ugu kaadi dhalo nadiif ah, qalalan ama koob caag ah oo shaabadaysan, ku qor taariikhda iyo wakhtiga saxda ah daboolka, oo ku kaydi gudaha talaajadda at 4 darajo Celsius (39 darajo Fahrenheit) si aad ugu wareejiso sharci fulinta.
5. Haddii aad ka shakisan tahay ** irbada cirbadeynta** (duritaanka duritaan), saaxiib isticmaal tooshka casriga ah ee qolka dhalaalaya si aad u hubiso gacmaha sare, deltoids, gacmaha hore, lugaha, bowdada, bowdada, miskaha, bowdada, miskaha, nabarrada, dhabarka, miskaha ama tusbax dhiig, iyo sidoo kale meel yar oo qoyan ama jeexjeexa shaadhkaaga ama surwaalkaaga. Si tartiib ah maqaarka ugu dhaq saabuun iyo biyo socda (weligaa ha ku tuujin, ha dhuuqin, hana ku xoqin nabarka daloolin biliij), ku wareeji qalin qalin si takhtarka degdega ah uu u helo marka bararku yaraado, kana codso ** HIV Kahortagga Soo-gaadhista Ka Dib (PEP)** iyo ** Kor u qaada Cagaarshowga B ama Immunoglobulin saacada gudahooda**2
6. ilaaliya tuhmanaha dhalada cabbitaanka oo ka codso maamulaha goobta in uu calaamadeeyo wakhtiga CCTV. Ku dabool dusha sare ee muraayadda maro ama maro, si toos ah ugu dhiib maareeyaha baarka ama sarkaalka booliiska ka jawaabaya intaad maro ku xidhan tahay farahaaga si aad u ilaaliso faraha qarsoon ee cidhifka bannaanka, oo qor ** goobta saxda ah ee diiwaanka bar, shaambada wakhtiga, iyo sharraxaadda jireed qof kasta oo miiskaaga agtiisa soo istaagay ama ku siiyay cabitaan si booliisku uu u xidho goobta adag -1 cag-TV wareegyada dib u qor ayaa tirtira.

Geedka go'aanka: Kala soocida naadiga cawayska, ilaalinta muunada, iyo soo saarista¶

Isticmaal geedkan tabo-tallaabo-tallaabo ah ee go'aaminta bukaan-socodka iyo taatikada laga bilaabo marka ugu horreysa adiga ama saaxiibka aad ka shakisan tahay inaad cabto tufinta ama tufinta cirbadda.

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Daaqadaha ka saarista dheef-shiid kiimikaad ee forensic: Maxay tahay sababta shaybaarada daawada ER ee caadiga ah ay u seegaan wakiilada caarada¶

Fahamka khaldan ee ka dhex jira bukaanada ayaa ah in cisbitaalka caadiga ah "shaashadda daawada kaadida" ee laga dalbado Waaxda Gurmadka ay si toos ah u ogaan doonto in cabitaanka la tufay iyo in kale. Xaqiiqda, koobka tallaalka-daryeelka caadiga ah ee isbitaalku wuxuu kaliya eegaa shan ilaa toddobo fasal oo caadi ah (amphetamines, cocaine, cannabis, opiates, phencyclidine, iyo benzodiazepines aasaasiga ah). Waxay ** si buuxda u tebisay GHB, GBL, 1,4-butanediol, ketamine, zolpidem, scopolamine, clonidine, tetrahydrozoline (Imidazolines-indhaha-dhicida), iyo flunitrazepam-ka hooseeya**.

Si loo ogaado naadiyada iyo wakiilada awood la'aanta taariikhda kufsiga, muunada dhiiga iyo kaadida waa in lagu soo ururiyaa gudaha daaqada ciribtirka cidhiidhiga ah oo lagu falanqeeyay iyada oo la adeegsanayo Gas Chromatography-Mass Spectrometry (GC-MS) ama ** Chromatography dareere-Tandem Mass Spectrometry (LC-MS/MS)** xirmo

Sida loo ururiyo oo loo ilaaliyo muunada kaadida ee "First-Void" ka hor inta aysan dhicin saacadda GHB ee 12-saac ah¶

Sida laga soo xigtay Xafiiska Qaramada Midoobay ee Daroogada iyo Dembiyada (UNODC) * Tilmaamaha Falanqaynta Forensic ee Daroogada Fududeynta Faraxumaynta Galmada iyo Falalka Dambiyada Kale * iyo Kulliyadda Dabiiciga ah ee UK (FFLM), caqabada kaliya ee ugu weyn ee dacwad oogista cabitaanka iyo duritaanka irbadda ayaa ah dib u dhaca u dhexeeya shilka galabnimo iyo 01:00 subaxnimo ee soo socota: Mar kasta oo aad kaadido inta lagu jiro habeenkii, waxaad ku daadinaysaa dawada metaboliyaha waalidka musqusha.

Haddii aad ka shakisan tahay in lagu tufay oo aad ku sugayso qolalka Waaxda Gurmadka Degdegga ah, oo aad ku sugayso booliiska, ama aad ku soo kabanayso guriga ka hor intaadan aadin cusbitaalka:

1. Weligaa ha nadiifin kaadidaada dhacdada ka dib¶

• Xitaa haddii kalkaalisada ama sarkaalka booliisku aanu weli ku siin koob rasmi ah oo muunado xadhig ah, ** isla markiiba weydii miiska diiwaangelinta ee Waaxda Degdegga ah koob ururinta kaadida oo nadiif ah ** daqiiqadda aad ka soo gudubto albaabbada, adigoo sheegaya: * "Waxaan halkan u joogaa cabitaan laga shakisan yahay ama irbad lagu tusinayo waxaanan u baahanahay inaan soo ururiyo bannaankayga ugu horreeya ka hor 12-saacadood."
• Haddii aad joogto qolka saaxiibka ama qolka huteelka oo ay qasab tahay in aad kaadido ka hor inta aanad u bixin cisbitaalka, isticmaal weel dhalo ah oo nadiif ah, qalalan, oo dhawaan la luqay oo dabool korka ka daboolan yahay, ama koob caag ah oo la tuuri karo oo aan furnayn oo si adag loogu daboolay filim cunto ***.

2. Uruuri ugu yaraan 50 ilaa 100 Milliliter (1.7 ilaa 3.4 Owska dareeraha ah) Adigoon ku milmin¶

• Ha cabbin biyo xad dhaaf ah ka hor inta aanad siin muunadda isku day inaad "ku nadiifiso nidaamkaaga"; qasin biyuhu waxay hoos u dhigtaa creatinine kaadi waxayna riixi kartaa raadadka nanogram-per-milliter (ng/mLHeerarka GHB ama 7-aminoflunitrazepam ee ka hooseeya goynta falanqaynta shaybaarka (typically 10 mg/L for exogenous GHB).
• Si toos ah ugu kaadi weelka nadiifka ah.

3. Ku calaamadee oo qaboojiyaha isla markiiba 4°C (39°F)¶

• Ku qor magacaga oo buuxa,taariikhda saxda ah,iyo daqiiqada saxda ah ee ururinta cajal ku dheggan weelka.
• Ku rid weelka xiran gudaha bac nadiif ah oo zip-top ah oo ku kaydi ** qolka qaboojiyaha ugu weyn 4 darajo Celsius (39 darajo Fahrenheit) ***. Qaboojintu waxay joojisaa korriinka bakteeriyada waxayna ka hortagtaa in vitro xaalufka enzymatic ee dheef-shiid kiimikaad aan degganayn.
• U dhiib weelkan “koowaad madhan” ee iskii isu soo ururiyay u dhiib baaraha kalkaaliyaha caafimaadka ama sarkaalka baadhista marka lagu daro bixinta kaadida xidhidhsiga iyo muunada dhiiga ee cusbitaalka.

Irbada lagu durayo (duritaanka duritaanka) ee meelaha dadku ku badan yahay: Aqoonsiga iyo nidaamka 72-saac ee PEP¶

Sharci fulinta iyo waaxaha dawada degdega ah ayaa dejiyay borotokool caafimaad oo gaar ah oo loogu talagalay cirbada cirbadaha, taasoo la macno ah shilalka ay dambiilayaasha ku sugan goobaha cawayska, riwaayadaha, ama xafladaha ay dhibanayaasha ku garaacaan dhar ama maqaar qaawan iyagoo isticmaalaya sirinji yar oo hypodermic ah, qalin insulin sonkorowga qaba, ama microneedle.

1. Kala soocida Duritaan Farmashilojiyeed ka soo daadad ka falcelinta makaanikada / Walaaca¶

Irbadu waxay soo bandhigaysaa saddex khataro caafimaad oo kala duwan oo ay tahay in isku mar wax lagaga qabto Waaxda Gurmadka: 1. ** Sakhraan Daroogada habaysan**: Muruqa ama ka-hoosaadka cirbadeynta ketamine, midazolam, ama dawooyin kale. 2. Xataa hadii uu gacankudhiigluhu ku guul darraystay in uu niyad jabiyo tuubada ama uu isticmaalo irbad faaruq ah ama dib loo isticmaalay oo ku dhex martay dhibbanayaal badan oo meel isugu yimid, dalool maqaarka ah oo irbad dalool leh oo wasakhaysan ayaa wadata halis la taaban karo oo bayooloji ah oo HIV ah, Cagaarshowga. 3. Acute Autonomic / Vasovagal Syncope: Dareemidda cirbad fiiqan oo lagu muday naadi mugdi ah oo ay weheliso kulayl iyo ciriiri waxay dhalin kartaa hoos u dhac dhiig-dhiig ah oo isla markiiba ah iyo miyir beel.

2. Gargaarka Degdegga ah ee Degdegga ah iyo Ilaalinta Caddaynta ee Daloolin Irbad laga shakisan yahay¶

Haddii aad dareento qanjaruufo fiiqan oo degdeg ah ama xoqan dadka dhexdiisa oo ay ku xigto dawakh ama kabuubyo: 1. Saaxiib aad aaminsantahay haku kormeero goobta oo iftiin dhalaalaya isla markiiba: Eeg cududda sare ee sare (deltoid), cududda, garabka danbe, sinta, bowdada, iyo kubka. Irbad cusub oo hypodermic ah waxay ka tagtaa 0.5-ilaa-1.5-milimitir dhibic cas, oo inta badan ay ku hareeraysan tahay halo cirro leh, dhibco yar oo dhiig qallalan ah, ama barar yar oo adag oo maqaarka hoostiisa ah. 2. Ku wareeji goobta daloolinta qalinka kubbadda cagta: Ku sawir 2-sintimitir (0.8-inji) giraan hareeraha dhibicda oo qaado sawir makro ah oo dhow oo ay ku ag taal qadaadiic si aad miisaanka u dhaqdo ka hor. Calaamadaha irbadda yaryar ee 30-geesoodka ah waxay ku dhammaan karaan 4 ilaa 6 saacadood gudahood. 3. Si tartiib ah ugu dhaq saabuun iyo biyo socda: Ku raaci dabada hoosteeda biyo nadiif ah oo qasabad ah oo socda saabuun khafiif ah 60 ilbiriqsi. Ha tuujin, caano, dhuuqin, ha marin warankiilo boogta dalool; tuujintu waxay burburisaa sariiraha xididada waxayna dedejisaa nuugista nidaamka. 4. Keydi dharka lagu xidho meesha daloolinta: Dhibcaha yar yar ee dareeraha saliingaha iyo taabashada dembiilaha ayaa ku tirtira fiilooyinka dunta ee ku wareegsan daloolka irbadda. Geli marada gudaha ** bac xaashi brown nadiif ah** (waligeed bac bac xiran) si aad u siiso booliiska.

3. Nidaamka Degdegga ah ee 72-Saacadood ee qasabka ah.¶

Dhibane kasta oo looga shakisan yahay dalool cirbad-tufin ah waa inuu aado Waaxda Gurmadka degdega ah ee cisbitaal sida ugu dhakhsaha badan, iyo ** si adag 72 saacadood gudahood (ku habboon 2 ilaa 24 saacadood gudahood)** afar waxqabadyo caafimaad: - Ka-hortagga Soo-gaadhista HIV-ga Kadib (PEP): Koorso 28-maalmood ah oo ah daawaynta ka-hortagga-ka-hortagga-ka-hortagga ee saddex-daawadood. PEP waxay yaraynaysaa halista isku-beddelka HIV-ga in ka badan 80 boqolkiiba marka la bilaabo 24-ka saacadood ee ugu horreeya gudahooda, laakiin waxay luminaysaa waxtarka haddii la bilaabo ka dib 72 saacadood. - Cagaarshowga B Kahortagga Soo-gaadhista Kadib: Dhiig miirid si aad u hubiso kahortaga jirkaaga cagaarshowga B ee jira (anti-HBsTiter, oo ay la socoto qiyaasta tallaalka cagaarshow B ee degdega ah ** iyo, haddii aan la tallaalin, Cagaarshowga B Immune Globulin (HBIG). - **Ka-hortagga Teetanaha ***: Tallaalka xoojisa ee Tdap ama Td haddii tallaalka teetanada ee u dambeeyay uu ahaa wax ka badan 5 sano ka hor. - Jadwalka Seterology-ka aasaasiga ah iyo Daba-galka ah: Dhiiga gunta wuxuu soo baxaa Maalinta 0, oo ay ku xigto baaritaanka ku celcelinta 6 usbuuc, 12 usbuuc, iyo 24 usbuuc ee HIV, Cagaarshowga B, iyo Cagaarshowga C.

Soo saarid badbaado leh oo laga soo saaray baararka, naadiga, ama xafladaha: Ka adkaanta dabinka ugaarsadaha "Samaritaan Wanaagsan"¶

Falanqaynta dambiyada ee xadgudubyada galmada ee naadiyada cawayska iyo afduubka muujinta waxay muujinaysaa in dembiilaha caqabada ugu adag uu yahay ** ka soo saarida dhibbanaha goobta dadweynaha ee saaxiibbadiis iyo ilaalada albaabka ** marka daroogada ay bilowdo shaqada 15 ilaa 25 daqiiqo ka dib. Gacan-ku-dhiiglayaashu waxay ku tiirsan yihiin saddex qoraal oo injineer-bulsheed oo la xisaabiyay oo kooxda saaxiibkaa ay tahay inay si toos ah u xannibaan:

1. Qoraalka "saaxiibka beenta ah / Caawinta Rideshare".¶

Marka ilaaliyaha caafimadka ahi uu ku turunturoodo meel u dhow marinka musqusha, dembiilaha ayaa isla markiiba kor u kacaya, oo cudud saaraya dhexda, oo u sheegaya kuwa ag maraaya ama kuwa soo boodaya: "Waxay ila joogtaa, waxaan u soo saarayaa hawo cusub ama waxaan gelinayaa Uber-kayaga." qof" oo u muuqda inuu ku tiirsan yahay shisheeyaha taageero jireed. - ** Difaaca ***: Samee heshiis bir ah ** Heshiis kooxeed *** ka hor inta aadan bixin: ** Qofna kama tago goobta qof uusan la imaan, xilli, xitaa haddii ay afka ka sheegaan gudaha naadiga inay "rabaan inay guriga aadaan" qof ay hadda la kulmeen.

2. "Qayb-iyo-Dhibaatooyin" Xeeladda Wax-ku-oolnimada¶

Kooxaha ugaarsiga ee laba qof ka kooban, mid ka mid ah la-hawlgalayaasha ayaa si ula kac ah ugu dhex dhuunta dhibbanaha saaxiibkiisa ugu wanagsan, ku daadiyaa cabitaan, ama bilaaba dood hadal oo qaylo ah halka wehelka labaad uu u horseedayo dhibbanaha maandooriyaha ah ee ka baxay dhinaca dabka. - ** Difaaca *: Marka saaxiibku muujiyo calaamadaha sakhradda degdega ah, ** gacmaha si jir ah u xir (xuxul-ilaa-xun) iskana ilaali dhammaan waxyaabaha dibadda ka jeedinaya, cabitaannada daadsan, ama doodaha shisheeyaha. Si toos ah ugu dhaqaaq miiska shaqada ee goobta.

3. "Weydiiso Angela" iyo borotokoolka xeerka daryeelka goobta¶

Kumanaan baararka, meelaha lagu caweeyo, garoommada, iyo makhaayadaha ee ku baahsan Boqortooyada Midowday, Maraykanka, Kanada, Australia, New Zealand, iyo Yurub waxay ku tababbaraan bakhaarradooda iyo kormeerayaashooda albaabbada ereyada kood badbaadada gaarka ah: - "Weydiiso Angela": U lugee baqaale kasta, adeegaha, ama horjoogaha albaabka oo waxaad tidhaahdaa, "Angela ma shaqaynaysaa caawa?" ama si toos ah u sheeg: "Saaxiibkay waxa uu muujinayaa calamadaha cabitaanka cabitaanka waxaanan u baahanahay qol caafimaad oo sugan iyo nabad gelyo isla markiiba." - **Waxa ay tahay in amaanka goobta sharciga ah uu sameeyo ***: Kormeerayaasha albaabka shatiga u haysta iyo saraakiisha daryeelka goobta ayaa keena dhibbanaha iyo asxaabtooda ** qol caafimaad oo xadidan dhabarka dambe ***, wac ambalaas, ilaali muraayada laga shakisan yahay, hubi CCTV si aad u ogaato cidda miiska u soo dhawaaday, oo si toos ah kuugu galbinaysa ambalaas la hubiyay ama gaadhi qoys.

Lambarada degdega ah ee gobolka iyo borotokoolka wakaalada¶

Jawaabta caafimaadka degdega ah, xirmooyinka sunta sunta ah ee fududaynta daroogada ee dawada, iyo gelitaanka PEP ee cirbaddu waxay ku hoos shaqeeyaan qaabab qaran oo gaar ah:

• **Mareykanka iyo Kanada ***:
• Diritaan Degdeg ah: Wac 911 isla markiiba wixii looga shakiyo in ay lulmo, matag, ama calaamadaha muhiimka ah isbeddelaan.
• ** Imtixaanka Dabiiciga ah ee SANE / DFC : Qaybta Gurmadka degdega ah ee cisbitaalka, waydii ** Kalkaalisada Xadgudubka Galmada (SANE)****************************************************************************************************************************************************************************************** Marka loo eego federaalka Mareykanka Xeerka Rabshadaha ka dhanka ah Haweenka (VAWA), baaritaanada caafimaadka forensic-ka ah iyo baarista sunta waxaa lagu bixiyaa **100 boqolkiiba lacag la'aan *** iyadoon loo eegin haddii aad dooratid inaad gudbiso warbixinta booliiska waqtigaas.
• klzzwxh:0051 1-800-222-1222 (US) / 1-844-764-7669 (Kanada).
• ** Boqortooyada Ingiriiska ***:
• Dirid Degdeg ah: Wac 999* (ama 112) si aad u hesho ambalaas degdeg ah ama jawaabta booliiska. Haddii aad ku badbaado guriga ama isbitaalka oo aad rabto inaad diyaariso ** Qalabka Cadaynta Hore (EEK)** muunadda kaadida gudaha daaqadda 12-saacadood, wac 101 isla markiiba oo sheeg inay tahay -waqti-muhiim u ah ururinta sunta sunta ah.
• Xarumaha Gudbinta Xadgudubka Galmada (SARCs) & NHS A&E*: Aad u dhow **NHS Shilalka & Gurmadka degdega ah (A&E) dhawray.
• *Midowga Yurub:
• Diritaan Degdeg ah: Wac 112 dhamaan wadamada xubnaha ka ah EU (ama 15 xaaladaha degdega ah ee caafimaadka SAMU / 17 ee Booliiska France).
• Faransiiska / Yurubta Irbada & Baratakoolka CabbitaannadaSoumission chimique / Piqûres sauvages: gudaha Faransiiska, wac xarunta tixraaca qaranka ** CRAFS (Centre de Référence sur les Agressions Facilitées par les Substances** iyo 01 40 05 42 70, oo isla markiiba u tag qaybta gargaarka degdegga ah ee isbitaalka (Urgences médico-judiciaires - UMJ) Dhiiga/Kaadi ururinta GC-MS iyo PEP ee ka hortagga retroviral. Guud ahaan Jarmalka, Isbaanishka, Nederland, iyo Beljamka, ka codso xirmada sunta sunta ah (Forensic toxicology)K.O.-Tropfen-Test / Sumisión química) qaybta gargaarka degdega ah ee isbitaalka jaamacada ugu dhow.
• ** Australia iyo New Zealand ***:
• Diritaan Degdeg ah: Wac 000 gudaha Australia ama 111 gudaha New Zealand.
• Daryeelka Dabiiciga ah iyo Caafimaadka: U soo bandhig isbitaal kasta oo dadweyne Waaxda Gurmadka degdega ah ee Irbad-stickeedka PEP (72-hour window) iyo ilaalinta kaadida ee forensic iyada oo loo marayo cisbitaalka ** Adeegga Weerarada Galmada / Qaybta Daryeelka Qalalaasaha . Wac 1800RESPECT (1800 737 732 gudaha Australia ama ** badbaado leh in lala hadlo (0800 044 334** New Zealand.
• Hindiya iyo Aasiya-Baasifik ***:
• Diritaan Degdeg ah: Wac 112 gudaha Hindiya (ama 1091 Khadka Caawinta Haweenka), 110/119 gudaha Japan, 112/119 gudaha Kuuriyada Koonfureed, iyo 999/995 gudaha Singapore.
• **Caafimaadka-Sharciga (MLC) Ilaalinta ***: Dawlad kasta ama la aqoonsan yahay waaxda degdegga ah ee isbitaalka gaarka ah ee Hindiya ama Singapore, codso diiwaangelinta degdegga ah ee a Medico-Legal Case (MLC) iyadoo la ilaalinayo ** kaadi madhan ee kowaad iyo sodium-fluoride venous dhiig ** loogu talagalay State Forensic Science Laboratory (FSL) baahida chromat chromat gaaska ee chromat chromat. dalool.

Su'aalaha soo noqnoqda¶

Waa maxay sababta qolalka xaaladaha degdega ah ee isbitaalku u sheegaan bukaannada "Ma tijaabinno daawooyinka taariikhda kufsiga"?¶

Marka kalkaalisada ama dhakhtarka kala soocida Waaxda Degdegga ah uu sheego in shaybaarka isbitaalku uusan tijaabin karin daawooyinka kufsiga taariikhda, waxay ula jeedaan isbitalka gudaha guriga ee falanqeeyaha kiliinikada degdega ah kaliya wuxuu maamulaa shaashadaha 5-ilaa-10-panel ee aasaasiga ah mana ogaan karo GHB, Rohypnol, ama imidazolines-ka isha. Si kastaba ha ahaatee, waax kasta oo degdeg ah waxa ay sawiri kartaa silsilad xidhidh xidhidh sunta sunta ah (ama wac Kalkaalisada Forensic Examiner ama sarkaal booliis) si ay u ururiyaan dhiiga sare ee cawl iyo tuubooyinka kaadida ee maran kuwaas oo loo diro shaybaadhka dambi baadhista gobolka ama gobolka oo ku qalabaysan falanqeeyayaasha GC-MS iyo LC-MS/MS. Had iyo jeer si gaar ah u weydiiso "Ururinta Silsiladda-Xeernimada Dabiiciga ah," ma aha shaashad dawooyinka caadiga ah.

Haddii aan hurdada ka kaco 14 ilaa 24 saacadood ka dib xafladda oo ay i xasuustu gabaabsi tahay, miyay aad u daahday in la is baadho?¶

Maya, waa in aad isla markaaba u tagtaa Waaxda Gurmadka ama Kalkaaliyaha Kalkaalisada Dabiiciga ah oo aad ka bixi muunadaada kaadida ee ugu horeysa markaad toosto. Iyadoo GHB ay caadi ahaan kaadida ka nadiifiso 12 saacadood gudahood, wakiilada kale ee caadiga ah (oo ay ku jiraan flunitrazepam/Rohypnol, naqshadeeye novel benzodiazepines sida bromazolam, ketamine, zolpidem, iyo scopolamine) ayaa weli lagu ogaan karaa kaadida iyada oo loo marayo baaritaanka LC-MS / MS xasaasiga ah 48 ilaa 96 saacadood. Haddii aad sugto 3 ilaa 5 toddobaad ka dib dhacdada, shaybaarada takhasuska leh ee dambiilayaasha waxay samayn karaan Tijaabada Timaha Strand Toxicology ee qayb ka mid ah si loo ogaado hal soo-gaadhis oo ku duuduuban timaha koraya.

Ma jiraa qof runtii si degdeg ah ugu duri kara daawada suuxinta ee naadi dadku ku badan yahay aniga oo aan arkin saliingaha?¶

Haa, labadaba irbado muruqa hoostiisa ah iyo kuwa korka ka baxa oo la isticmaalayo cirbadaha 30-ilaa-32-fudud ee ganaaxa ama qalimaanka is-muritaanka gu'ga ee horay loo raray waxay qaadanayaan wax ka yar 1.5 ilbidhiqsi cod dheer, madow, buuq badan. Sababtoo ah irbaddu waa timo-dhuuban, dareenka bilawga ah wuxuu inta badan dareemaa sida xoqitaanka ciddida ama sequin, dhibbanuhuna wuxuu ogaanayaa dhibicda gaduudan ee yar ee nabarka leh ka dib marka dawakhaad lama filaan ah u dhacdo. B ka hortagga.

Miyaan naftayda matagayaa haddii aan u maleeyo inaan cabbay cabitaan la tumay 5 daqiiqo kahor?¶

Weligaa ha keenin matag haddii adiga ama saaxiibkaa aad dareentaan dawakhaad, lulmo, isku-dubbarid la'aan, ama hadal cay ah. Niyad-jabiyayaasha habdhiska dhexe ee habdhiska dareenka sida GHB iyo benzodiazepines-ku-bilawga degdega ah waxay waxyeeleeyaan fal-celinta gaag laryngeal ee difaaca 10 ilaa 15 daqiiqo gudahood; Ku qasbidda matagga marka falcelisyada neerfayaashaadu ay indho beelaan waxay abuurtaa khatar nafta halis gelisa oo ah in dareeraha caloosha oo acidic ah si toos ah loogu neefsado sambabadaada. Taa beddelkeeda, isla markiiba jooji cabbitaanka, u badbaadi dhalada booliiska, u gudub meel ammaan ah oo shaqaale ah, oo ay qiimeeyaan shaqaalaha caafimaadka.

Maxaa dhacaya haddii aan haysto xashiishadda madadaalada ama walax kale oo ka mid ah nidaamkayga: ma la i xidhayaa haddii aan weydiiyo baadhitaan fiiqan?¶

Gudaha Maraykanka, Kanada, Boqortooyada Midowday ee Ingiriiska, Midowga Yurub, iyo Australia, sharciyada sirta caafimaadka iyo siyaasadaha ilaalinta dhibbanaha ayaa ka mamnuucaya isbitaallada inay xiraan bukaanada raadsada daryeel caafimaad degdeg ah ama baaritaanno faraxumeyn/faraxeed dambiyeedka marka raadadka madadaalada ay ka soo muuqdaan guddigooda sunta. Si daacadnimo ah ugu sheeg kalkaalisada baadhista wax ku saabsan daawo kasta oo laguu qoray, aalkolo, ama walxaha madadaalada ee aad si mutadawacnimo ah u qaadatay waa lama huraan si takhtarka toxicologistku uu u kala saaro qaadashada ikhtiyaarka ah iyo wakiilka aan la qorin.

Tilmaamaha la xidhiidha¶

• Cab daawada kufsiga iyo taariikhda-kufsiga kala soocida caafimaadka
• Irbad-usha, dalool saliingaha la tuuray, iyo cudur-sidaha dhiigga ee PEP
• Ka bixida taariikhda xun si badbaado leh: ereyada koodka, galbiyeyaasha goobta, iyo iska-caabbinta
• Riwaayadda, damaashaadka, goobta lagu caweeyo, iyo qorshaynta ka bixitaanka garoonka iyo dad badan oo baxsad ah
• Tusaha lambarada degdega ah

Ilaha iyo hanuuninta rasmiga ah¶

• Xafiiska Qaramada Midoobay ee Daroogada iyo Dembiyada (UNODC): Hagaha Falanqaynta Forensic ee Dawooyinka Fududeeya Faraxumaynta Galmada iyo Fal Dembiyada Kale (Ururinta Muunadaha Shaybaarka ee Daaqadaha, GHB Cutoffs, iyo Heerarka LC-MS/MS).
• Bulshada Dhakhaatiirta Dabiiciga ah (SOFT) & Xafiiska Baarista Federalka (FBI) Shaybaadhka: *Guddiga Danbiyada Fududeeyay Daroogada (DFC) waxay ku taliyeen xadaynta waxqabadka ugu yar iyo borotokoolka ilaalinta muunada ee GHB, Flunitrazepam, iyo walxo cilmi nafsi ah.
• Kulliyadda Boqortooyada Midowday ee Forensic & Sharciga Daawaynta (FFLM) & Golaha Taliyayaasha Booliiska Qaranka (NPCC): Maaraynta Cabbitaanka Shakiga ah iyo Irbada Tuhunka ah ee Goobaha Dhaqaalaha Habeenkii, Qalabka Cadaynta Hore (EEK) Ururinta Kaadida, iyo Kala soocida Waaxda Degdegga ah.
• Xarumaha Xakamaynta iyo Kahortagga Cudurrada (CDC) & Ururka Caafimaadka Adduunka (WHO): *Xeerarka La cusboonaysiiyay ee Maaraynta Kahortagga Soo-gaadhista Ka-dib-Shaqada (nPEP) ee HIV, Cagaarshowga B, iyo Cagaarshowga C iyadoo la raacayo soo-gaadhista irbado aan la aqbali karin.
• ** Kulliyadda Dhakhaatiirta Degdegga ah ee Maraykanka (ACEP):** * Siyaasadda Caafimaadka iyo Qiimaynta Sunta ee Bukaanka Waaxda Degdegga ah ee aadka u sakhraansan ama kiimiko ahaan tabarrucday*.