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Zehirlenme olgularına acil yaklaşım

Emergency management of intoxication cases

Journal Name:

  • Türkiye Aile Hekimliği Dergisi

Publication Year:

  • 2008
DOI: 
doi:10.2399/tahd.08.081

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
A poisoning occurs when exposure to a substance adversely affects the function of any system within an organism. Poisoning patients are frequently seen in emergency departments. In such patients suitable emergency management decreases mortality rate. The setting of the poison exposure may be occupational, environmental or iatrogenic. A poisoning may result from varied portals of entry, including inhalation, ingestion, cutaneous and mucous membrane exposure. It may occur different sings and symptoms due to intake ways. Diagnosis and resuscitation proceed simultaneously. For the primary care of poisoned patients the first priorities are always airway security, breathing, and circulation support (ABC), decontamination, and the proper use of antidotes is also essential. Once the airway and respiratory status are secured, abnormalities of blood pressure, pulse, rectal tem¬perature, oxygen saturation and hypoglycemia must be corrected.
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Abstract (Original Language): 
Zehirlenme, organizmanın herhangi bir sistemi, fonksiyonunu olumsuz etkileyecek maddelere maruz kaldığında gerçekleşir. Zehirlenen hastalar acil servislerde sıklıkla görülür. Bu hastalara uygun acil yaklaşım ölüm oranını azaltır. Mesleksel ve çevresel etkilenmelerle ya da ilaç doz aşımı sonucu zehirlenme oluşabilir. Ze¬hirleyici etmen solunum, sindirim, cilt ya da müköz mambranlar aracılığıyla vücuda girebilir ve alım yollarına göre farklı belirti ve bulgular görülebilir. Zehirlenme hastalarında tanı ve tedavi eşzamanlı olarak yapılır. Zehirlenmiş hastaya ilk yaklaşımda havayolu açıklığı sağlanmalı, solunum ve dolaşım desteği sağlanmalı, de-kontaminasyon sağlanmalı ve uygun antidot uygulanmalıdır. Ha¬vayolu ve solunum temininden sonra kan basıncı düzensizliği, na¬bız, rektal ısı, oksijen satürasyonu ve hipoglisemi kontrol edilmeli ve düzeltilmelidir.
FULL TEXT (PDF): 
PDF icon arastrmx_116859_12_pp_81-88.pdf
  • 2
81-88
  • Turkish

REFERENCES

References: 

1.
Tunço
k Y. Toksikoloji Tanımı ve Tarihçesi. TKlin Farmakoloji 2003; 1: 1¬5.
2. Linden CH, Burns JM. Poisoning and drug overdosage. The 16th Edition of Harrison's Principles of Internal Medicine'de. Ed. Harrison TR. 16. baskı. USA, McGraw-Hill, 2006; 2581-93.
3. Özköse Z, Ayoğlu F. Etiological and demographical characteristics of acute adult poisoning in Ankara, Turkey. Hum Exp Toxicol 1999; 18: 514¬618.
4. Pınar A, Fowler J, Bond GR. Acute poisoning in Izmir, Turkey- A pilot epidemiologic study. J Toxicol Clin Toxicol 1993; 31: 593-691.
5. Akbaba M, Nazlican E, Demirhindi H, Sütoluk Z, Gökel Y. Etiological and demographical characteristics of acute adult poisoning in Adana, Turkey. Hum Exp Toxicol 2007; 26: 401-6.
6. Hoffman RS, Hack JB. General management of poisoned patients. Emergency Medicine'de. Ed. Tintinalli JE, Kelen DG. 5. baskı. New
York, Mc Graw-Hill Comp. 2000; 1057-63.
7. Ellenhorn MJ, Schonwald, S, Ordog, G. Wasserberger J. Ellenhorn's Medical Toxicology:. Diagnosis and Treatment of Human Poisoning. 2.
baskı.
Baltimore
, Williams and Wilkins, 1997; 1-148.
8. Turnbull TL, Smilkstein MJ. The poisoned patient. Emergency medi¬cine: an approach to clinical problem solving'de. Ed. Hamilton GC, Sander AB, Strange GR et al. Philadelphia, WB Saunders, 1991; 347-78.
9. Eray
O
, Tunçok Y. Zehirlenen hastaya yaklaşım: akut zehirlenmelerde hastaya acil yaklaşımda yenilikler. T Klin Farmakoloji 2003; 1: 36-40.
10. Olson KR. Emergency evaluation and tratment. Poisoning And Drug Overdose'da Ed. Olson KR.. 4. baskı. New York, Lange Medical Boks/McGrawHill, 2004; 1-59.
11. Toll LL, Hurlbut KM. POISINDEX System: Thompson. MICROMEDEX Healthcare Series. Cilt 117. Greenwood Village, Colorado: Thompson MICROMEDEX, 2003.
12. Krenzelok EP, Keller R, Stewart RD. Gastrointestinal transit times of cathartics combined with charcoal. Ann EmergMed 1985; 14: 1152-5.
13. Goldfrank LR, Flomenbaum NE, Lewin NA, Howland MA, Hoffman RS, Nelson LS. Principles of managing the posioned and overdosed patient. An overview. Goldfrank's Toxicologic Emergencies'de. Ed. Goldfrank LR, Flomenbaum NE, Lewin NA, Weisman RS, Howland
MA, Hoffman RS. 7. baskı. New York, USA. The McGraw-Hill
Companies, 2002; 37-9.
Türkiye Aile Hekimliği Dergisi |
Turkish Journal of Family Practice | Cilt 12 | Sayı 2 | 2008
87
14. Donnely A, Cunnigham F, Baugham V, Naloxane. Anesthesiology and Critical Care Drug Book. 4.baskı. Hudson, Lexi-Comp Inc, 2001; 582-3.
15. Krenzelok E, Vale A. Position statements: gut decontamination. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1997;
35: 695-786.
16. Bond GR. The role of activated charcoaland gastric emptying in gas¬trointestinal decontamination: a state-of-art review. Ann Emerg Med
2002; 39: 273-86.
17.
Olgune
r ÇG. Zehirlenen hastaya yaklaşım: antidotlar ve kullanım ilkeleri. T Klin Farmakoloji 2003; 1: 41-4.
18. Krenzelok EP. New developments in tha therapy intoxications. Toxicol
Lett 2002; 127: 299-305.
19. Neuvonen PJ, Olkkola KT. Oral activated charcoal in the treatment of intoxications. Role of single and repeated doses. Med Toxicol Adverse Drug
Exp1988; 3: 33-58.
20. Birnbaumer D. Poisoning and ingestion. Current Ciritical Care Diagnosis and Treatment'ta. Ed. Bongard FS, Sue DY. 2. baskı. London:
Appleton and Lange, 1994; 686-715.
21. Kayaalp SO. Rasyonel Farmakoterapi Yönünden Tibbi Farmakoloji. 9. Baskı, Cilt 1. Ankara, Hacettepe Taş, 2000; 99-101.
22. Öz H. Zehirlenmelerde temel tedavi ilkeleri. Acil Hekimlik Sempozyumu
1997; 167-73.
23. Dökmeci D. Akut zehirlenmelerde tanı ve tedavi. Toksikoloji 1.baskı. İstanbul, Nobel, 1988; 124-36.
24. Garrettson LK, Geller RJ. Acid and alkaline diuresis. When are they of value in the treatment of poisoning? Drug Saf 1990; 5: 220-32.
25. Linden CH, Lovejoy FH. Poisoning and drug overdosage. Harrison's Principles of Internal Medicine'de (Ed) Fauci AS ve ark. 14. baskı, Cilt 2.
New York, McGraw-Hill, 1998; 2523-44.
26. Gary NE, Saidi P. Methamphetamine intoxication. A speedy new treat¬ment. Am J Med1978; 3: 537-40.
27. Bizmuth L, Muczinski J. Are extracorporeal techniques of elimination validated in acute poisonning? Am J Drug Alcohol Abuse 1976; 3: 605-9.
28. Erichson TB. Diagnosis and management of the patient with unknown ingestion. ACEP Scientific Assembly San Diego 1998; 12-7.
29.
Keke
ç Z ve ark. Özkıyım girişimi nedeniyle acil servise başvuran hastalar¬da hazırlayıcı etkenler. Anadolu Psikiyatri Dergisi 2000; 1: 157-61.
30.
Keke
ç Z, Sözüer EM, Duymaz H, Özkan S. Acil servise başvuran çoklu ilaç zehirlenmelerinin 7 yıllık analizi. Turk J Emerg Med 2005; 5: 69-72.

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