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Clinical Review: Emergency management of acute poisoning

机译：临床评论：急性中毒的应急处理

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摘要

Acutely poisoned patients are commonly encountered in Emergency Centres. Acute poisoning (accidental or intentional) requires accurate assessment and prompt therapy. The necessity to prevent cross contamination during the initial evaluation should be emphasized. Early identification of the involved toxin/s is crucial and the majority will be identified by a thorough history and physical examination. An ABC-approach should be followed ensuring a protected airway, adequate ventilation and hemodynamic stability. Supportive and symptomatic care remains the cornerstone of treatment. A stepwise approach may be followed to decrease the bioavailability of toxins. Indications, contra-indications, risks and dosage regimens are describe for decontamination procedures including both termination of topical exposures and decreasing exposure to ingested toxins. Furthermore, procedures to increase the elimination of toxins and a short section covering specific toxins and their antidotes are also included. The aim of this commissioned review was to establish concise guidelines for the initial management of the acutely poisoned patient in the Emergency Centre. The American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists are the international leaders in the field of toxicology and the guidelines in their position papers were generally followed. Most of the dosage regimes are according to the South African Medicines Formulary.
机译：在急救中心通常会遇到急性中毒的患者。急性中毒（偶然或故意）需要准确的评估和及时的治疗。应该强调在初步评估过程中防止交叉污染的必要性。尽早识别所涉及的毒素至关重要，并且将通过彻底的病史和体格检查来识别大多数毒素。应遵循ABC方法，以确保保护气道，充分的通气和血液动力学稳定性。支持和对症护理仍然是治疗的基石。可以采用逐步方法来降低毒素的生物利用度。描述了去污程序的适应症，禁忌症，风险和剂量方案，包括终止局部暴露和减少摄入的毒素的暴露。此外，还包括增加毒素消除的程序和涵盖特定毒素及其解毒剂的简短内容。此次委托审查的目的是为急救中心中的急性中毒患者的初始治疗建立简洁的指南。美国临床毒理学研究院和欧洲毒物学协会和临床毒理学协会是毒理学领域的国际领导者，通常遵循其立场文件中的指导原则。大多数剂量方案是根据《南非药品配方》制定的。

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