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Management of early whether conducted by the ER in coma patients with a suspected drug overdose? The approach is similar to the approach to every patient who comes into the ER with decreased consciousness, such as the following:
a. Reviewing the ABC (airway, breathing, and circulation).
b. Provide 100% oxygen therapy with a heart monitor.
c. Inserting an IV.
d. Checking for vital signs, including core body temperature monitoring and pulse oximetry.
e. Giving 2 mg naloxone which is a competitive antagonist of opiates in opiate receptors. Opiates often misused, and is the most commonly used preparations for a suicide attempt. Naloxone may cause withdrawal symptoms-drug.
f. Giving dextrose or glucose measuring fast. Hypoglycemia is a cause of impairment of consciousness that are common and easily treated with dextrose administration. Adult patients should receive 50% dextrose solution (50 ml) and children 0.5 to 1.0 mg / kg of D10-D25 solution (2-4 ml / kg). Medications commonly used, including insulin and oral hypoglycemic preparations, in addition to causing many medical problems can cause hypoglycemia. Because of dextrose can worsen hyperglycemia status and cerebral ischemia, it is recommended dextrose rapid measurements prior to infusion of dextrose.
g. Thiamine with dextrose to provide adult patients suspected of an alcoholic or malnourished to prevent aggravation of the Wernicke-Korsakoff syndrome. Wernicke-Korsakoff syndrome caused by deficiency of vitamin B1 (thiamine) and is indicated by symptoms of ocular motor abnormalities, ataxia and confusion.
h. Acetaminophen and salicylate serum levels, serum electrolytes (including blood urea and creatinine levels), and electrocardiography should didapatkanauntuk most patients with coma suspected drug overdose.
a. Reviewing the ABC (airway, breathing, and circulation).
b. Provide 100% oxygen therapy with a heart monitor.
c. Inserting an IV.
d. Checking for vital signs, including core body temperature monitoring and pulse oximetry.
e. Giving 2 mg naloxone which is a competitive antagonist of opiates in opiate receptors. Opiates often misused, and is the most commonly used preparations for a suicide attempt. Naloxone may cause withdrawal symptoms-drug.
f. Giving dextrose or glucose measuring fast. Hypoglycemia is a cause of impairment of consciousness that are common and easily treated with dextrose administration. Adult patients should receive 50% dextrose solution (50 ml) and children 0.5 to 1.0 mg / kg of D10-D25 solution (2-4 ml / kg). Medications commonly used, including insulin and oral hypoglycemic preparations, in addition to causing many medical problems can cause hypoglycemia. Because of dextrose can worsen hyperglycemia status and cerebral ischemia, it is recommended dextrose rapid measurements prior to infusion of dextrose.
g. Thiamine with dextrose to provide adult patients suspected of an alcoholic or malnourished to prevent aggravation of the Wernicke-Korsakoff syndrome. Wernicke-Korsakoff syndrome caused by deficiency of vitamin B1 (thiamine) and is indicated by symptoms of ocular motor abnormalities, ataxia and confusion.
h. Acetaminophen and salicylate serum levels, serum electrolytes (including blood urea and creatinine levels), and electrocardiography should didapatkanauntuk most patients with coma suspected drug overdose.
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