Assessment for deaths in out-of-hospital heroin overdose patients treated with naloxone who refuse transport
Assessment for deaths in out-of-hospital heroin overdose patients treated with naloxone who refuse transport
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DOI：
10.1111/j.1553-2712.2003.tb00636.x
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发表时间：
2003-08-01
影响因子：
4.4
通讯作者：
Chan, TC
中科院分区：
文献类型：
--
作者：
Vilke, GM;Sloane, C;Chan, TC
纳洛酮经常被用来治疗院外环境中疑似海洛因和阿片类药物过量。提交人的紧急医疗服务系统实施了一项政策，允许这些患者在成功治疗后签字反对现场的医疗建议(AMA)。目的：评价该AMA政策的安全性。方法：对五年来医院外和法医(ME)数据库进行了回顾。作者审查了所有阿片类药物过量被列为死亡原因的ME病例。这些病例与所有接受了现场护理人员的纳洛酮，然后拒绝运送的患者进行了交叉比较。这些图表按日期、时间、年龄、性别、地点和种族进行了审查。结果：接受纳洛酮治疗并拒绝进一步治疗的院外患者998例，阿片类药物过量死亡601例。当按年龄、时间、日期、性别、地点和种族进行比较时，没有患者在被发现死于阿片类药物过量后12小时内接受纳洛酮治疗的病例。结论：在现场给海洛因过量患者服用纳洛酮，然后允许他们退出AMA，在本研究人群中没有可识别的死亡。
Naloxone frequently is used to treat suspected heroin and opioid overdoses in the out-of-hospital setting. The authors' emergency medical services system has operated a policy of allowing these patients, when successfully treated, to sign out against medical advice (AMA) in the field. Objectives: To evaluate the safety of this AMA policy. Methods: This is a retrospective review of out-of-hospital and medical examiner (ME) databases over a five-year period. The authors reviewed all ME cases in which opioid overdoses were listed as contributing to the cause of death. These cases were cross-compared with all patients who received naloxone by field paramedics and then refused transport. The charts were reviewed by dates, times, age, sex, location, and ethnicity when available. Results: There were 998 out-of-hospital patients who received naloxone and refused further treatment and 601 ME cases of opioid overdose deaths. When compared by age, time, date, sex, location, and ethnicity, there were no cases in which a patient was treated by paramedics with naloxone within 12 hours of being found dead of an opioid overdose. Conclusions: Giving naloxone to patients with heroin overdoses in the field and then allowing them to sign out AMA resulted in no identifiable deaths within this study population.