Stimulant Overdose ('Overamping'): Hyperthermia, Mahlaba a Sefubeng, le Agitation Triage¶

Ho fapana le overdose ea li-opioid, moo motho a omang butle-butle, a fetoha buluu, 'me a khaotsa ho phefumoloha, ho feteletseng stimulant overdose , e tsejoang haholo ho fokotsa kotsi le meriana ea tšohanyetso e le ** "ho tlōla", ke bothata bo mabifi, hyper-metabolic ea pelo, boko, methapo ea mali le mocheso oa 'mele. Ha motho a e-noa tekanyo e chefo ea methamphetamine, powder cocaine, crack cocaine, MDMA ("ecstasy" / "molly"), lipilisi tse seng molaong tsa amphetamine, kapa cathinones ea maiketsetso ("matsoai a ho hlapa" / alpha-PVP / mephedrone), kapa esale a falimehile ka matsatsi a mangata ka har'a ts'ebetso e tsosang takatso, dopamine e tsamaisana le likhohola. norepinephrine, le serotonin. Ho otla ha pelo ho feta ** 140 ho isa ho 180 ho otla ka motsotso **, khatello ea mali e phahama ho ea ho maemo a bakoang ke stroke (220/130 mmHg+), methapo ea pelo e koala ka vasospasm e matla, 'me mocheso oa mantlha oa 'mele o ka nyoloha ka potlako ho feta 40.0 ho isa ho 41.5 likhato tsa Celsius (104.0 ho isa ho 106.7 likhato tsa Fahrenheit).

Ha e sa phekoloe, chefo e matla e tsosang takatso e bolaea ka mekhoa e mene e potlakileng: ** hyperthermia e kotsi (ho pheha litho tsa ka hare le ho etsa hore ho be le coagulation ea intravascular) **, ** coronary artery vasospasm le sodium-channel blockade (e bakang acute myocardial infarction kapa fatal ventricular arrhythmia, arrhythmia ea lilemo tse 20 *) **intracerebral hemorrhagic stroke kapa status epilepticus seizures **, le **rhabdomyolysis (ho robeha ha mesifa e kholo ea masapo e senyang liphio) **. Ka nako e ts'oanang, hobane ** fentanyl e seng molaong le nitazenes hona joale e silafatsa karolo e kholo ea cocaine ea seterateng, crack, methamphetamine, le lipilisi tse hatelitsoeng tsa Adderall/MDMA **, mosebedisi leha e le ofe ea susumetsang eo ka tšohanyetso a otselang, a hlotsang, kapa a liehang ho hema o tlameha ho fumana intranasal naloxone (Narcan) hang-hang. Ho tseba ho khetholla ho tlōla tekano kelellong le boemong ba tšohanyetso bo behang bophelo kotsing, mokhoa oa ho pholisa mokuli ea nang le mocheso o tukang ka metsotso e seng mekae, le hore na ke hobane'ng ha U LOKELA HO HLAHALA ho hlaba mokuli ea hlasimollang sefahleho ka mpeng ho pholosa bophelo.

Etsa sena hona joale¶

1. Hlahloba ho phefumoloha le ho arabela pele: haeba motho ea hlasimollang a ilibane, a bobola, a hemela holimo, kapa a hema butle, fana ka Naloxone (Narcan) 4 mg nasal spray 'me u qale ho pholosa ho hema hang-hang. Cocaine ea seterateng, methamphetamine, le lipilisi tse hlasimollang tse hatelitsoeng hangata li silafatsoa ka* *fentany. Esita le haeba u tseba hore ba ne ba rerile ho sebelisa ntho e susumetsang feela, naloxone e tla fetola fentanyl e patiloeng 'me **e ke ke ea ntša motho ea nang le ts'ohanyetso e hloekileng ea tšohanyetso ** e ke keng ea ntša kotsi.
2. ** Letsetsa nomoro ea hau ea tšohanyetso ea lehae (911 naheng ea US le Canada, 112 naheng ea EU, 999 in the UK) hang-hang haeba motho a e-na le folakha e khubelu 'meleng: bohloko ba sefuba kapa khatello ea maikutlo, letlalo le ka hare le utloang le chesa, ho oa, hlooho e bohloko ka tšohanyetso, sefahleho se opang / letsoho le fokolang, kapa delirium e sa laoleheng.* dinomoro tsa tshohanyetso directory.
3. klzzwxh:0025 ho li tšela, kapa u li qoelise ka bateng e pholileng (boloka hlooho e tšehelitsoe ka holim'a metsi). **Motsotso o mong le o mong mocheso oa mantlha o lula o le kaholimo hoikhato tse 40.5 tsa Celsius (105 degrees Fahrenheit) o baka tšenyo e ke keng ea khutlisoa bokong le setho sa 'mele.**
4. ** LE KA mohla u se ke ua tšoara, ua thae, kapa ua lula holim'a mokokotlo kapa sefubeng sa mosebelisi ea ferekaneng kapa sefubeng (ho tsitlella ho ithiba).** Motho ea nang le chefo e matla o na le metabolic acidosis e feteletseng 'me o hloka ho atolosoa ho hoholo ha sefuba ho ntša carbon dioxide (CO2). Ho li hlaba lifahleho li shebile fatše ho thibela diaphragm, ho eketsa asiti ea mali, 'me ho baka ho tšoaroa ha pelo ka tšohanyetso ("restraint asphyxia") nakong ea metsotsoana e 60.
5. Haeba motho a e-na le mahlaba a sithabetsang sefubeng, mohlahareng/letsohong le letšehali, kapa a fufuleloa ka mor'a ho sebelisa k'hok'heine kapa meth, mo lulise hamonate hamonate, u mo boloke a khobile matšoafo, 'me u fe 162 ho ea ho 325 mg ea Aspirin e hlafunoang (ntle le haeba a hana kapa a otloa ke stroke/ho tsoa mali). ka sekepeng* (lingaka tsa sepetlele li tlameha ho qoba li-beta-blockers tse mpefatsang ho otla ha methapo ea pelo).
6. *Haeba motho a na le "overamp" ea kelello (ho tšoenyeha, ho tsieleha, ho tsieleha, kapa ho khathala ka HA HO mahlaba sefubeng, HA HO ho chesa ho feta tekano, le ho hema ka tsela e tloaelehileng), mo ise kamoreng e pholileng, e lefifi, e khutsitseng. Fana ka lino tse batang tsa electrolyte, shaoara e pholileng kapa lesela la ho hlatsoa, ​​lijo tse nyane, le ho ba teng ka khutso ho fihlela ho sa tsotelloe.

Potlako e Potlakileng: Ho Fetisisa ha Kelelloho e Bonolo vs. Chefo ea Bongaka e Kotsing ea Bophelo¶

Tloaelong ea ho fokotsa kotsi, lentsoe ** "ho fetella"** le akaretsa mefuta e mengata e fapaneng: ho tloha ts'ebetsong e sa phutholohang, ea jittery panic attack ka mor'a ho noa Adderall, meth, kapa coke e ngata haholo, ho ea fihla ho hyperthermia e bolaeang, stroke, kapa lefu la pelo. Sebelisa sefate sena sa liqeto ho arola se ka khutsisoang lapeng ho se hlokang sepetlele sa ICU hona joale.

flowchart TD
    A["Motho ea Mahlomoleng ka Mor'a Cocaine, Meth, Crack, MDMA, kapa Lipilisi"] --> B{"Na ha ba arabele kapa ba phefumoloha butle / baa khora?"}
    B -->|YES: Limp, Blue Lips, Slow Breathing| C["TSOELA PELE TŠEBELETSO EA FENTANYL: Fana ka Naloxone 4 mg Spray + Rescue Breaths + Call 911"]
    B -->|NO: Awake, Fast Heartbeat, Sweating, Agitated, or In Pain| D{"Na ho na le Matšoao a Koluoa ​​ea Letšoao le Lefubelu la Sympathomimetic?"}
    D -->|Hot Skin > 39.5C/103F, Chest Pain, Seizure, Stroke Signs, Dark Urine, or Violent Delirium| E["TŠIRELETSO EA MEDICAL: Letsetsa 911/112/999 Hang-hang"]
    D -->|NO Physical Red Flags: Jittery, Anxious, Racing Thoughts, Exhausted, Mild Paranoia| F["Ho fetella ha Ha Hantle/Ho Itekanetse: Theoha ka Phaposing e Phodileng, e Khutsitseng"]
    E --> G["1. Rapid Ice-Pack / Evaporative Cooling 2. Aspirin e Chewang 325 mg haeba Sefubeng Mahlaba 3. Zero Prone Restraint"]
    F --> H["1. Dim Lights & Turn Off Music 2. Cold Water / Electrolytes & Snack 3. Cool Washcloth 4. Sheba Metsotso e meng le e meng e 15"]

Letlapa la Clinical Triage: Green / Yellow Overapping vs. Red Sympathomimetic Emergency¶

Boemo ba Tšohanyetso bo Bokang Bophelo ba 1: Hyperthermia e Hlahisang Malignant ("Ho Pheha ho Tsoa ka Hare").¶

Sesosa se le seng sa lefu le potlakileng ho methamphetamine, MDMA ("molly"), le cathinone ea maiketsetso ("letsoai la ho hlapa") ho feta tekano ke runaway hyperthermia.

1. Hobaneng ha lintho tse hlasimollang li etsa hore mocheso oa 'mele o fete likhato tse 41 tsa Celsius (106 degrees Fahrenheit)¶

Li-stimulants ka nako e le 'ngoe li phahamisa sebōpi sa ka hare sa' mele ha li ntse li pshatla radiator ea eona:

• Tlhahiso e Khōlō ea Mocheso: Dopamine e feteletseng, serotonin, le norepinephrine li baka tsitsipano e tsoelang pele ea mesifa ea masapo, ho thibana ha mohlahare, ho ferekana, le ho kopanya ha mitochondrial (UCP-3), e hlahisang mocheso o mongata oa metabolism (haholo-holo li-nightclub tse phetheselang, tse chesang haholo, mekete ea lehlabula, kapa likamoreng tse sa tsoellang moea hantle).
• Ho Thibela Mocheso: Ka nako e ts'oanang, norepinephrine e baka alpha-1 adrenergic peripheral vasoconstriction, e koala methapo ea mali e letlalong e le hore mali a chesang a se ke a fihla bokaholimo ba letlalo ho fola.
• The 40.5C (105F) Multi-Organ Failure Threshold: Hang ha mocheso oa mantlha o feta 40.5 degrees Celsius (105 degrees Fahrenheit) ka nako e fetang metsotso e 20 ho isa ho e 30, denature ea liprotheine tsa cellular, mokoallo oa mala oa putlama (ho qhalla li-endotoxins tsa mala* ka har'a mesifa*) 'me tsamaiso ea ho thibela mali e ea haywire (Disseminated Intravascular Coagulation / DIC), e bakang mali a bolaeang ho tsoa sethong se seng le se seng.

2. Mohato ka mohato Protocol ea Pele ho Sepetlele ka potlako ea Pholiso¶

U se ese ho emela baoki ba thuso ea bongaka maemong a tšohanyetso hore ba qale ho pholisa mokuli ea tsosang mocheso o tukang, le **le ka mohla u se ke ua fana ka acetaminophen (paracetamol / Tylenol) kapa ibuprofen/aspirin ho theola feberu e tsosang takatso **. Lipilisi tsa antipyretic fever li sebetsa hypothalamus nakong ea feberu e tšoaetsanoang / feberu ea baktheria 'me li etsa zero bakeng sa hyperthermia ea mesifa e bakoang ke lithethefatsi (ho hobe le ho feta, acetaminophen e potlakisa ho hloleha ha sebete nakong ea hyperthermia, 'me li-NSAID li mpefatsa ho hloleha ha liphio).

1. Suthela Tikolohong e Phodileng ka ho Fetisisa: Tlisa motho eo ka phaposing e nang le moea o pholileng kapa moea o fokang moriti 'me u mo role lihempe tse boima, likatiba, likatiba le lieta, u mo ise lirapeng tse ka tlaase.
2. Sebetsa Li-Ice Packs ho Melato e Meholo ea Arterial: Roala liphutheloana tsa leqhoa, mekotla ea leqhoa, kapa liphutheloana tsa lijo tse hatselitsoeng ka thaole e tšesaane e metsi ebe u li paka ka thata khahlanong le molala (carotid arteries), makhwapha (axillary arteries), le groin creases (lithapo tsa botšehali).
3. Mouoane oa Spray-and-Fan Cooling (kapa ho qoelisoa ka Metsi a Cold):
   • Seponche kapa u fafatse libaka tse kholo tsa letlalo le se nang letho ka metsi a pholileng (15 to 20 degrees Celsius / 60 to 68 degrees Fahrenheit) ha u ntse u supa fene e matla ka ho fetisisa e fumanehang ea motlakase (kapa e fehla ka matla ka khateboto/lithaole) ka ho toba ho pholletsa le letlalo le metsi. Moea o tsoang moeeng o tlosa mocheso ka makhetlo a supileng ho feta moea o omileng.
   • Haeba bate e fumaneha hang-hang 'me motho a falimehile (kapa bathusi ba babeli ba matla ba ka tšoara hlooho ka ntle ho metsi), ** inela 'mele le maoto le matsoho metsing a pompong a pholileng**. (Bona Ho otloa ke mocheso khahlano le ho felloa ke matla ha mocheso.)

Boemo ba Tšohanyetso bo Behang Bophelo ba 2: Cocaine le Methamphetamine Sefuba sa Sefuba (Heart Attack & Vasospasm)¶

Cocaine le methamphetamine li baka acute ** myocardial infarction (heart attack)**, **aortic dissection **, le **ho tšoaroa ha pelo ka tšohanyetso ** esita le ho basebelisi ba lilemo tse 19 ho isa ho tse 35 ba nang le zero cholesterol plaque methapong ea bona.

1. Ho otla ha cocaine ka makhetlo a mararo (le Cocaethylene ka joala)¶

• Coronary Artery Vasospasm + Surging Oxygen Demand: Cocaine le meth li etsa hore mesifa ea pelo e otle haholoanyane le ka potlako ha ka nako e le ’ngoe ho tsikitlanya ha methapo ea pelo ho koala, ho bolaea mesifa ea pelo ea oksijene.
• Direct Sodium-Channel Blockade (Cocaine Feela): Cocaine ke sethethefatsi sa lehae ("caine") se thibelang ka kotloloho sodium e potlakileng ea pelo (Na+) likanale, ho atolosa motlakase oa pelo QRS e rarahaneng le e bakang ho bolaea ventricular tachycardia kapa ventricular fibrillation (eo lingaka tsa sepetlele li tšoarang intravenous sodium bicarbonate).
• Accelerated Blood Clotting: Lintho tse susumetsang li etsa hore liplatelete li sebetse, e leng se etsang hore mali a hoele ka tšohanyetso ka har'a mothapo o hlabang oa pelo.
• The Cocaethylene Multiplier (Cocaine + Alcohol): Ha motho a e-noa joala a ntse a sebelisa phofo kapa crack cocaine, sebete sa motho se fetisetsa lithethefatsi tsena tse peli motsoako oa boraro, o ikhethang oa psychoactive o bitsoang cocaethylene. Cocaethylene e na le halofo ea bophelo ba plasma ** 3 ho makhetlo a 5 nako e telele ho feta cocaine feela ** mme e eketsa kotsi ea ** lefu la tšohanyetso la pelo ka 18- ho 25-fold **.

2. Thuso ea pele bakeng sa mahlaba a sefubeng a hlasimollang (le Tlhokomeliso ea Beta-blocker ea Sepetlele)¶

1. Letsa 911 / 112 / 999 hang-hang bakeng sa ho petetsoa, ​​boima, ho cha, kapa bohloko bo matla ba sefubeng, ho hema ka thata, mofufutso o batang, kapa mahlaba a tsoang mokokotlong, molala, mohlahare kapa letsoho.
2. ** Qobelisa Phomolo e Felletseng ea 'Mele le Khotso:** Lulisa motho eo sebakeng se khutsitseng sa halofo (45 degrees) ka mangole a kobehileng. Mohato o mong le o mong oo ba o tsamaeang o eketsa catecholamines le tlhokahalo ea oksijene ea myocardial.
3. Fana ka 162 ho 325 mg ea Non-Enteric Chewable Aspirin: Ntle le haeba motho a e-na le allergy ea 'nete ea aspirin kapa a bontša matšoao a ho tsoa mali bokong/ho otloa ke lefu la mokokotlo (aortic dissection), e-ba **hlafuna le ho koenya motho e moholo a le mong 325 mg aspirin (kapa tse peli ho isa ho tse' nè tse 81 mg tse thibelang lesea ka har'a lipilisi tsa coronary) (Bona Thuso ea pele ea lefu la pelo.)
4. ** Bolella Lingaka tsa Paramedics le ER Hanghang hore Cocaine kapa Meth e Sebelisitsoe: **
   • Ka tlhaselo e tloaelehileng ea pelo e sa sebeliseng lithethefatsi, lingaka tsa tšohanyetso li fana ka intravenous beta-blockers (tse kang metoprolol kapa propranolol).
   • Ka tšebeliso e feteletseng ea cocaine kapa methamphetamine, ho fana ka beta-blocker e hloekileng (beta-1 / beta-2 blockade) e ka baka "ts'usumetso e sa hanyetsoeng ea alpha-adrenergic," moo ho thibela li-receptor tsa beta ho siea li-alpha receptors li bulehile, ho etsa hore methapo ea pelo e koalehe ka botlalo le khatello ea mali e phahame haholo.
   • Ha u bolella ngaka ea ER ka 'nete hore k'hok'heine kapa meth e teng, ba tšoara bohloko ba sefuba ka mokhoa o sireletsehileng ba sebelisa intravenous benzodiazepines (lorazepam kapa diazepam) ho khutsisa central sympathetic drive, sublingual kapa IV nitroglycerin, le **calcium-channel blockers (diltiazem/veraphentolamine kapa**veraphentolamine)

Boemo ba Tšohanyetso bo Sokelang Bophelo 3: MDMA ("Molly" / "Ecstasy") Botahoa ba Metsi Khahlanong le Ho Felloa ke Metsi¶

MDMA (3,4-methylenedioxymethamphetamine) e na le kotsi e ikhethang e 'meli ea hydration e bolaileng bacha ba moketeng le ba tlileng moketeng ba lekileng ho "etsa se nepahetseng" ka ho hula lilithara tsa metsi a hlakileng.

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

Boemo ba 4 bo Behang Bophelo bo Kotsing: Leqeba le Matlafatsang, Tšimoloho ea Maemo a Subarachnoid, le Ho Oa ke Bolutu.¶

Hobane methamphetamine, k'hok'heine, crack, le li-cathinone tsa maiketsetso li baka tsitsipano ea tšohanyetso, e mabifi khatellong ea mali.200/120 to 260/150 mmHg) haufi le boko bo otlang pelo le platelet clumping, acute ischemic stroke le hemorrhagic hemorrhage bleeds (intracerebral hemorrhage kapa ruptured cerebral aneurysm) ke mathata a atisang ho baka likoluoa tse bakoang ke ho tlōlela holimo ho matla, esita le ho batho ba lilemo tse mashome a mabeli le mashome a mararo.

1. Ho lemoha ho tsoa mali ho bakoang ke tšusumetso bokong kapa stroke (BE-FAST)¶

Le ka mohla u se ke ua qhelela ka thōko hlooho e bohloko, ho khoptjoa, kapa puo e sa hlakang nakong ea ho matha ka mokhoa o tsosang takatso e le "ho ba holimo" kapa ho hloka boroko:

• Ho opeloa ke Hlooho ea "Thunderclap" (Ruptured Aneurysm / Subarachnoid Hemorrhage): Haeba motho ea sa tsoa tsuba crack, snorted cocaine, kapa ea sebelisitseng methamphetamine ka tšohanyetso a tšoara hlooho 'me a lla ka*** hlooho e bohloko ka ho fetisisa ea bophelo ba hae ** (ho fihlela bohloko bo boholo ka hare ho metsotsoana e 60, ho hlatsa, molala), ho putlama, ho ka etsahala hore mothapo oa mali o botlaaseng ba boko o phatlohe tlas'a khatello e feteletseng ea mali ea catecholamine.
• BE-FAST Neurological Stroke Red Flags:
  • B (Ho leka-lekana): Ho lahleheloa ke botsitso ka tšohanyetso, ho tsekela, kapa ho se khone ho tsamaea hantle.
  • E (Mahlo): Ka tšohanyetso pono e lerootho, habeli, kapa e lahlehetsoe ke leihlo le le leng kapa ka bobeli.
  • F (Sefahleho): Lehlakore le leng la sefahleho le a kokobela kapa le ikutloa le tsielehile ha le kōptjoa ho bososela.
  • A (Liphaka): Letsoho le le leng kapa leoto le hoholehela tlase kapa le ikutloa le fokola/le tsielehile ha le le lelekoa.
  • S (Puo): Puo e sa hlakang, mantsoe a sa hlakang, kapa ho sitoa ho utloisisa lipolelo tse bonolo.
  • T (Nako): Letsa 911 / 112 / 999 hang-hang 'me U SE KE UA fana ka aspirin haeba motho a opa ka hlooho e opang kapa a belaelloang hore boko bo tsoa mali (aspirin e mpefatsa mali a tsoang ka har'a cranial).

2. Ho laola sets'oants'o se susumetsang motho ha u ntse u emetse baoki¶

Li-stimulants li theola moeli oa boko ka ho toba ka litlamorao tsa sodium-channel (cocaine), cerebral vasospasm, hyperthermia, le hyponatremia (MDMA). Ho fapana le lefu la sethoathoa la khale le emang ka botsona ka mor'a metsotsoana e 60, ** ho tsieleha ho bakoang ke lithethefatsi hangata ho fetela boemong bo sa khaotseng ba lefu la sethoathoa ** ntle le haeba ho phekoloa ka benzodiazepines e kenang methapong kapa intramuscular (**midazolam, lorazepam, kapa diazepam **):

1. Hleka fatše 'me u be le mosamo hloohong: Beha motho fatše fatše, u kenye baki e mennweng kapa mosamo ka tlas'a hlooho ea hae, 'me u sutumelle litafole tsa kofi, lihitara le lintho tsa khalase moo li sa fihlelleheng.
2. Bea Lipakete tsa Leqhoa Molamong, Liphakeng, le Bophakong: Mokuli ea hlasimollang ea sisinyehang o hlahisa mocheso o moholo oa mesifa o ka sutumetsang mocheso oa mantlha ho feta likhato tse 41 tsa Celsius (106 degrees Fahrenheit) ka metsotso; qala ho pholisa molala le liphaka hang ha ba ntse ba tšoara.
3. Le ka mohla u se ke ua kenya letho ka hanong le ka mohla u se ke ua tšoara maoto le matsoho a bona a sisinyehang: Ho qobella likhaba, lipache, kapa menoana pakeng tsa meno a koalehileng ho roba meno le ho thiba tsela ea moea, 'me ho penya maoto le matsoho a thothomelang ho robeha masapo le ho mpefatsa ho robeha ha mesifa (rhabdomyolysis).
4. Rollela Maemong a ho Phela ka Lehlakoreng ha ho tsukutla ho emisa: Hlakola mathe kapa mahlatsa a tsoang molomong ka ho a phutholla ka lehlakoreng le letšehali, selelu se sekame hanyenyane e le hore ba khone ho hema ka bolokolohi ho fihlela baoki ba liphallelo ba fihla.

Phokotso ea Kotsi Pele ho Tšebeliso le Tšireletseho ea Bohareng ba ho Binge: Ho Thibela ho tlōlisa le Chefo ea Fentanyl¶

Bakeng sa batho bao hajoale ba sebelisang li-stimulants kapa litho tsa lelapa tse tšehetsang motho ea kotsing, mehato ea ho fokotsa kotsi e thehiloeng bopaking e fokotsa haholo kotsi ea ho sebelisa lithethefatsi tse ngata haholo:

Mohato ka Mohato oa Phokotso ea Kotsi Ho Fokotsa ho Eketseha Bakeng sa Ho Feta Hoa Ho Se Hloko¶

Haeba u hlahlobile ntho e 'ngoe le e 'ngoe e tafoleng e ka holimo, 'me u netefalitse hore motho ha a na **mahlaba sefubeng, ha a na feberu / letlalo le chesang, ha a na sethoathoa, ha a na matšoao a stroke, le ho phefumoloha ho tloaelehileng **, ba na le motlakase o sa hlokahaleng oa kelello / oa boipheliso (hangata o bakoa ke ho nka ntho e susumetsang haholo, ho kopanya lintho tse susumetsang tse nang le k'hafeine lihora tse 2, kapa lihora tse 2 ho tsoha ha caffeine).

1. Lethathamo la tlhahlobo ea ho theola maemo a tikoloho le 'mele¶

1. Fetola Tikoloho ya Maikutlo Hanghang:
   • Tloha hole le 'mino o lerata oa bass, likamore tse petetsaneng, mabone a khanyang, kapa likhutlong tse sithabetsang tsa literata ho ea kamoreng e pholileng, e khutsitseng e nang le mabone a lerootho.
2. ** Folisa Mothapo oa Vagus (Ntle le ho Tsosa 'Mele):**
   • Beha lesela le pholileng, le metsi holim'a phatleng ea bona, mahlo, le mokokotlo oa melala, kapa u ba lumelle ho itlhatsoa ho fofo ho ea ho pholileng (ha ho mohla ho batang) ** shaoara ha ba lutse kapa ba hlokometsoe.
3. Hydrate e nang le Electrolyte le Li-carbohydrate tse bonolo:
   • Ho itlopa joala ho senya tsoekere ea mali, sodium, potasiamo le magnesium ha ho ntse ho baka molomo o omileng haholo ("cottonmouth") le ho sila ha mohlahare (bruxism).
   • Fana ka li-sips tse nyane, tse tsitsitseng tsa ** chilled electrolyte, metsi a kokonate, lebese, kapa litholoana tse smoothie **, hammoho le lijo tse bonolo, tse bonolo ho koenya (banana, yogurt, applesauce, kapa moro) le sengoathoana sa cheche kapa sekhutlo se hloekileng sa ho hlatsoa ho ba thibela ho senya molars ho tloha mohlahareng.
4. Khothaletsa Motsamao o Bonolo KAPA O Phomotse (Eng kapa Efe e Ikutloang e Sireletsehile ho Bona):
   • Batho ba bang ba tsielehileng ba ikutloa ba tšoasehile ha ba bolelloa hore ba bue leshano ka ho feletseng; ho tsamaea butle ka kamoreng e sireletsehileng, ho otlolla, kapa ho lula u otlolohile ha u ntse u ikoetlisa ** butle 4-second inhale / 6-second exhale breathing ** ho chesa matla a kinetic ea methapo ho fihlela tlhōrō e feta.

2. Mokhoa oa ho bua le motho ea nang le pherekano e susumetsang kapa ea hlobaelang boroko.¶

Ka mor'a lihora tse 48 ho isa ho tse 96 ntle le ho robala ka methamphetamine kapa crack cocaine, ho fihlela ** 40 ho karolo ea 60 lekholong ea basebelisi ba ba le psychosis ea nakoana e susumetsang maikutlo **: maikutlo a utloahalang (ho utloa ho hoeshetsa kapa seea-le-moea sa mapolesa ka ntle), moriti-batho ba ponong, maikutlo a tactile / "meth mitense" kapa "meth mites" ho shebella lifesetere.

• Le ka mohla u se ke ua ngangisana le bona kapa ua soma leshano la bona, 'me le ka mohla u se ke ua etsa eka u bona thetso:
  • Phoso: "Ua hlanya, ha ho motho ka ntle ho fensetere, lula fatše" (ho tsosa khalefo le ho ba kholisa hore u karolo ea morero).
  • Phoso: "Ee, le 'na ke bona lihloela ka ntle" (ho eketsa tšabo ea bona).
  • Ka ho le letona (Tiisa maikutlo, fatše ka tšireletseho): *"Kea bona hore na seo se tšosa hakae hona joale. U sireletsehile mona le 'na ka kamoreng ena, lemati le notletsoe, 'me ke tla lula mona ho u lebela ha u ntse u lula fatše u noa metsi ana a batang."
• Bonahatsa matsoho a hao, ema ka lehlakoreng la likhato tse 45 bonyane limithara tse 2 (maoto a 6) ho tloha moo, 'me le ka mohla u se ke ua thiba monyako oa ho tsoa: Motho ea tsielehileng ea ikutloang a koalehile ka kamoreng eo ho nang le motho ea thibileng lemati, o tla tšoha, a bousele kapa a loane. A ba dule moo ba ka bonang monyako hantle.
• Qoba ho fana ka lipilisi tsa "landing gear" tse sa ngolisoang seterateng: Le ka mohla u se ke ua fa motho ea fetang seterata "Xanax" bar kapa pilisi ea opioid ho mo robatsa; li-barprazolam tsa maiketsetso tsa seterateng li tlatsitsoe haholo ka **fentanyl, bromazolam, le xylazine **, ho fetola mokhoa o ka pholohang oa ho ts'oara phefumoloho e bolaeang ha bohle ba robala.

(Haeba uena kapa moratuoa oa hau le loana le methamphetamine, cocaine, crack, kapa bokhoba ba lithethefatsi bo susumetsang, bona Tšebeliso ea lithethefatsi le bokhoba ba lithethefatsi: tataiso ea thuso ea tšohanyetso, Thibelo ea ho khutlela morao le ho feta tekano: lihlopha tsa tlhahlobo tsa fentanyl/xylazine le naloxone, le Ho tšehetsa setho sa lelapa se nang le bokhoba ba tahi. Nahana ka ho nka thupelo ea thuso ea pele ea matsoho le CPR ho tsoa ho Red Cross, St John Ambulance, kapa mofani oa lehae.)

Lipotso tse botsoang khafetsa¶

Mehloli e hlahlobiloe¶

• American Heart Association (AHA, United States): Polelo ea Saense ka Tsamaiso ea Bohloko bo Amanang le Sefuba sa Cocaine le Myocardial Infarction (Coronary vasospasm pathophysiology, sodium-channel blockade, benzodiazepine le nitroglycerin ea pele ea phekolo, le ho qoba beta-blockade e sa hanyetsoeng).
• Tlhahiso ea Tlhekefetso ea Lithethefatsi le Tsamaiso ea Litšebeletso tsa Bophelo bo Botle ba Kelello (SAMHSA) & Setsi sa Sechaba sa Tšebeliso e Mpe ea Lithethefatsi (NIDA / NIH, United States): Kalafo ea Mathata a Tšebeliso e Matla (TIP 33 / Clinical Guidance), sympathomimetic toxidrome triage, le fentanyl co-kenyeletso ho inllimulants.
• ** American College of Medical Toxicology (ACMT) le American College of Emergency Physicians (ACEP):** Clinical Management of Severe Sympathomimetic Toxicity, Excited Delirium / Severe Agitation, le Drug-Induced Hyperthermia (Rapid conductive/evaporative cooling, ho qoba ea prone restraint asphyxialysis).
• National Harm Reduction Coalition (United States) & Drug Policy Alliance: Ho Lemoha le ho Arabela ho Fetisetsoang ho Stimulant (Ho fapana ho fetelletseng hoa kelello ho tsoa maemong a tšohanyetso a bongaka le mekhoa e sireletsehileng ea ho theoha).
• ** Setsi sa European Monitoring for Drug and Drug Addiction (EMCDDA / EUDA) & UK National Poisons Information Service (TOXBASE): ** Tataiso ea tleliniki mabapi le MDMA-induced ** Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH / acute dilutional hyponatremia) ** le cocaethylene cardiotoxicity.

Litataiso tse amanang¶

• Opioid overdose thuso ea pele
• Thibelo ea ho khutlela morao le ho feta tekano: lihlopha tsa tlhahlobo tsa fentanyl/xylazine le naloxone
• Tšebeliso ea lithethefatsi le bokhoba ba lithethefatsi: tataiso ea thuso ea tšohanyetso
• Ho tšehetsa setho sa lelapa se nang le bokhoba ba tahi
• Thuso ea pele ea lefu la pelo
• Ho otloa ke mocheso khahlano le ho felloa ke matla ha mocheso
• Kotsi e mpe ea liphio, rhabdomyolysis, le tlhahlobo ea moroto o lefifi
• Linomoro tsa maemo a tshohanyetso