Inadequate assessment of the airway and ventilation in acute poisoning. a need for improved education?

Cosgrove, J. F.; Gascoigne, A.

doi:10.1016/s0300-9572(99)00025-8

Cited by 20 publications

(18 citation statements)

References 11 publications

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“…Our findings are consistent with studies from multiple countries that report variable and inadequate preparedness levels [28,38,39]. Although this study is the first of its type, there were some limitations.…”

Section: Availability Of Elimination Enhancement Resourcessupporting

confidence: 90%

“…These included all resources required for airway support (endotracheal tubes, oxygen masks, laryngeal masks, nasal catheters and cannulas, and mechanical ventilator), volume expanders (colloids and crystalloids), and cardiac support (electrical defibrillation); breathing support resources were not as common. A review of the published studies indicate that supportive measures including the ''ABC'' (airway, breathing, circulation) are frequently necessary before proof of intoxication [7,10,28]. Intubation is indicated in acute respiratory failure [7,10].…”

Section: Availability Of Stabilization Resourcesmentioning

confidence: 99%

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Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

et al. 2011

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Acute poisoning is a common medical emergency in Malaysia. Life can be saved if the patient is diagnosed properly and receives the appropriate treatment such as gastrointestinal decontamination techniques and resources to increase poison elimination according to clinical guidelines at a reasonable time. The aims of this study were to determine the availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in accident and emergency departments in Malaysia, and to compare the availability of such facilities among various types of hospitals. A comparative, descriptive cross-sectional study was conducted using a structured questionnaire. Seventy-four (58.3%) out of the targeted 127 hospitals replied and completed the questionnaire. The availabilities of most items related to stabilization resources were far better in general hospitals compared to district hospitals with specialists and district hospitals without specialists. These items were mechanical ventilators (p = 0.011), non-invasive positive pressure ventilators (0.024), pacemakers (p = 0.019), and transcutaneous cardiac pacing (p < 0.001). The availability of decontamination resources varied substantially with hospital type. Nevertheless, these differences did not reach statistical significance in any of the cases, whereas sodium sulphate, sorbitol, and polyethylene glycol were almost never available. The availabilities of most items related to elimination enhancement resources were far better in general hospitals and district hospitals with specialists compared to district hospitals without specialists. These items were haemodialysis (p = 0.046), haemoperfusion (p = 0.002), haemofiltration (p = 0.002), acid diuresis (p = 0.04), peritoneal dialysis (p < 0.001), and exchange transfusion (p < 0.001). Most Malaysian hospitals have certain important immediate interventions such as gastrointestinal decontamination techniques and resources to increase poison elimination. The availabilities of most facilities were far better in the general hospitals. Coordination between the National Poison Centre in Malaysia and hospitals should be established regarding the emergency facilities for effective management of poisoning cases in each hospital in order to direct the poisoned patients to the hospital where the appropriate management resources is available.

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Section: Availability Of Elimination Enhancement Resourcessupporting

confidence: 90%

Section: Availability Of Stabilization Resourcesmentioning

confidence: 99%

Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

et al. 2011

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“…They suggest that poor understanding of airway and ventilation care, that is, the "ABCD" approach, and the lack of an appropriate area for monitoring poisoned patients are problems that could be modified to improve care. A ward managed by senior emergency medicine staff addresses these problems (6).…”

Section: Discussionmentioning

confidence: 99%

“…It has also been said that a GCS of 8 or less is a useful guide for the requirement of endotracheal intubation where the cause of coma is poisoning (5,6). Poisoned patients are unlikely to suffer from secondary brain injury, but decreased consciousness and loss of protective airway reflexes predispose to respiratory failure and aspiration injury (6).…”

Section: Introductionmentioning

confidence: 99%

“…Poisoned patients are unlikely to suffer from secondary brain injury, but decreased consciousness and loss of protective airway reflexes predispose to respiratory failure and aspiration injury (6). However, the risk of aspiration is not confined to patients with a GCS of 8 or less, and the loss of airway reflexes cannot be reliably predicted using the GCS alone (7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

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Decreased Glasgow Coma Scale Score Does Not Mandate Endotracheal Intubation in the Emergency Department

Duncan

Thakore

2009

The Journal of Emergency Medicine

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Primary Assessment and Stabilization of Life-Threatening Conditions in Older Patients

Karamercan

Bellou

Blain

2017

Geriatric Emergency Medicine

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Inadequate assessment of the airway and ventilation in acute poisoning. a need for improved education?

Cited by 20 publications

References 11 publications

Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

Decreased Glasgow Coma Scale Score Does Not Mandate Endotracheal Intubation in the Emergency Department

Primary Assessment and Stabilization of Life-Threatening Conditions in Older Patients

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