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Could NCM-3S be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?

Yıl 2020, Cilt: 2 Sayı: 1, 15 - 22, 24.03.2020

Öz

Objectives: We aimed to evaluate the need for endotracheal intubation of patients with NCM scoring system we developed by using findings of examinations, vital parameters, and results of blood gas tests of the patients coming to the emergency room with acute toxicity caused by synthetic cannabinoid.
Method: Information regarding the 140 patients (out of all 319905 patients coming to the ER in 1 year) between the ages of 15-65, showing findings of acute toxicity caused by synthetic cannabinoid, such as complaints at first admission, sex, demographic characteristics, vital signs, examination findings, results of performed imaging and lab tests, administered treatments, information on the service in which the patients stay or are referred are all retrospectively reviewed. The ones who need intubation are evaluated under risky patient group (RPG) while the ones that have been discharged from the ER are evaluated as non-risk group (NRPG).
Findings: When the intubation need of the patients is reviewed, it has been seen that there is statistically significant difference in the respiratory rate measured in the ER, systolic blood pressure, O2 saturation, Glasgow coma score, PCO2 values and pulse rate of patients in the risk group. NCM-3S scoring has been created to evaluate the intubation need of patients showing acute toxicity of synthetic cannabinoid.
Conclusion: It has been concluded that NCM-3S score, which we created using pulse rate, systolic blood pressure, respiratory rate, fingertip oxygen saturation, mental state and PCO2 values of patients showing signs of acute toxicity of synthetic cannabinoid in the ER, can be used in projecting the intubation need of patients.
Keywords: Synthetic cannabinoid, emergency service, symptom and findings

Kaynakça

  • 1. A. S. Başak,New Generation psycho-active subtances symposium book. Istanbul Forensic Medicine Institute; 2013 p. 5-6.
  • 2. Vandrey R, Dunn KE, Fry JA, Girling ER. A survey study to characterize use of Spice products (synthetic cannabinoids). Drug Alcohol Depend 2012; 120:238-41.
  • 3. Bretteville-Jensen AL, Tuv SS, Bilgrei OR, Fijeld B. Synthetic Cannabinoids and Cathinones: Prevalence and Markets. Forensic Sci Rev 2013; 25: 8- 26.
  • 4. Cohen J, Morrison S, Greenberg J, Saidinejad M. Clinical Presen¬tation of Intoxication Due to Synthetic Cannabinoids. Pediatrics 2012;129;1064-7.
  • 5. Gregori A, Damiano F, Bonavia M, et al. Identification of two can¬nabimimetic compounds WIN48098 and AM679 in illegal produ¬cts. Sci Justice 2013; 53: 286-92.
  • 6. Forrester MB, Kleinschmidt K, Schwarz E, Young A. Synthetic cannabinoid exposures reported to Texas poison centers. J Addict Dis. 2011 Oct;30(4):351.
  • 7. Gokhan Aksel, Oner Bozan, Mine Kayacı, Ozlem Güneysel, Seckin Bahar Sezgin, Rising Threat; Bonzai March 02, 2015, tatd doi: 10.5505/1304.7361.2015.80388.
  • 8. Filiz Izci, Vedat Izci, Servet Izci , Merve Setenay Iris Koc, Rabia Bilici, Engin Emrem Beştepe, Lipid infusion therapy in sinus tachycardia induced with synthetic cannabinoid (SC) intoxication: two cases report Bulletin of Clinical Psychopharmacology, Vol: 25, Supplement: 1, 2015 - www.psikofarmakoloji.org S209.
  • 9. Emre Salçın, Merter Gümüşel, Serkan Emre Eroğlu, Kerem Ali Kabaroğlu, Haldun Akoğlu, Özge Onur, Arzu Denizbaşı Bonzai-ilişkili solunum/kardiyovasküler komplikasyonların Analizi: Üniversite Hastanesi Deneyimi J Kartal Baskıdaki Makaleler: KEAH-43650 | DOI: 10.5505/jkartaltr.2015.43650.
  • 10. Sezen Kumaş Solak, Aslı Vural, Serdar Demirgan, Pınar Ceylan,Ömer Karaca,Çiğdem Atan,Mustafa Ferhat Çolak, Emine Yurdakul Ertürk, Sevgi Kazı, İKSST Derg 2018;10(1):7-11 Klinik Araştırma doi:10.5222/iksst.2018.007
  • 11. Schneir AB, Cullen J, Ly BT. “Spice” girls: Synthetic cannabinoid intoxication. J Emerg Med 2011; 40:296-299.
  • 12. Bozkurt M, Umut G, Evren C, Karabulut V. Clinical characteristics and laboratory test results of patients admitted to outpatient clinic for synthetic cannabinoid usage. The Journal of Psychiatry and Neurological Sciences. 2014;27: 328-34.
  • 13. Hoyte CO, Jacob J, Monte AA, Al-Jumaan M,Bronstein AC, Heard KJ. A characterization ofsynthetic cannabinoid exposures reported to the National Poison Data System in 2010. Ann Emerg Med 2012;60: 435-8.
  • 14. Yoshito Kamijo, Michiko Takai, Yuji Fujita, Yasuo Hirose, Yasumasa Iwasaki,Satoshi Ishihara, Takashi Yokoyama, Keiichi Yagi, Tetsuya Sakamoto, A Multicenter Retrospective Survey of Poisoning after Consumption of Products Containing Synthetic Chemicals in Japan, Intern Med 53: 2439-2445, 2014 DOI: 10.2169/internalmedicine.53.2344.
  • 15. Egemen Küçük, İrfan Küçük, Yasemin Yıldız Kirazaldı, Acil serviste sentetik kannabinoidler- Küçük ve ark. Genel Tıp Derg 2015; 25:18-22.
  • 16. Gremec S, Gasparovic V. Comparison of APACHE II, MEES and Glasgow Coma Scale in patients with nontraumatic coma for prediction of mortality. Critical Care 2001; 5:19-23
  • 17. Lee A, Bishop G, Hillman KM, Daffurn K. The Medical Emergency Team. Anaesthesia and İntensive Care 1995; 23:183-6
  • 18. Unertl K, Kottler BM. Prognostic scores in intensive care. Anaesthesist, 1997; 46(6): 471–80
  • 19. Olsson T. 2004. Risk Prediction at the Emergency Department. Acta Universitatis Upsaliensis. Comhrensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1983.63 pp. Upssala. 91- 554-6070-6074
  • 20. Hennes HJ, Reinnhardt T, Dick W. The Mainz Evaluation Scoring for assessment of emergency patient [in German]. Emerg Med 1992; 18:130-136
  • 21. Subbe CP, Davies RG, Williams E, Rutherford P, Gemmell L. Effect of introducing the Modified Early Warning Score on clinical outcomes, cardio-pulmonary arrests and intensive care utilisation in acute medical admissions. Anaesthesia 2003; 58:775-803
  • 22. Subbe CP, Kruger M, Rutherford P, Gemmell L. Validation of a Modified early Warning score in medical admission. Q J Med 2001; 94:521-526
  • 23. Jinwala FN, Gupta M. Synthetic cannabis and respiratory depression. J Child Adolesc Psychopharmacol. 2012 Dec;22(6):459-62.
  • 24. Schmid K, Niederhoffer N, Szabo B.Analysis of the respiratory effectsof cannabinoids in rats. Naunyn Schmiedebergs Arch Pharmacol2003; 368:301-8.
  • 25. Uğur Altınışık, Hatice Betül Altınışık, Tuncer Şimşek, Tuğba Doğu, Esen Şimşek, Halide AydınYoğun Bakım Ünitesinde Takip Edilen Sentetik Kannabinoid (Bonzai) Zehirlenmesi Olgularının Klinik ÖzellikleriJ Turk Soc Intens Care 2015;13:117-21 DOI: 10.4274/tybdd.36025.
  • 26. Gulser Esen Besli, Mehmet Alper Ikiz, Sema Yildirim, Selcuk Saltik synthetıc cannabınoıd abuse ın adolescents: a case serıes The Journal of Emergency Medicine, Vol. 49, No. 5, pp. 644–650, 2015.
  • 27. Seely KA, Prather PL, James LP, Moran JH. Marijuana-based drugs: innovative therapeutics or designer drugs of abuse? Mol Interv. 2011 Feb;11(1):36-51.
Yıl 2020, Cilt: 2 Sayı: 1, 15 - 22, 24.03.2020

Öz

Amaç: Acil servise sentetik kannabinoid akut toksisitesi ile başvuranlarda; muayene bulguları, vital parametreleri ve kan gazı test sonuçlarına göre geliştirdiğimiz NCM skorlama sistemi ile hastaların endotrakeal entübasyon ihtiyacını değerlendirmeyi amaçladık.
Metod: Acil servise 1 yıl boyunca başvuran 319905 hastadan sentetik kannabinoid akut toksisite bulguları gösteren 15- 65 yaş aralığındaki 140 hastanın başvuru şikayetleri, cinsiyeti, demografik özellikleri, vital bulguları, muayene bulguları, yapılmış olan görüntüleme ve laboratuar testleri, uygulanan tedavi, yattığı veya sevk edildiği bölüm bilgileri retrospektif olarak incelendi. Entübasyon ihtiyacı olan hastalar riskli hasta grubu olarak, acil servisden taburcu olan hastalar riskli olmayan grup olarak değerlendirildi.
Bulgular: Hastaların entübasyon ihtiyacını değerlendirmek için Riskli hasta grubunda acil serviste ölçülen solunum sayısı, sistolik kan basıncı, saturasyon O2, Glaskow koma skoru, PCO2 değeri ve nabız dakika sayısında istatistiksel olarak anlamlı fark tespit edildi. Sentetik kannabinoid akut toksisitesi gösteren hastaların entübasyon ihtiyacını değerlendirmek için NCM-3S skorlaması oluşturuldu.
Sonuç: Acil serviste Sentetik kannabinoid akut toksisite bulguları gösteren hastalarda ölçülen nabız dakika sayısının, sistolik kan basıncının, solunum sayısının, parmak ucu sat O2 değerinin, mental durumunun, PCO2 değeri ile oluşturduğumuz NCM-3S skorunun hastaların entübasyon ihtiyacını öngörmede kullanılabileceği sonucuna varılmıştır.. 

Kaynakça

  • 1. A. S. Başak,New Generation psycho-active subtances symposium book. Istanbul Forensic Medicine Institute; 2013 p. 5-6.
  • 2. Vandrey R, Dunn KE, Fry JA, Girling ER. A survey study to characterize use of Spice products (synthetic cannabinoids). Drug Alcohol Depend 2012; 120:238-41.
  • 3. Bretteville-Jensen AL, Tuv SS, Bilgrei OR, Fijeld B. Synthetic Cannabinoids and Cathinones: Prevalence and Markets. Forensic Sci Rev 2013; 25: 8- 26.
  • 4. Cohen J, Morrison S, Greenberg J, Saidinejad M. Clinical Presen¬tation of Intoxication Due to Synthetic Cannabinoids. Pediatrics 2012;129;1064-7.
  • 5. Gregori A, Damiano F, Bonavia M, et al. Identification of two can¬nabimimetic compounds WIN48098 and AM679 in illegal produ¬cts. Sci Justice 2013; 53: 286-92.
  • 6. Forrester MB, Kleinschmidt K, Schwarz E, Young A. Synthetic cannabinoid exposures reported to Texas poison centers. J Addict Dis. 2011 Oct;30(4):351.
  • 7. Gokhan Aksel, Oner Bozan, Mine Kayacı, Ozlem Güneysel, Seckin Bahar Sezgin, Rising Threat; Bonzai March 02, 2015, tatd doi: 10.5505/1304.7361.2015.80388.
  • 8. Filiz Izci, Vedat Izci, Servet Izci , Merve Setenay Iris Koc, Rabia Bilici, Engin Emrem Beştepe, Lipid infusion therapy in sinus tachycardia induced with synthetic cannabinoid (SC) intoxication: two cases report Bulletin of Clinical Psychopharmacology, Vol: 25, Supplement: 1, 2015 - www.psikofarmakoloji.org S209.
  • 9. Emre Salçın, Merter Gümüşel, Serkan Emre Eroğlu, Kerem Ali Kabaroğlu, Haldun Akoğlu, Özge Onur, Arzu Denizbaşı Bonzai-ilişkili solunum/kardiyovasküler komplikasyonların Analizi: Üniversite Hastanesi Deneyimi J Kartal Baskıdaki Makaleler: KEAH-43650 | DOI: 10.5505/jkartaltr.2015.43650.
  • 10. Sezen Kumaş Solak, Aslı Vural, Serdar Demirgan, Pınar Ceylan,Ömer Karaca,Çiğdem Atan,Mustafa Ferhat Çolak, Emine Yurdakul Ertürk, Sevgi Kazı, İKSST Derg 2018;10(1):7-11 Klinik Araştırma doi:10.5222/iksst.2018.007
  • 11. Schneir AB, Cullen J, Ly BT. “Spice” girls: Synthetic cannabinoid intoxication. J Emerg Med 2011; 40:296-299.
  • 12. Bozkurt M, Umut G, Evren C, Karabulut V. Clinical characteristics and laboratory test results of patients admitted to outpatient clinic for synthetic cannabinoid usage. The Journal of Psychiatry and Neurological Sciences. 2014;27: 328-34.
  • 13. Hoyte CO, Jacob J, Monte AA, Al-Jumaan M,Bronstein AC, Heard KJ. A characterization ofsynthetic cannabinoid exposures reported to the National Poison Data System in 2010. Ann Emerg Med 2012;60: 435-8.
  • 14. Yoshito Kamijo, Michiko Takai, Yuji Fujita, Yasuo Hirose, Yasumasa Iwasaki,Satoshi Ishihara, Takashi Yokoyama, Keiichi Yagi, Tetsuya Sakamoto, A Multicenter Retrospective Survey of Poisoning after Consumption of Products Containing Synthetic Chemicals in Japan, Intern Med 53: 2439-2445, 2014 DOI: 10.2169/internalmedicine.53.2344.
  • 15. Egemen Küçük, İrfan Küçük, Yasemin Yıldız Kirazaldı, Acil serviste sentetik kannabinoidler- Küçük ve ark. Genel Tıp Derg 2015; 25:18-22.
  • 16. Gremec S, Gasparovic V. Comparison of APACHE II, MEES and Glasgow Coma Scale in patients with nontraumatic coma for prediction of mortality. Critical Care 2001; 5:19-23
  • 17. Lee A, Bishop G, Hillman KM, Daffurn K. The Medical Emergency Team. Anaesthesia and İntensive Care 1995; 23:183-6
  • 18. Unertl K, Kottler BM. Prognostic scores in intensive care. Anaesthesist, 1997; 46(6): 471–80
  • 19. Olsson T. 2004. Risk Prediction at the Emergency Department. Acta Universitatis Upsaliensis. Comhrensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1983.63 pp. Upssala. 91- 554-6070-6074
  • 20. Hennes HJ, Reinnhardt T, Dick W. The Mainz Evaluation Scoring for assessment of emergency patient [in German]. Emerg Med 1992; 18:130-136
  • 21. Subbe CP, Davies RG, Williams E, Rutherford P, Gemmell L. Effect of introducing the Modified Early Warning Score on clinical outcomes, cardio-pulmonary arrests and intensive care utilisation in acute medical admissions. Anaesthesia 2003; 58:775-803
  • 22. Subbe CP, Kruger M, Rutherford P, Gemmell L. Validation of a Modified early Warning score in medical admission. Q J Med 2001; 94:521-526
  • 23. Jinwala FN, Gupta M. Synthetic cannabis and respiratory depression. J Child Adolesc Psychopharmacol. 2012 Dec;22(6):459-62.
  • 24. Schmid K, Niederhoffer N, Szabo B.Analysis of the respiratory effectsof cannabinoids in rats. Naunyn Schmiedebergs Arch Pharmacol2003; 368:301-8.
  • 25. Uğur Altınışık, Hatice Betül Altınışık, Tuncer Şimşek, Tuğba Doğu, Esen Şimşek, Halide AydınYoğun Bakım Ünitesinde Takip Edilen Sentetik Kannabinoid (Bonzai) Zehirlenmesi Olgularının Klinik ÖzellikleriJ Turk Soc Intens Care 2015;13:117-21 DOI: 10.4274/tybdd.36025.
  • 26. Gulser Esen Besli, Mehmet Alper Ikiz, Sema Yildirim, Selcuk Saltik synthetıc cannabınoıd abuse ın adolescents: a case serıes The Journal of Emergency Medicine, Vol. 49, No. 5, pp. 644–650, 2015.
  • 27. Seely KA, Prather PL, James LP, Moran JH. Marijuana-based drugs: innovative therapeutics or designer drugs of abuse? Mol Interv. 2011 Feb;11(1):36-51.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Original Articles
Yazarlar

Mehmet Necmeddin Sutaşır 0000-0001-6472-5092

Yayımlanma Tarihi 24 Mart 2020
Gönderilme Tarihi 6 Ocak 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 2 Sayı: 1

Kaynak Göster

APA Sutaşır, M. N. (2020). Could NCM-3S be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?. Eurasian Journal of Toxicology, 2(1), 15-22.
AMA Sutaşır MN. Could NCM-3S be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?. Eurasian J Tox. Mart 2020;2(1):15-22.
Chicago Sutaşır, Mehmet Necmeddin. “Could NCM-3S Be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?”. Eurasian Journal of Toxicology 2, sy. 1 (Mart 2020): 15-22.
EndNote Sutaşır MN (01 Mart 2020) Could NCM-3S be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?. Eurasian Journal of Toxicology 2 1 15–22.
IEEE M. N. Sutaşır, “Could NCM-3S be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?”, Eurasian J Tox, c. 2, sy. 1, ss. 15–22, 2020.
ISNAD Sutaşır, Mehmet Necmeddin. “Could NCM-3S Be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?”. Eurasian Journal of Toxicology 2/1 (Mart 2020), 15-22.
JAMA Sutaşır MN. Could NCM-3S be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?. Eurasian J Tox. 2020;2:15–22.
MLA Sutaşır, Mehmet Necmeddin. “Could NCM-3S Be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?”. Eurasian Journal of Toxicology, c. 2, sy. 1, 2020, ss. 15-22.
Vancouver Sutaşır MN. Could NCM-3S be Used in the Intubation Decision of Patients Showing Toxicity Findings After Synthetic Cannabinoid Abuse?. Eurasian J Tox. 2020;2(1):15-22.

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