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2015-17년 전국 20개 거점병원 응급해독제 비축 및 제공 결과

Antidotes Stocking and Delivery for Acute Poisoning Patients at 20 Emergency Departments in Korea 2015-2017

  • 이승민 (서울아산병원 응급의학과) ;
  • 윤한덕 (국립중앙의료원 중앙응급의료센터) ;
  • 장한석 (국립중앙의료원 중앙응급의료센터) ;
  • 원신애 (국립중앙의료원 중앙응급의료센터) ;
  • 김경환 (인제대학교 일산백병원 응급의학과) ;
  • 오범진 (서울아산병원 응급의학과)
  • Lee, Seungmin (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Youn, Han Deok (National Emergency Medical Center, National Medical Center) ;
  • Chang, Hanseok (National Emergency Medical Center, National Medical Center) ;
  • Won, Sinae (National Emergency Medical Center, National Medical Center) ;
  • Kim, Kyung Hwan (Department of Emergency Medicine, Inje University Ilsan Paik Hospital) ;
  • Oh, Bum Jin (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2018.06.15
  • 심사 : 2018.07.18
  • 발행 : 2018.12.31

초록

Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.

키워드

참고문헌

  1. Wang RY, Kazzi ZN. Antidotes and rescue therapies. Curr Pharm Biotechnol 2012;13(10):1914-6. https://doi.org/10.2174/138920112802273164
  2. Mazer-Amirshahi M, Stolbach A, Nelson LS. ACMT Position Statement: Addressing the Rising Cost of Prescription Antidotes. J Med Toxicol 2018;14(2):168-71. https://doi.org/10.1007/s13181-017-0639-z
  3. Dart RC, Goldfrank LR, Erstad BL, Huang DT, Todd KH, Weitz J, et al. Expert Consensus Guidelines for Stocking of Antidotes in Hospitals That Provide Emergency Care. Ann Emerg Med 2018;71(3):314-25 e1. https://doi.org/10.1016/j.annemergmed.2017.05.021
  4. Lau FL. Emergency management of poisoning in Hong Kong. Hong Kong Med J 2000;6(3):288-92.
  5. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol (Phila) 2017;55(10):1072-252. https://doi.org/10.1080/15563650.2017.1388087
  6. Statistics Korea. Press release of 2015 statistics for death reason. http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&aSeq=356345.
  7. Sohn CH, Ryoo SM, Lim KS, Kim W, Lim H, Oh BJ. Kind and Estimated Stocking Amount of Antidotes for Initial Treatment for Acute Poisoning at Emergency Medical Centers in Korea. J Korean Med Sci 2014;29(11):1562-71. https://doi.org/10.3346/jkms.2014.29.11.1562
  8. Park KH, Park JS, Lee SW, Kim SJ, Han KS, Lee EJ. Changes of Poison Data Characteristics Collected from Telephone Response in 1339 and 119: Discrepancy in Characteristics of Post-toxin Exposure Data Obtained through Telephone Counselling Provided by 1339 and 119. J Korean Soc Clin Toxicol 2017;15(2):116-21. https://doi.org/10.22537/jksct.15.2.116
  9. Han CS, Jeon WC, Min YG, Choi SC, Lee JS. Retrospective Analysis on the Clinical Differences of Children and Adolescents Treated for Acute Pediatric Poisoning in an Emergency Department? J Korean Soc Emerg Med 2013;24(6):742-9.
  10. Lee K, Kim KH, Shin DW, Park J, Kim H, Jeon W, et al. Trends in Korean Pediatric Poisoning Patients: Retrospective Analysis of National Emergency Department Information System. J Korean Soc Clin Toxicol 2017;15(2):69-78. https://doi.org/10.22537/jksct.15.2.69
  11. Chung SP, Lee MJ, Kang H, Oh BJ, Kim H, Kim YW, et al. Analysis of Poisoning Patients Using 2016 ED Based Injury in-depth Surveillance Data. J Korean Soc Clin Toxicol 2017;15(2):86-93. https://doi.org/10.22537/jksct.15.2.86
  12. Kim SJ, Choa MH, Park JS, Lee SW, Hong YS. Different Characteristics of Toxic Substance/poison Exposure Data that Collected from Pre-hospital Telephone Response and Emergency Department. J Korean Soc Clin Toxicol 2014;12(1):1-7.
  13. Lee HS, Han J, Kim JH, Kim S, Kim SH, Lee JS, et al. Epidemiologic Characteristics of Intentional Poisoning: Emergency Department Based Injury in-depth Surveillance During 2011-2015. J Korean Soc Clin Toxicol 2017;15(2):131-9. https://doi.org/10.22537/jksct.15.2.131
  14. Park SY, Oh BJ, Sohn CH, Jeong RB, Lim KS, Kim W, et al. The research society for emergency antidotes stock and delivery system in Korea. The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center. J Korean Soc Clin Toxicol 2013;11(1):9-18.
  15. Broto-Sumalla A, Rabanal-Tornero M, Garcia-Pelaez M, Aguilar-Salmeron R, Fernandez de Gamarra-Martinez E, Martinez-Sanchez L, et al. Availability of antidotes in 70 hospitals in Catalonia, Spain. Med Clin (Barc) 2018;150(1):16-9. https://doi.org/10.1016/j.medcli.2017.05.037
  16. Thanacoody RH, Aldridge G, Laing W, Dargan PI, Nash S, Thompson JP, et al. National audit of antidote stocking in acute hospitals in the UK. Emerg Med J 2013;30(5):393-6. https://doi.org/10.1136/emermed-2012-201224
  17. So BH, Lee MJ, Kim H, Moon JM, Park KH, Sung AJ, et al. 2008 Database of Korean Toxic Exposures: A Preliminary Study. J Korean Soc Clin Toxicol 2010;8:51-60.