Construction Of Acute Poisoning Treatment Unit And Its Application In The Treatment Of Acute Organophosphorus Poisoning

ObjectiveTo discuss the value and feasibility of the application of acute poisoning unit in integrated treatment of acute organophosphorus pesticide poisoning.Aimed at opening up a new way of integration treatment for emergency multiple poisoning,to improve the diagnosis of acute poisoning,differential diagnosis and treatment level,increase the early diagnosis rate,early treatment rate,success rate of rescue and survival rate of patients with acute poisoning,reduce the damage of target organs,reduce fatality rate and mutilation rate,shorten the hospitalization time,reduce the incidence of complications caused by poisoning,reduce the cost of healthcare.MethodsFrom July 2014 to 2015 December,the 45 patients who meet the inclusion criteria of acute organic phosphorus poisoning were listed as the experience group,namely acute poisoning unit;53 patients from 2013 January to 2014 June,treated with the inclusion criteria of acute organic phosphorus poisoning were selected as the control group,namely non acute poisoning unit group.The acute poisoning unit group were responsibled by acute poisoning unit team members,strictly according to the standard treatment of established acute poisoning treatment unit to treat,to ensure the timely and effective implementation of every aspect,and emphasis on the early timely and effective treatment of pre hospital emergency,seamless convergence between outhospital and inhospital,multidisciplinary cooperation,psychological support therapy,rehabilitation of late stage and health education.In addition to early special detoxification drug use,gastric lavage,vomiting,tracheal intubation treatment,with an emphasis on early mechanical ventilation,blood purification,the monitoring of electrocardiogram,heart rate,blood pressure and blood oxygen saturation of critically ill patients in emergency intensive care unit(EICU),recordpatients' 24 hour access amount detailed,observation records of patients' organ damage,if there is complications,give timely symptomatic therapy,and strengthen psychological counseling for patients.Non acute poisoning unit group were treated according to the conventional treatment principles.No multidisciplinary team under the unified command,not in place of pre hospital care,no health education and psychological intervention,no systematic treatment of this.The main outcome measures included: the incidence of organ damage,the incidence of complications,length of stay,hospital costs,mortality and Suicide rates again.ResultsThere was no significant difference in the two groups patients' gender,age,occupation,the amount of poison,poison species,the classification of theseverity of poisoning,past history and so on.In the experimental group,18 cases(40%)have liver function damage,14 cases(31.1%)with renal function damage,11 cases(24.4%)have myocardial damage,9cases of acute pancreatitis(20%),8 cases of respiratory failure(17.8%),MODS4 cases(8.9%);In control group,the incidence of liver function damage is 32(60.3%)and renal function damage is 27 cases(50.9%),myocardial injury is 24cases(45.3%),23 cases of acute pancreatitis(24.5%),19 cases of respiratory failure(35.8%),MODS 15 cases(28.3%);the incidence of acute pancreatitis is similar between the two groups and has no statistical significance,p value is 0.592,the other is no statistically significant differences in incidence of viscera function damage,p<0.05.Experimental group had intermediate syndrome in 13 cases,the infection cases,2 deaths,hospitalization time(8.934±3.934)days,intermediate syndrome occurrence rate of 27 cases in the control group,11 cases of death,hospitalization time(10.679±3.507)days,two group p value less than 0.05,the difference was statistically significant.The total cost of hospitalization per experimental group(13404.987±7402.268)dollars.Total hospital costs per capita in the control group(15633.764±5889.869)dollars,p> 0.05,the difference was not statistically significant.Conclusions(1)Acute poisoning unit can effectively reduce the damage of each viscera fun ction and the incidence rate of complications caused by the acute organophosphorus pesticide poisoning,reduce the mortality.(2)Acute poisoning unit group can shorten the average hospitalization days of patients with AOPP,without increasing the average hospitalization expenses.(3)The curative effect of the acute poisoning unit in the treatment of AOPP is superior to the non treatment of acute poisoning unit group.Its an effective method,whichcan effectively improve the success rate of treatment,improve the prognosis of patients,improve the quality of life of patients.