U radu je retrospektivno analizirana učestalost bolesnika zaprimljenih u Centar za hitnu medicinu – Središnji hitni prijam KB „Sveti Duh” zbog trovanja sedativima u razdoblju od siječnja 2008. do rujna 2015. godine. Analizirani su demografski podaci bolesnika, vrste sedativa kojima je izvršeno trovanje, te klinička simptomatologija, terapijski postupci i ishod liječenja. Podaci su prikupljeni iz baze podataka informatičkog bolničkoga sustava, te arhive medicinske dokumentacije. Istraživanje je obuhvatilo 444 bolesnika. Najveći broj bolesnika zaprimljenih zbog trovanja bio je u dobnoj skupini od 36 do 55 godina (50%). S obzirom na spol, veći je udio žena (64%), a najčešći uzročnik trovanja bio je diazepam (67,1%). Kod najvećeg broja otrovanih bolesnika nije bilo značajnih kliničkih simptoma (31%) ili je bila izražena blaga somnolencija, sedacija ili pospanost (45%). U 87% bolesnika primijenjena je infuzijska terapija kristaloidnim otopinama, a u 55% njih antidot flumazenil. Najveći broj bolesnika (81%) bio je zadržan na promatranju do nestanka simptoma, te nakon toga upućen u nadležnu psihijatrijsku ustanovu. Smrtni ishod zabilježen je kod 8 bolesnika. U zaključku možemo naglasiti da trovanja sedativima predstavljaju značajan problem za sve liječnike koji rade u hitnoj medicinskoj službi. Iako većina bolesnika ne zahtijeva hospitalizaciju i nema izraženu težu kliničku simptomatologiju, 8 umrlih bolesnika ukazuje na široku dostupnost sedativa, a time i potrebu za boljom regulacijom propisivanja, kao i potrebu za stalnom edukacijom u zbrinjavanju istih.The study retrospectively analyzed sedative poisoning among patients admitted to the Centre of Emergency Medicine of Clinical Hospital “Sveti Duh" from January 2008 to September 2015.
Patients’ demographic, sedative medication type, clinical symptoms, therapeutic procedures and outcomes were analysed. Data were collected from the hospital medical information system, and from the patients\u27 medical records. The study included 444 patients. The majority of patients were between 36 to 55 years of age (50%). In relation to gender, a greater number of cases occurred in female patients (64%) and the most frequently ingested drug was diazepam (67.1%). Most patients had no clinical manifestation of poisoning (31%) or just relatively mild symptoms included sedation, drowsiness and mild somnolence (45%). For the treatment, 87% of patients received IV solution and 55% received antidote flumazenil. The majority of patients were kept under observation until signs and symptoms of poisoning had been resolved, and then sent to psychiatric hospitals. Deaths were recorded in 8 patients.
In conclusion, we need to emphasize that the acutely poisoned patient remains a common problem facing doctors working in the Emergency Department. Although, most poisoned patients do not requirehospitalization and do not have significant clinical symptoms, the widespread use and availability of sedatives resulted in 8 deaths. This high rate of mortality indicated the need for better control and more restrictions on prescribing sedatives and continuing education in the management of these patients
