Substance Abuse Among Emergency Medical Service Patients: A Pilot Study on the Clinical Impact of an On-site Oral Fluid Screening Test

Mikael Söderqvist, J. Virta, A. Kämäräinen
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引用次数: 1

Abstract

Abstract Diagnosing illicit substance and drug intoxications in prehospital setting may be difficult. Invasive treatment procedures might be avoided with substance specific antidote treatment. An oral fluid (OF) screening device may aid differential diagnostics in the care of a patient suffering from an unknown intoxication or unconsciousness. The aim of this study was to evaluate whether on-site OF screening improves the diagnosis and treatment of emergency medical service (EMS) patients with lowered level of consciousness due to suspected intoxication or an unknown cause. A retrospective analysis was conducted on patients who were treated by a mobile intensive care unit due to a lowered level of consciousness and tested with an OF screening device. Patient characteristics, the cause of EMS activation, and screening test results were recorded from EMS run sheets, hospital medical records, and laboratory data. Prehospital treatment was evaluated in regard to the OF screening result. A total of 57 patients were tested during the study period. Of these, 8 were excluded owing to missing screening results. Of the final 49 patients (35 males, 14 females), 16 patients (33%) tested positive for one or more substances. In 6 (38%) of the 16 patients, treatment was modified based on the screening results, and in 4 of these cases, there was a clinically relevant prehospital response. Oral fluid screening for illicit substances can be a valuable diagnostic tool in addition to the usual diagnostic methods in EMS patients with unconsciousness due to an unknown cause or intoxication.
急诊医疗服务患者药物滥用:现场口服液筛选试验临床影响的初步研究
院前诊断非法物质和药物中毒可能是困难的。针对特定物质的解毒剂治疗可以避免侵入性治疗程序。一种口腔液(OF)筛查装置可以帮助鉴别诊断患有不明中毒或昏迷的病人。本研究的目的是评估现场of筛查是否能改善急诊医疗服务(EMS)患者因疑似中毒或原因不明而意识水平降低的诊断和治疗。回顾性分析了由于意识水平降低而在流动重症监护病房治疗的患者,并使用of筛查装置进行了测试。从EMS运行表、医院医疗记录和实验室数据中记录患者特征、EMS激活原因和筛选测试结果。院前治疗根据OF筛查结果进行评估。在研究期间,共有57名患者接受了测试。其中8例因筛查结果缺失而被排除。在最后的49名患者(35名男性,14名女性)中,16名患者(33%)对一种或多种物质检测呈阳性。16例患者中有6例(38%)根据筛查结果修改了治疗方案,其中4例出现了与临床相关的院前缓解。对于因不明原因或中毒而失去意识的EMS患者,除了常用的诊断方法外,口腔液体筛查非法物质是一种有价值的诊断工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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