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I-Liquid Nicotine Vape Juice, isingxobo seNicotine, kunye nePatch Poisoning ebantwaneni nakubantu abadala.

Amanani kaxakeka ayohluka ngokwamazwe. Eli phepha lisebenzisa u-911, inani laseMelika naseKhanada. Amanye amazwe amaninzi asebenzisa i-112, 999, okanye elinye inani. Fumana inombolo yelizwe lakho.

I-nicotine esulungekileyo yenye yezona zinto zikhawulezayo zisebenza kwibhotani ye-neurotoxins eyaziwa kwi-toxicology yeklinikhi, esebenza ngokuthe ngqo kwi-nicotinic acetylcholine receptors kuyo yonke ingqondo, inkqubo ye-nervous autonomic, i-adrenal glands, kunye ne-skeletal muscle neuromuscular junctions. Ngelixa imidiza yecuba yesintu ibangele intaphane yeengxaki zolawulo lwetyhefu yabantwana amashumi eminyaka, ukukhula okugqabhukileyo kwe-i-nicotine e-liquids exutyiweyo yolwelo ("ijusi yevape" kunye ne-5% / 50 mg/mL iibhotile zokuzalisa ityuwa yenikotini), isingxobo se-nicotine somlomo esinencasa yelekese, kunye neRow**, kunye neRowu** mg ukuya kwi-15+ mg ngengxowa nganye), nikotine gum kunye ne-lozenges, kunye ne-transdermal nicotine patches (equlathe ukuya kuthi ga kwi-21 mg ukuya kwi-114 mg ye-nicotine ye-reservoir epheleleyo ngesiqwenga ngasinye) iguqule ityhefu ye-nicotine yasekhaya ibe yimeko engxamisekileyo yonyango eguqukayo ngokukhawuleza. Ngenxa yokuba iibhotile ze-e-liquid kunye ne-nicotine pouch toins zivumba njengeziqhamo, i-mint, i-vanilla, okanye i-bubble gum kwaye zihlala zishiywe kwiitafile zekofu, iindawo zokulala, okanye iinqwelo zemoto, abantwana abancinci abanomdla banokuginya okanye bachithe idosi enokuba yingozi ngemizuzwana.

Ukuba umntwana okanye umntu omdala uginye ijusi yevape engamanzi, wahlafuna okanye waginya iipowutshi okanye itshungama yenikotine, wagalela iipetshi ezininzi zenikotine, okanye wagalela ulwelo olugxininisiweyo lwe-e esikhumbeni sakhe, fowunela inombolo yakho yexesha likaxakeka (911 eUnited States naseKhanada, 112 kwi-European Union, 999 eUnited Kingdom) amanani kaxakeka ulawulo ngoko nangoko, kwaye uphonononge ityhefu uncedo lokuqala, ukubamba uncedo lokuqala, kwaye CPR yabantwana kunye nosana. Yintoni eyenza ityhefu ebukhali yenikotini ibe nobuqhophololo yi isantya se-biphasic toxidrome sokuqala Isigaba 1 se-hyper-cholinergic excitation storm (ukugabha okuqhumayo, ukubila kakhulu, ukugxadazela, uxinzelelo lwegazi oluphezulu, ukubetha kwentliziyo ekhawulezayo, ukungcangcazela, ukutsalwa kwemisipha, kunye** nokuxhuzula okuqhelekileyo* kwimizuzu eyi-30 ukuxhuzula) **Isigaba se-2 sokunciphisa i-depolarizing blockade kunye nokuwa ** (izinga lokubetha kwentliziyo ngokukhawuleza, i-hypotension enzulu, i-coma, kunye ne-*i-flaccid paralysis ye-diaphragm kunye nezihlunu zokuphefumla **).

Yenza oku ngoku

  1. Fowunela u-911/112/999 okanye uLawulo lwetyhefu ngokukhawuleza: Tsalela umnxeba kwiinkonzo zonyango ezingxamisekileyo ngoko nangoko ukuba umntwana uginye NALUPHI na inani lenikotine engamanzi (ijusi yevape), uginye okanye uhlafune ngaphezu kwesingxobo senicotine esinamandla aphantsi/isiqwenga seentsini, okanye ukuba nawuphi na umntwana okanye umntu omdala uhlanza, ukuphaphatheka, ukungcangcazela kwesikhumba, ukungcangcazela, ukungcangcazela, ukungcangcazela kwesikhumba okanye ubunzima bokuphefumla. Ukubonakaliswa okuncinci kwe-asymptomatic, fowunela uLawulo lwePoison (** 1-800-222-1222** e-US) ngokukhawuleza.
  2. Sweep the mouth and check the entire body for hidden nicotine pouches or patches: Immediately look inside the child's or patient's mouth, especially tucked between the upper or lower lip and the gums, and use a finger wrapped in a cloth to remove any nicotine pouches (ZYN, Velo, On), chewing gum, lozenges, or **snus/tobacco iiqhekeza . Ukuba isigulane sididekile okanye asiphenduli, hluba iimpahla zabo kwaye ukhangele umqolo, isifuba, amahlombe, iingalo, kunye namathanga e- transdermal nicotine patches ** (ezihlala ziguquguqukayo okanye zinemibala yesikhumba kwaye ziphosakele ngokulula).
  3. Hlamba inikotini yolwelo echithekileyo (ijusi yevape) okanye uqhoboshele ulusu ngeSEPHA edikidiki NAMANZI: I-Freebase kunye ne-nicotine yolwelo esekwe kwityuwa ifunxa ngokukhawuleza ngolusu lomntu olungaguqukiyo ngqo kwigazi. Ukuba i-e-liquid ichithekile ezandleni zomntwana, ebusweni, entanyeni, okanye kwihempe, susa zonke iimpahla ezingcolileyo ngokukhawuleza kwaye uhlambe ulusu kakuhle ngamanzi adikidiki kunye nesepha ethambileyo kangangemizuzu eli-10 ukuya kweli-15. UNGAsebenzisi amanzi ashushu (ubushushu buvula imithambo yegazi yesikhumba kwaye bukhawulezise ukufunxwa kwenikotini egazini) kwaye UNGAsebenzisi izicoci zezandla ezisekwe etywaleni (eziphazamisa umqobo wolusu kunye nokwandisa ukufunxa).
  4. Ungaze ufune ukugabha okanye usele utywala: Inikotini ivuselela iziko lobuchopho lokugabha (area postrema) ngokuthe ngqo kwimizuzu embalwa emva kokuba uyityile, KWAYE inokubangela ukuxhuzula okuqhelekileyo okanye ukulahlekelwa zingqondo phakathi kwemizuzu 10 ukuya kuma-20. Ukubangela ukugabha okanye ukugalela amanzi/ubisi emlonyeni kudala umngcipheko omkhulu wokufuna ukufa kwemiphunga ukuba isigulana sibambe ngequbuliso okanye siqhwalele.
  5. Beka umntu ohlanzayo okanye owozelayo kwicala lakhe (Indawo yoBuyiselo) kwaye ujonge ukuphefumla kwakhe kufutshane: Ngenxa yokuba ityhefu yeSigaba 2 yenicotine ikhubaza i-diaphragm kunye nezihlunu zokuphefumla phakathi kwe-intercostal* (ngokufanayo neyeza lotyando elikhubazekileyo i-succinylcholine), isigulana esiyekayo ukungcangcazela kwelizwi emva kokuba singene emva kokungcangcazela ukusilela kokuphefumla**. Ukuba abaphenduli kwaye bayeke ukuphefumla ngokuqhelekileyo, qalisa ngokukhawuleza **CPR kunye nokuphefumla okuhlangula ** (30:2 kubantu abadala okanye abantwana abangabodwa; 15:2 kwiCPR yabantwana ababini abahlangulayo).
  6. Yiza neyona bhotile yevape, isixhobo sevape esilahlwayo, okanye inkonkxa yetoti kwigumbi likaxakeka: Funda ileyibhile yenikotini yoxinzelelo (mg/mL okanye %, khumbula ukuba 5% nicotine iyalingana 50 mg/mL) kunye ne pouch milligram amandla (3 mg, 6 mg, 8 mg, 12 mg, or 15+ mg).

I'5% yeVape Juice' yeMathematika Trap: Kutheni icephe elinye liqulathe ama-50 eCigarette' eliXabiso leNikotine engamanzi

Uninzi lwee-vapers kunye nabazali ngephutha bacinga ukuba ibhotile okanye i-pod ebhalwe ** "5% Nicotine" (i-Nicotine Salt)** ibuthathaka. Ngokwemigaqo yamachiza, ** i-nicotine eyi-5% ilingana ne-50 milligrams ye-nicotine ecocekileyo kwi-milliliter nganye (50 mg/mL)**. - Inye 5 mL (1 itispuni) ukuginya i-5% ye-e-liquid ihambisa 250 milligrams yenikotine engamanzi enyityilisiweyo, elingana nenikotine efunxekileyo ngaphezu kwama-200 ecuba zonke zibetha umgca wesisu ngaxeshanye. - Ku 10-kilogram (22-pound) umntwana ohambahambayo, ukuginya nokuba isiqingatha setisipuni (1 ukuya ku-2 mL) se-5% (50 mg/mL) ulwelo lwevape (okanye DIY 100 mg/mL isiseko sokuxuba) sihambisa ** i-5 ukuya kwi-10 mg / kg ** ye-nicotine ye-bioavailable ngokukhawuleza ye-bioavailable, ekwazi ukubangela ** ukuxhatshazwa okunobundlobongela, ukukhubazeka kwemisipha yokuphefumula, kunye nokubanjwa kwentliziyo ngaphakathi kwe-15 kwimizuzu ye-30 **.

Umthi wesigqibo: Ulwelo lweNicotine, isingxobo, isiziba, kunye novavanyo lwetyhefu yecuba

flowchart TD
    Start["Suspected Nicotine Exposure (E-Liquid Vape Juice, Oral Pouches [ZYN/Velo], Gum, Patch, or Tobacco)"] --> ClearSource["1. Tshayela uMlomo ukwenzela iiPoutshi/Intsini/Icuba\n2. Jonga Ulusu ukuba ufuna iiPatches ezifihlakeleyo\n3. Impahla yokuhluba kunye nokuhlamba i-E-Liquid echithiweyo esikhumbeni ngesepha eshushu kunye namanzi (AKUKHO Manzi atshisayo)"]

    ClearSource --> RouteSource{"Chonga uhlobo lweMveliso kunye neSimo seSimbo"}

    RouteSource -->|Liquid Nicotine (Vape Juice / Refill Bottle / Broken Pod) Ingested OR Any Symptomatic Patient| Urgent911["CALL 911 / 112 / 999 NGOKUNGOKO:\nUkuqala okuKhawulezayo (10 ukuya kwi-30 Min) yokugabha, ukuxhuzula, kunye nokukhubazeka kokuphefumla."]

    RouteSource -->|Oral Nicotine Pouch (ZYN/Velo/On), Gum, or Cigarette Butt in Asymptomatic Child| DoseCheck{"Ngaba Umntwana Wase-1 > Isingxobo/Intsini e-1 OKANYE > I-Cigarette e-1 OKANYE > 0.2 mg/kg?"}
    DoseCheck -->|Yes or Uncertain Count| UrgentED["UVavanyo lweSebe likaNgxamiseko kunye noPhononongo lweyure ezi-4 ukuya kwezi-6 (Ukuya kuthi ga kwi-12-24h ukuba iPatch eGqiweyo eNgagungqiyo)"]
    DoseCheck -->|Minor Brief Taste (< 1/2 Cigarette Butt or Brief Pouch Mouthing) + Zero Symptoms| PoisonCall["Fowunela uLawulo lwetyhefu (1-800-222-1222 e-US) ngokuJongwa kwiKhaya leeyure ezi-4 eziKhokelwayo"]

    Urgent911 --> BiphasicTrack["Ukujongwa kwe-ICU yesibhedlele kwi-Biphasic Nicotine Toxidrome"]
    UrgentED --> BiphasicTrack

    BiphasicTrack --> Phase1["ISIGABA 1 (Ekuqaleni: I-15 Min ukuya kwiiyure ze-1-2) - I-Nicotinic Receptor Overstimulation:\nI-Nausea, i-Projectile Vomiting, i-Pale Diaphoresis, i-Salivation / Bronchorrhea, i-Hypertension, i-Tachycardia, i-Agitation, i-Tremors, i-Fasciculations, i-Generalized Seizures"]

    Phase1 --> Phase2["ISIGABA 2 (Kamva: 30 Min ukuya kwiiyure ze-4+) - I-Receptor Desensitization & Depolarizing Neuromuscular Blockade:\nI-Bradycardia enzima, i-Hypotension / Shock, Lethargy / Coma, i-Flaccid Muscle Weakness, Diaphragmatic Paralysis & Apnea"]

    Phase2 --> HospitalRescue["Uhlangulo eSibhedlele ekuJoliswe kuso:\n1. Ukuxhuzula: IV Benzodiazepines (Lorazepam/Midazolam)\n2. I-Muscarinic Secretions / Bradycardia: IV Atropine (0.5-1 mg Umntu omdala / 0.02 mg / kg Umntwana)\n3. Ukukhubazeka kokuphefumla: Intubation yokuqala ye-Endotracheal + i-Mechanical Ventilation (AVOID Succinylcholine)\n4. I-GI Decontamination: Ilahle eliVunyiweyo (leePoutshi eziginyiweyo/iiCwecwe/iiPatches) + Ukunkcenkceshela kwamathumbu onke ukuba iPatch iginyiwe."]

I-Pathophysiology: Ukuqonda iBiphasic Nicotine Toxidrome

Kutheni le nto umntu otyhefelwe yi-nicotine eqala ngesky-high blood pressure, intliziyo ebalekayo, ukungcangcazela, nokuxhuzula ngamandla, aze ngequbuliso antlithe emva kwemizuzu engama-30 ukuya kwengama-90 ngeuxinzelelo lwegazi oluphantsi ngokuyingozi, ukubetha kwentliziyo kancinane, isiqaqa, nokukhubazeka ngokupheleleyo kwezihlunu zokuphefumla?

1. Apho iNicotinic Acetylcholine Receptors (nAChRs) Phila kuMzimba woMntu

I-Nicotine yinkqubo yokulinganisa i-neurotransmitter i-acetylcholine (ACh) kwaye ibophelela ngokukhethiweyo kwi-ligand-gated nicotinic acetylcholine receptor ion channels (nAChRs)* kwiindawo ezine ezibalulekileyo ze-anatomical: 1. I-Central Nervous System (Ubuchopho kunye ne-Brainstem): Kubandakanya indawo ye-chemoreceptor trigger zone (indawo ye-postrema)* kwi-medulla (ebangela ukuqhuma kokuhlanza kwangaphambili), i-cortex (ebangela ukuphazamiseka, ukungcangcazela, kunye nokuxhuzula ngokubanzi), kunye neziko lokuphefumula. 2. I-Sympathetic Autonomic Ganglia kunye ne-Adrenal Medulla: Ukuvuselela imithambo-luvo ye-postganglionic sympathetic kunye ne-adrenal glands ukulahla ukunyuka okukhulu kwe-epinephrine kunye ne-norepinephrine* egazini (okubangela i-vasoconstriction kwangaphambili, **isikhumba, i-hypertension, kunye ne-tachycardia). 3. Parasympathetic Autonomic Ganglia: Ukuvuselela i-vagal kunye ne-cholinergic pathways ezibangela ukuhluma amathe amaninzi (ukuvuza), ukukrazula, i-bronchorrhea (ukukhutshwa kwemiphunga yamanzi), ukubila (i-diaphoresis), ukukrazula kwesisu, ukugabha, kunye norhudo. 4. Izihlunu zeSkeletal Muscle Neuromuscular Junctions (NMJ, I-Motor End-Plates): I-receptors ye-nicotinic echanekileyo efanayo kwimicu yemisipha ye-skeletal kunye ne-*diaphragm ** ebangela ukuchithwa kwemisipha xa uphefumla okanye uhamba.

2. Kutheni iNqanaba loku-1 Uchulumanco Lujikela kwiSigaba sesi-2 sokukhubazeka (i-Depolarizing Blockade)

Xa isiqhelo ** i-acetylcholine ** ibophelela kwi-nicotinic receptor kwi-neuromuscular junction, ivula i-sodium / i-calcium channel kwi-fraction ye-millisecond ukuze iqalise ukuchithwa kwe-muscle kwaye emva koko ** itshatyalaliswe ngokukhawuleza yi-enzyme acetylcholinesterase **.

Ngokwahlukileyo koko, nikotini AYIKWAZI ukucandwa yi-acetylcholinesterase: - Isigaba soku-1 (I-Agonist Hyper-Stimulation: Imizuzu eyi-10 ukuya kwi-1 ukuya kwiiyure ze-2): Inikotini itshixa kwi-nicotinic receptors kwaye inyanzelisa i-ion channels ukuba ivuleke ngokuqhubekayo, idubula imithambo-luvo kunye nezihlunu ngokungayekiyo. Isigulana sifumana ukuhlanza okubonakalayo, ukubila okubanda okubanda, ukuvuza, uxinzelelo lwegazi oluphezulu, i-tachycardia, i-muscle fasciculations (i-rippling twitches), kunye ne-tonic-clonic seizures ngokubanzi. - Isigaba sesi-2 (I-Depolarization eZingileyo kunye ne-Receptor Desensitiization: Imizuzu engama-30 ukuya kwiiyure ze-4+): Ngenxa yokuba i-nicotinic receptors ihlala ibotshelelwe ngokuqhubekayo yi-nicotine kwaye i-membrane yeseli ihlala ihlanjululwe ngokuqhubekayo, iziteshi ze-sodium ezine-voltage-gated ezikufutshane ne-motor end-plate azikwazi ukuseta kwakhona kwi-nicotinic state kwi-receptor yazo **i-desensitized, i-refractory ivaliwe i-conformation ** (**i-depolarizing neuromuscular blockade , ifana nokugqithiswa kwe-overdose ye-surgery paralytic ** succinylcholine ). - Ngaxeshanye, i-autonomic ganglia iyavalwa kwaye i-brainstem drive ephakathi iyasilela. Uxinzelelo lwegazi luyehla (hypotension and shock), ukubetha kwentliziyo kuyehla ku ibradycardia eqatha okanye iAV block, ingqondo iyancipha ibecoma, kwaye i-diaphragm kunye nezihlunu ze-intercostal ziba buthathaka ngokupheleleyo, nto leyo ebangela ukufa nge-asphyxiation (apnea) ngaphandle kokuba isigulane sifakwe kwi-mechanical venti.

Isigaba seklinikhi kunye nefestile yexesha Iimpawu ezibalulekileyo (Izinga lentliziyo, uxinzelelo lwegazi, ukuphefumla) Iziphumo zeNeurological & Muscular Iimpawu zeGastrointestinal & Autonomic
Inqanaba loku-1: iNqanaba lokuKhuthaza i-hyper-Stimulation
(Ukuqalisa: kwimizuzu eyi-10 ukuya kwengama-30 emva kolwelo/isingxobo; ifikelela incopho ngaphakathi iyure enye)		 Tachycardia (isantya sentliziyo ekhawulezayo), Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu), Tachypnea (ukuphefumula ngokukhawuleza) kunye ne-hyperpnea. Ukuxhalaba, ukungazinzi, isiyezi, intloko ebuhlungu, ukudideka, ** ukungcangcazela kwe-fine-to-coarse **, i-muscle fasciculations **, kunye ne-*-generalized tonic-clonic seizures **. Uqhushumbo lwesicaphucaphu kunye nokugabha okuqhumayo (okudla ngokuba luphawu lokuqala), ukuqaqanjelwa sisisu, urhudo, ukubila okubandayo okugqithisileyo, isikhumba esiluthuthu (i-pallor), ukuvuza kakhulu (ukuntywila), kunye nokuphuma kwebronchi enamanzi.
Inqanaba lesi-2: Ukuchithwa kweBlockade kunye neSigaba sokuwa
(Ukuqalisa: imizuzu engama-30 ukuya kwiiyure ezi-4; ithatha 4 ukuya kwiiyure ezingama-24)		 ** I-Bradycardia enzima ** (izinga lentliziyo ecothayo), iibhloko ze-AV conduction, ** i-Profound Hypotension kunye ne-Shock **, i-hypoventilation enzulu eqhubela phambili ku- ** Apnea (ukubanjwa kokuphefumula) **. I-Lethargy, stupor, ** i-coma enzulu , ukulahlekelwa kwee-tendon reflexes ezinzulu ( areflexia ), kunye ** ukunyuka okanye ukukhubazeka kwemisipha ye-flaccid ngokubanzi ** (kubandakanywa nokukhubazeka kwe- diaphragm **). Abafundi banokutshintsha ukusuka kwi-constricted (miosis) ukuya kwi-dilated (mydriasis); Izandi zamathumbu ziyancipha njengoko i-ganglionic blockade ingena.

Ukuthelekisa iiMveliso zeNikotine zanamhlanje: Kutheni iJuice yeVape eLiquid kunye neePoutshi ziyingozi kakhulu kuneebhuthi zeCigarette

Kangangamashumi eminyaka, oogqirha abangxamisekileyo baye bafumanisa ukuba abantwana abatya icuba okanye icuba lecuba babengafane bafe. Kutheni le nto ii-e-liquids zale mihla kunye nezingxobo zenikotini zibangela ubutyhefu obugqithisileyo?

Imveliso yeNicotine Umxholo weNicotine oqhelekileyo Isantya sokufunxa kunye ne-Bioavailability Kutheni Umngcipheko Wetyhefu Wahluka
1. Inikotini yolwelo ("Ijusi yeVape" / iibhotile zokuzalisa i-E-Liquid kunye neePods) ** 3 mg / mL ukuya ku-24 mg / mL ** (Freebase) okanye ** 25 mg / mL ukuya kwi-50 mg / mL [2.5% ukuya kwi-5%] ** (I-Nicotine Salts); ukuya kuthi ga ku- 100 mg/mL (10%) kwiziseko zokuxuba ze-DIY. Ibhotile enye ye-30 mL yetyuwa ye-5% = 1,500 mg yenikotini ecocekileyo. I-ULTRA-RAPID (imizuzu emi-5 ukuya kwe-15) kwi-mucosa yomlomo, isisu, KUNYE ne-**isikhumba esiqinileyo **. Sele i-100% ichithwe kwi-propylene glycol / i-glycerin yemifuno; ifunxa ngoko nangoko ngomlomo nangolusu phambi kokuba iziko lobuchopho lokugabha liyikhuphe. Iilekese/incasa yeziqhamo zikhuthaza abantwana ukuba basele iigulp ezininzi.
2. Izingxobo zeNikotini zoMlomo (Izingxobo eziMhlophe ezingaXolwayo)
(ZYN, Velo, On, Rogue, Fre, Kurwa / Iceberg)		 3 mg, 4 mg, 6 mg, 8 mg, 12 mg, okanye 15 mg pouch nganye kwi-US/EU yokuthengisa (iipowutshi "ezingekho mthethweni" / ezithunyelwa ngaphandle ziqulethe ** 30 mg ukuya ku-50 + mg ngengxowa **). Itoti enye ye-15-pouch ye-6 mg ZYN = 90 mg. I-RAPID kwi-buccal/oral mucosa (i-alkaline buffering agents njengesodium carbonate yonyusa i-pH yomlomo ukuya 8.0-8.8 ukunyanzela inikotini yomanyano ngokuthe ngqo ngeentsini) + i-GI ezinzileyo yokukhululwa ukuba iginyiwe. Ngokungafaniyo namagqabi ecuba amdaka amdaka enza ukuba umntwana oselula atshice ngoko nangoko, iipowutshi ezimhlophe zeselulosi zinencasa eswiti (ipeppermint, isitrasi, ikofu, iqunube) kwaye zenziwe nge-alkaline pH buffers ukunyusa ukufunxa ngokukhawuleza kwe-mucosal.
3. INcotine Gum & Lozenges
(Nicorette, Zibophelele, Rogue)		 2 mg okanye 4 mg iqhekeza ngalinye. Ukufunxeka ngokukhawuleza kwe-buccal ukuba ihlafunwa okanye ifunxiwe; ukufunxa okucothayo ukuba iginywe ngokupheleleyo. Ukuluma kunye nokuhlafuna amaqhekeza amaninzi eziqhamo- okanye i-nicotine enencasa yetshungama ikhupha inikotine ekhululekileyo kumlomo we-alkaline phambi kokuba isisu siphume kuqala.
4. Iziqwenga zeNikotini zeTransdermal
(I-Nicoderm CQ, iHabitrol)		 Ibhalwe njenge 7 mg, 14 mg, or 21 mg / 24 hours, kodwa **isiqwenga ngasinye siqulethe i-reservoir epheleleyo ye-15 mg ukuya kwi-114 mg ye-nicotine ** (Nokuba i-"esetyenzisiweyo" i-patch elahliweyo isabambe i-50% ukuya kwi-75% ye-nicotine yayo iyonke **). Ukufakwa ngokuqhubekayo kwe-zero-odolo ngesikhumba okanye ngephecana le-GI ngaphezu kwe-*12 ukuya kwiiyure ezingama-24+**. Imigibe emibini eyingozi: (1) Umntwana oselula utsalela isiziba "esisetyenzisiweyo" kwinkunkuma aze asibeke eluswini lwakhe (okanye asiginye); (2) Umntu omdala ozama ukuyeka ukutshaya usebenzisa amabala amaninzi ngexesha elinye (okanye uyatshaya enxibe iziziba). Amabala aginyiweyo abangela ityhefu eyongezelelekileyo yeeyure ezingama-24.
5. Imidiza yesiNtu, iiNtuthu zeSigarethi & neCigar Icuba Elipheleleyo: 10 mg to 20 mg.
Impundu yeCigarette: 2 mg to 5 mg igxile kwisihluzo.
Isigarethi esiLiquid esiSoka saManzi (impundu iwiswe kwitoti yesoda): IYAYItyhefu KAKHULU (10 to 30+ mg chitha).		 Ukufunxa ngomlomo okucothayo kwiiflakes zecuba ezineasidi eyomileyo (i-high hepatic first-pass metabolism icoca malunga ne-70%), PLUS ukugabha kwangoko okukhuselayo. Ngaphandle kwemeko: Amanzi okusela/isoda apho iimpundu zecuba zifunxeka ngokukhawuleza njenge-e-liquid. I-acidic pH (5.5) yecuba elomileyo elinyangisiweyo ligcina inikotini ine-iyoni esiswini ukuze ifunxe kancinci ngelixa ibangela ukugabha kwangoko okukhupha amagqabi. Ungaze ucinge ukuba amanzi anolwelo okanye afakwe kwisigarethi aziphathe njengempundu eyomileyo yecuba.
6. Isigulo seCuba esiLihlaza (Ukuvezwa kweZolimo ngoNyango) Amagqabi aluhlaza amanzi INicotiana tabacum ngexesha lokuvuna. I-Transdermal (ulusu) yokufunxa inyibilikiswe ngumbethe wakusasa, imvula, kunye nokubila komsebenzi. Abasebenzi bezolimo bavuna amagqabi ecuba amanzi ngaphandle kwezixhobo zemvula ezingangeni manzi kunye neeglavu ze-nitrile zifunxa **50 ukuya kwi-90 mg ye-nicotine ngesikhumba sabo **, ukuphuhlisa ukuhlanza okukhulu, isiyezi, i-pallor, ukubila, kunye ne-bradycardia.

Skin (Dermal) and Eye Decontamination Protocols

Because un-ionized (freebase) nicotine is both water- and lipid-soluble, concentrated liquid nicotine passes rapidly through the outer stratum corneum of intact skin directly into dermal capillaries, completely bypassing the liver's protective 70% first-pass metabolism:

  1. Immediate Clothing Removal and Lukewarm Soap-and-Water Wash:
  2. Put on nitrile or latex gloves before touching a person or child soaked in e-liquid so you do not poison yourself through your fingers.
  3. Strip off all splashed shirts, pants, socks, or diapers immediately.
  4. Wash the affected skin gently and thoroughly with mild dish soap or hand soap and lukewarm running water for 10 to 15 minutes.
  5. Why You Must NEVER Use Hot Water, Vinegar, or Alcohol Hand Sanitizer:
  6. No Hot Water: Hot water causes cutaneous vasodilation (widening of skin blood vessels), which dramatically accelerates the rate at which nicotine enters the systemic circulation.
  7. No Alcohol / Solvents: Rubbing alcohol or hand sanitizer strips skin lipids and enhances transdermal penetration.
  8. No Acidic Solutions: Do not waste time trying to neutralize nicotine on the skin with vinegar or lemon juice; plain soap and copious lukewarm water physically remove the propylene glycol/glycerin carrier immediately.
  9. Removing Transdermal Nicotine Patches:
  10. Peel off all patches immediately, fold them in half with the sticky edges pressed together (so no child or pet can touch them), and wash the skin site with plain water and mild soap to remove residual nicotine depot gel on the skin surface. (Note: Even after removing a patch, a "skin depot" of nicotine already absorbed into the epidermis will continue entering the bloodstream for 2 to 6 hours).
  11. Ocular (Eye) Splash:
  12. Ulwelo lwe-E oluchaphazekileyo kwiliso lubangela ukutshisa okukhulu, ububomvu be-conjunctival, iziphene ze-corneal epithelial, kunye ** nenkqubo ye-nicotine yokufunxa kwi-nasolacrimal duct *. nkcenkceshela iliso elivuliweyo ngokuqhubekayo ngamanzi etephu adikidiki okanye i-0.9% yetyuwa eqhelekileyo kangange-15 ukuya kwimizuzu engama-20 kwaye ufune uvavanyo olungxamisekileyo.

ISibhedlele esiNgxamisekileyo kunye neeProtokholi zoNyango lwe-ICU

Akukho **akukho ngqo kwi-receptor-blocking antidote ** eguqula i-nicotinic ephakathi kunye ne-neuromuscular toxicity ngaxeshanye; ukusinda kuxhomekeke kulawulo olunobundlongondlongo, lwesigaba esikhethekileyo se-ICU:

1. UKhuseleko lweNdlela yoMoya kunye nokuPhumelela kweMitshini (Ungenelelo lwe-#1 oluSindis ubomi)

Ngenxa yokuba ukufa kwityhefu ye-nicotine eyingozi phantse isoloko iphumela kwi- Isigaba se-2 sokungaphumeleli kokuphefumla (okudityanisiweyo okudakumba okuphefumla okuphakathi, ukukhuselwa okukhulu kwe-bronchial, kunye ne-depolarizing neuromuscular paralysis of the diaphragm*): - ** Intubation ye-Endotracheal Early *: Oogqirha be-Emergency intubate kunye ne-mechanically ventilate nasiphi na isigulane esibonisa iimpawu zokukhathala kwemisipha yokuphefumula, ukuphefumla okunzulu, i-hypoxia, i-coma, okanye i-epilepticus yesimo esiphindaphindiweyo. - UMGAQO OMQHELEKO WE-RSI DRUG: Gwema i-Succinylcholine: Xa wenza i-Rapid Sequence Intubation (RSI) kwisigulane esinetyhefu ye-nicotine, gwema ukusebenzisa i-depolarizing paralytic Succinylcholine **, esebenza ngendlela efanayo ye-nicotinic receptor depolarization prolongdemus okanye ineurospolarization ye-depolarization embi kakhulu sebenzisa i-*non-depolazing neuromuscular blocker ekhuphisanayo (efana neRocuronium) endaweni yoko. - ** Ukuguqulwa kwe-Respiratory Paralysis **: Ngethuba nje isigulane sixhaswa kwi-ventilator yomatshini kunye ne-1% yokukhuselwa kwe-airway kunye ne-oxygenation, isibindi ( CYP2A6 ** i-metabolism kwi-cotinine) kunye nezintso zisusa i-nicotine ngaphezu kwe- ** 4 kwiiyure ze-24 **, kwaye ** i-100 ipesenti ye-diaphragm ngokupheleleyo kunye namandla emisipha * abuyele ngokupheleleyo.

2. Ukulawula iNqanaba loku-1 lokuxhuzula kunye nokuphazamiseka

  • Ii-Anticonvulsants zomgca wokuqala: I-Benzodiazepines ye-Intravenous: Lawula i-Lorazepam (0.1 mg/kg IV, ixhomekeke ku 4 mg), Midazolam (0.1 to 0.2 mg/kg IV or IM), okanye Diazepam ngoko nangoko ngenxa yokuxhuzula okubangelwa inikotini ngokubanzi okanye ukungcangcazela okukhulu.
  • I-Second-Line Refractory Seizures: Ukuba isimo se-epilepticus siyaqhubeka nangona i-benzodiazepines, inyuka ngokukhawuleza ukuya ku-**Phenobarbital **, ** i-Propofol **, okanye ** i-Levetiracetam ** (ukuphepha i-phenytoin, engasebenziyo ekubanjweni kwe-toxin).

3. Ukulawula ukungazinzi kwe-Biphasic Autonomic (i-Atropine ye-Muscarinic Overload vs. Vasopressors yeSigaba se-2 Shock)

  1. I-Atropine ye-Intravenous ye-Muscarinic Symptoms ezinzima (i-Bronchorrhea, i-Salivation, kunye neSigaba se-2 Bradycardia):
  2. Ngenxa yokuba inikotini ivuselela i-parasympathetic ganglia ukukhulula ngokugqithiseleyo i-acetylcholine kwi-muscarinic receptors kwimiphunga, i-salivary glands, kunye ne-sinoatrial/atrioventricular nodes, izigulane zinokutshona kwiimfihlo zazo zemiphunga yamanzi (bronchorrhea) kunye ne-heart blocked bradyfound*
  3. Lawula Intravenous Atropine (0.5 mg to 2 mg IV kubantu abadala; 0.02 mg/kg IV kubantwana, ubuncinane 0.1 mg), iphindaphindwa rhoqo kwimizuzu emi-5 ukuya kweli-10 de incindi yebronchi yomile kwaye ibradycardia eneempawu isonjululwe.
  4. Ukulawula iSigaba soku-1 soxinzelelo lwegazi ngokuchasene neSigaba sesi-2 soxinzelelo lwegazi:
  5. Ungaze uNyange ngokuPhezulu kwiSigaba soku-1 soxinzelelo lwegazi okanye i-Tachycardia ene-Beta-Blockers eSebenza ixesha elide: Ngenxa yokuba i-Phase 1 hypertension idlula kwaye ihlala ijika ngokukhawuleza kwi- **Isigaba se-2 hypotension, i-bradycardia, kunye nomothuko ngaphakathi kwe-30 ukuya kwimizuzu engama-60 **, ukunika ixesha elide elisebenza njenge-Phanololol-prose-prose-prose-prose proseproloer iya kubangela ukuwohloka kwentliziyo okungafumanekiyo xa iSigaba 2 sibetha. Phatha iNqanaba loku-1 ukuphazamiseka / uxinzelelo lwegazi ngobumnene nge- **IV benzodiazepines ** (okanye i-ultra-short-acting titratable infusions kuphela ukuba kwenzeka ingxaki ye-hypertensive).
  6. ISigaba sesi-2 Uxinzelelo lwe-hypotension kunye noMothuko: Lawula **i-intravenous isotonic crystalloid boluses (20 mL/kg 0.9% Normal Saline) ** kwaye uqale i-vasopressor infusion esebenza ngokuthe ngqo (**Norepinephrine ** okanye ** i-Epinephrine **) ukuba i-blockade ye-ganglionic ibangela i-vasoplegic eqhubekayo / i-hypotension ye-cardiogenic.

4. Imithetho yokuNxilwa kweGastrointestinal ngohlobo lweMveliso

  • Inikotini yolwelo (Ijusi yeVape): Ngenxa yokuba inikotini yolwelo ifunxwa kwimizuzu kwaye ibangele ukugabha okuzenzekelayo kunye nokuxhuzula ngokukhawuleza phakathi kwe- **10 ukuya kwimizuzu engama-20 **, **ukuhlamba isisu okanye ilahle elivuthayo ngomlomo ngokuqhelekileyo libanjwa ** kwi-unintubated engaguqukiyo ngenxa ye-nicotine emngciphekweni omkhulu we-nicotine ngexesha lolwelo. ukuxhuzula **. Ukuba umthamo omkhulu wolwelo olubulalayo uginywe kwimizuzu engama-30, umnqweno we-nasogastric kunye namalahle asebenzayo (1 g/kg) zilawulwa **emva kwe-endotracheal intubation ** ikhusela indlela yomoya.
  • Izingxobo zeNikotini eziginyiweyo, iintsini, iiLozenges, okanye iiPatches zeTransdermal:
  • Ngenxa yokuba iipowutshi, iimatrices zegum, kunye ne-transdermal patches zikhupha i-nicotine ngokuqhubekayo kwiiyure ezininzi ngaphakathi kwesisu kunye namathumbu, Idosi enye okanye i-Multi-Dose Activated Charcoal (1 g/kg up to 50 g) Iboniswa ukuba isigulana sivukile kwaye sikhusela indlela yaso yomoya (okanye ifakwe ngaphakathi).
  • Ukunkcenkceshela kwamathumbu apheleleyo (WBI): Ukuba umntwana okanye umntu omdala uginya i-nicotine patches ye-nicotine engaguqukiyo okanye inani elikhulu leengxowa zenicotine/iziqwenga zeentsini, oogqirha abangxamisekileyo balawula **Ukunkcenkceshela kwamathumbu onke ngePolyethylene Glycol Electrolyte Solution (PEG-Dislushing out the patches) yomzila wesisu.

5. Amaxesha okujongwa kweSibhedlele phambi kokuKhupha ngokuKhuselekileyo

  • **I-Nicotine ye-Liquid (E-Liquid) okanye i-Chewed Gum / Pouches **: Ngenxa yokuba i-nicotine ye-liquid kunye ne-mucosal ifunxa ngokukhawuleza, ukuba isigulane sihlala ** i-100 yeepesenti ingabonakali (akukho kugabha, izinga lentliziyo eliqhelekileyo, uxinzelelo lwegazi oluqhelekileyo, ukuphaphama okuqhelekileyo) kwi-4 ukuya kwiiyure ze-6 ** emva kokuvezwa, i-toxicity enzulu ikhutshwe.
  • Izingxobo zeNikotini Eziginyiweyo, Iisigarethi/IiCigar ezipheleleyo, okanye iiPatches zeTransdermal: Ngenxa yokuba iimatrics ezihlala zikhutshwa kunye neziqwenga zinokukhupha inikotini kwindawo esezantsi ye-GI iiyure ezininzi, izigulane eziginya iipetshi okanye izixa ezikhulu zifuna 12 ukuya kwiiyure ezingama-24 zokujongwa esibhedlele.

Iinombolo zengingqi zikaxakeka kunye neeprothokholi ze-arhente

Ingingqi / Ilizwe Inombolo yeAmbulensi yoNgxamiseko Umnxeba woNcedo woLawulo lwetyhefu yeSizwe Amanqaku eProtocol yeklinikhi esemthethweni
EUnited States naseKhanada 911 US: 1-800-222-1222 (Amaziko etyhefu aseMelika) / Canada: 1-844-POISON-X (1-844-764-7669) Umthetho i-US Child Nicotine Poisoning Prevention Act ugunyazisa ukupakishwa okunganyangekiyo kwabantwana kwizikhongozeli ezingamanzi, nangona iipodi ezilahlwayo kunye neetoti zengxowa ze-ZYN/Velo zihlala zikhokela abantwana ababangela ukufowuna; 5% yetyuwa (50 mg/mL) iivapes zixhaphakile.
United Kingdom 999 (okanye 112) NHS 111 (Kawonke-wonke) / NPIS TOXBASE (0344 892 0111 yoogqirha) Imimiselo ye-UK TRPR ibeka i-legal retail e-liquid nicotine amandla ku- ** 20 mg / mL (2%) ** kunye nobukhulu betanki kwi-2 mL, nangona ii-vapes ezingavumelekanga ezingekho mthethweni kunye ne-10 ukuya kwi-50 mg ye-nicotine pouches zidibana kakhulu ne-NPIS.
Imanyano yaseYurophu 112 Qhagamshelana neziko lesizwe elinetyhefu nge-112 (umzekelo, eJamani +49 30 19240, France 01 40 05 48 48) I-EU Tobacco Products Directive (TPD) caps retail e-liquid at 20 mg/mL (2%), ngelixa iipowutshi zenicotine zomlomo ezinamandla kakhulu ("i-white snus") kunye ne-DIY 100 mg/mL iziseko zibangela ityhefu ebukhali ebukhali.
Ostreliya kunye neNew Zealand Ostreliya: 000 / eNew Zealand: 111 Australia: 13 11 26 (Iziko leNgcaciso yePoisons) / New Zealand: 0800 764 766 (0800 POISON) IOstreliya ihlela inikotini elulwelo phantsi kolawulo olungqongqo lwekhemesti, nangona iivapes ezilahlwayo ezivela kumazwe angaphandle (50 mg/mL) kunye neepowutshi zifuna rhoqo iPoisons Information Centre triage.
Indiya kunye neAsia-Pacific Indiya: 112 (okanye 108) / Japan/Singapore: 119 / 995 India: AIIMS National Poisons Information Centre (1800-116-117 / 011-26589391) Ukuba sesichengeni esiphezulu sabantwana kwiipakethi zecuba ezingenamsi emlonyeni (gutka, khaini, zarda), iintsini zenikotine/iipowutshi, kunye nezolimo Isigulo secuba esiluhlaza phakathi kwabavuni becuba.

Imibuzo ebuzwa qho

Kutheni le nto ukuginya ijusi yevape elulwelo okanye isingxobo senikotini ye-ZYN kuyingozi kakhulu emntwaneni kunokutya impundu yecuba?

Xa umntwana osemncinci esitya umdiza owomileyo okanye i-cigarette butt, i-acidic pH yamagqabi ecuba eyomileyo igcina uninzi lwe-nicotine kwifomu ye-ionized ethatha ngokucothayo esiswini, ngelixa incasa ekrakra kunye nokucaphuka kwesisu kubangela ukugabha kwangaphambili okukhupha icuba ngaphambi kokuba ithamo elibulalayo lingene egazini. Ngokwahlukileyo, ijusi yevape engamanzi (ingakumbi i-5% yetyuwa yenikotine, equlethe i-50 mg yenikotine esulungekileyo ngemililitha nganye) sele i-100 yeepesenti inyibilika kulwelo, kunye neengxowa zenikotini ezimhlophe (ezifana ne-ZYN, iVelo, okanye i-On) ziqulethe iityuwa ze-alkaline eziphazamisayo ngokukodwa ezenzelwe ukunyanzela inikotini ngokukhawuleza kunye neentsini zomlomo. Zombini incasa njengesiqhamo okanye imint endaweni yecuba elikrakrayo, nto leyo evumela umntwana ukuba afunxe ithamo elibangela ukuba axhuzule okanye eliphefumlayo kwisithuba semizuzu eli-10 ukuya kwengama-20.

Ithetha ukuthini "ityhefu ye-biphasic" kwityhefu yenikotini?

I-Biphasic ithetha ukuba ityhefu yenzeka kwizigaba ezibini ezichaseneyo. Ngexesha leSigaba soku-1 (imizuzu yokuqala eyi-10 ukuya kwengama-60), inikotini ivuselela i-nicotinic receptors kuyo yonke ingqondo, i-adrenal glands, kunye nezihlunu, ibangela ukugabha okugqabhukileyo, ukubila okubanda okubanda, ukuthontsiza, uxinzelelo lwegazi oluphezulu, ukubetha kwentliziyo ngokukhawuleza, ukuxhuzula kwemisipha, kunye nokuxhuzula okuqhelekileyo. Ngexesha leSigaba se-2 (imizuzu engama-30 ukuya kwiiyure ze-4 kamva), i-receptors e-overstimulated ivalela kwaye i-desensitize (i-depolarizing blockade), ibangela ukuba iimpawu ezibalulekileyo zesigulane ziphendulele kwelinye icala: ukubetha kwentliziyo ngokukhawuleza, ukuwa kwengcinezelo yegazi, i-coma, kunye nokukhubazeka okupheleleyo kwe-diaphragm kunye nezihlunu zokuphefumla.

Kutheni kufuneka i-nicotine engamanzi (incindi yevape) ihlanjwe esikhumbeni ngesepha edikidiki kunye namanzi endaweni yamanzi ashushu?

Inikotini yolwelo olusulungekileyo ifunxa ngokuthe ngqo eluswini lomntu olusempilweni, olungaqhawukanga lungena egazini kanye njengepetshi yenikotini yonyango. Ukuba uhlamba ulusu ngamanzi ashushu, ubushushu buyanwebeka (bandisa) imithambo yegazi emincinci eluswini, esebenza njengokuvula uhola wendlela ukuya egazini kwaye ikhawulezise kakhulu ityhefu ye-nicotine. Hlala ukhulula nayiphi na impahla efakwe kwi-e-liquid usebenzisa iiglavu kwaye uhlambe ulusu ngobunono ngesepha ethambileyo kunye namanzi abalekayo adikidiki okanye apholileyo kangangemizuzu eli-10 ukuya kweli-15.

Ngaba i-nicotine patch "esetyenzisiweyo" ephoswe emgqomeni isenokuyityhefa umntwana okanye isilwanyana sasekhaya?

Ewe. I-transdermal nicotine patch ifuna i-concentration gradient ukutyhala inikotini kancinane eluswini lomntu ngaphezulu kweyure ezingama-24. Ngenxa yolo yilo, isiqwenga esibhalwe "21 mg ngeeyure ezingama-24" eneneni siqulathe ukuya kuthi ga kwi-50 mg ukuya kwi-114 mg yenikotine iyonke kwindawo yayo, kwaye xa umntu omdala eyixobula emva kweeyure ezingama-24, ngaphezu kwe-50% ukuya kuma-70% inikotini isala ngaphakathi kwipetshi. Ukuba umntwana oselula okanye inja ikhupha isiziba esele sisetyenzisiwe kwinkunkuma ize sisincamathelise esikhumbeni okanye siyihlafune ize isiginye, oko kunokubangela ityhefu yenikotini esongela ubomi. Songa iipetshi ezisetyenzisiweyo ngalo lonke ixesha zincangathi-ndawonye kwaye uzilahle kwisikhongozeli esitywiniweyo apho zingafikelelekiyo.

Yintoni isigulo secuba esiluhlaza kwaye sinyangwa njani?

I-Green Tobacco Sickness (GTS) yityhefu ye-nicotine eyingozi ehlasela abasebenzi bezolimo abavuna amagqabi ecuba aluhlaza, aluhlaza, ingakumbi ekuseni xa amagqabi egqunywe ngumbethe okanye emva kwemvula. Amanzi emagqabini anyibilikisa inikotini yendalo ukusuka kumphezulu wesityalo, ethi ke ingene kwihempe emanzi yabasebenzi kunye neebhulukhwe ize ifunxe ngqo eluswini lwabo (ihambisa icuba elilingana nama-30 ukuya kuma-50+ ecuba inikotini). Abasebenzi baba nesicaphucaphu esiqatha, ukugabha okubonakalayo, ukubila okubanda okubanda, ukuba nesiyezi, intloko ebuhlungu, kunye nokuguquguquka koxinzelelo lwegazi kunye nesantya sentliziyo. Uncedo lokuqala olukhawulezayo lubandakanya ukushiya intsimi, ukuhlutha zonke iimpahla ezimanzi, ukuhlamba umzimba wonke ngesepha edikidiki kunye namanzi, ukuphumla kwindawo epholileyo enomthunzi kunye nolwelo lomlomo okanye lwe-intravenous, kunye nokufuna unyango ukuba ukuhlanza, i-bradycardia, okanye ingxaki yokuphefumula kwenzeka.

Izikhokelo ezinxulumeneyo

Imithombo kunye nezikhokelo ezisemthethweni

  • Umbutho waseMelika wamaZiko oLawulo lwePoison (AAPCC) kunye namaZiko oLawulo lweSifo kunye noThintelo (CDC): * INicotine yoLiquid, i-E-Cigarette, kunye ne-Oral Nicotine Pouch Exposure Surveillance and Triage Guidelines *.
  • I-American Academy of Pediatrics (AAP): * Ingxelo yeKlinikhi kunye neNgxelo yoMgaqo-nkqubo: I-E-Cigarettes, i-Liquid Nicotine Concentrates, kunye ne-Peediatric Nicotine Poisoning Prevention *.
  • INkonzo yeSizwe yoLwazi lwePoisons (NPIS, eUnited Kingdom): * I-TOXBASE yoLawulo lweKlinikhi ye-Acute Nicotine Poisoning (E-Liquids, i-Oral Nicotine Pouches, kunye ne-Transdermal Patches) *.
  • Umbutho wezeMpilo weHlabathi (i-WHO): *Inyathelo lokungaSebenzi iCuba kunye noKhuseleko lweMichiza: Ityhefu yeNicotine eAcute kunye neSigulo seCuba esiLuhlaza IsiKhokelo *.
  • Iziko leSizwe loKhuseleko lweMisebenzi kunye neMpilo (i-NIOSH / i-CDC): * Izisombululo zendawo yokusebenzela: Ukuthintela ukugula kweCuba okuHlaza (i-Deermal Nicotine Poisoning) kubasebenzi beCuba *.

*Esi sikhokelo senzelwe iinjongo zolwazi kwaye asithathi indawo yovavanyo lonyango lobuchwephesha, ukubonisana noLawulo lwetyhefu, okanye ukhathalelo olungxamisekileyo esibhedlele. Ngenxa yokuba i-nicotine poisoning eyingozi ingabangela ukutshatyalaliswa ngokukhawuleza kunye nokukhubazeka kwemisipha yokuphefumla kubantwana nakubantu abadala, sincoma kakhulu ukuthatha izandla eziqinisekisiweyo kumntu omdala kunye nonyango lwabantwana kunye nekhosi yeCPR ngokusebenzisa i-International Federation ye-Red Cross kunye ne-Red Crescent Societies (IFRC), uluntu lwakho lwesizwe lwe-Red Cross, i-St John Ambulance, okanye umboneleli wendawo ovunyiweyo.