Scientific and organizational optimization of pre-hospital care in acute poisoning

Abstract

The incidence of acute poisoning is constantly increasing and ranges from 140 to 200 cases per 100,000 population in Western countries. In the Russian Federation, the overall incidence of acute poisoning in 2002 was approximately 184.9 per 100,000 population, and in 2008, it was 149.7 per 100,000 population. However, many authors believe that the number of poisonings occurring annually in the country is 1.5 to 2 times higher than official statistics. Acute poisoning monitoring is based on data on hospitalized patients and does not include patients who received care only at the prehospital stage or at the emergency room level without subsequent hospitalization. Available domestic and international literature contains virtually no comprehensive studies on the prevalence, structure, and clinical presentation of acute poisoning in the prehospital stage, including analysis of treatment measures. The aim of this study was to propose scientifically based approaches to optimizing prehospital management of patients with acute poisoning. A clinical and epidemiological analysis of the incidence and outcomes of acute poisoning in adults demonstrated the need to incorporate prehospital data into acute poisoning monitoring. This first-ever prospective study provided a comprehensive assessment of the structure, nature, and main clinical syndromes of acute poisoning in the prehospital setting and evaluated the factors associated with hospitalization of patients with acute poisoning. Predictors of in-hospital and out-of-hospital mortality were identified. Algorithms for key treatment measures were developed, including correction of respiratory distress, gastric lavage, and infusion therapy.