The relation between the skin temperature of the puncture site (ST) and the performance of the intravenous approach (IVA) by paramedics was studied. METHODS: 282 records of IVA cases, from the data base of BANDO-MC (Ibarakiseinan Fire Department) between August 2018 to March 2019, were enrolled. RESULTS: High temperature group (HTG: ST ≥28.5˚C) was significantly better in width (p<0.05), perceptibility (p<0.01), palpability (p<0.01) of the target vein and shorter time for IVA procedure than the low temperature group (LTG: ST<28.5˚C). Despite the years of experience of paramedics in HTG was significantly lower than LTG, no difference was found in success rate of IVA between the groups. CONCLUSION: Our data suggests that higher ST may provide better condition for IVA and less procedure time in the prehospital setting.
The increase in the number of elderly people and the increase in the number of emergency dispatch cases in super aged society has risen to the right. Among them, transportation ratio of mild and moderate age 65 years and older occupies more than other ages, and it is necessary to support urgent emergency request measures, household of poor people and elderly care cooperation with medical institutions and city welfare departments is indispensable for countermeasures to people. As a method of going so, we distributed of leaflets concerning home health care through ambulance, corresponded not only to emergency transportation, efforts to eliminate anxiety of frequent ambulance users, and formulated manuals. As a result, it is possible to jointly provide telephone consultation and individual visits to one emergency number of users through an individual support meeting with the welfare department, thereby reducing the number of exercises, and future organizational issues I was able to derive.
Cardiovascular collapse caused by overdose of drugs including tricyclic antidepressant has been conventionally treated by fluid and vasopressors. Intravenous lipid emulsion (ILE) is reported as a rescue therapy for the toxicity of lipophilic drug overdose, of which the logP (octanol: water partition coefficient) is > 2. We report the case of a 49-year-old woman transferred to our critical care center following an overdose of multiple psychotropic drugs. Drugs (logP [measured/theoretical value]) she took included amoxapine [ND/2.6] 450 mg, amitriptyline [1.9/5.0] 90 mg, and trazodone [3.85/2.8] 600 mg. Her BP suddenly dropped to 57/33 mmHg 5 hours after overdosing and her BP didn’t rise by intravenous fluid infusion and administration of dopamine. After ILE was administered, her BP returned to 84/41 mmHg. This case suggests that ILE can reduce the toxicity of lipophilic drug overdose. Therefore, ILE should be considered when resuscitating patients with cardiovascular collapse caused by lipophilic drug toxicity.