Emergency department presentations of XXXX -accelerated detoxification.

@entity1 @entity836 @entity341 @entity391 @entity294 @entity344 @entity7405 @entity1245 @entity2146 @entity490
OBJECTIVES: To analyze @entity341 ( @entity341 ) presentations after @entity836 -accelerated detoxification. METHODS: This was a retrospective cohort analysis of @entity1 presentations to Sir Charles Gairdner Hospital Emergency Department over a six-month period (November 2000 to April 2001). RESULTS: During the six-month study period, 42 @entity1 presented to the @entity341 after @entity836 -accelerated detoxification. This represented 7% of @entity1 treated at a single clinic over the same period. Presentation occurred within 24 hours in 40% of cases and within 48 hours in 74%. Clinical features on presentation included @entity344 ( @entity391 , 60%; @entity490 , 55%; @entity294 , 45%), central nervous system [CNS] symptoms (excessive drowsiness, 55%; @entity2146 requiring sedation, 50%), and respiratory symptoms ( @entity7405 , 33%; respiratory difficulties, 19%). Gastrointestinal symptoms were managed adequately with supportive therapy in most cases (intravenous fluids; antiemetics). Agitation sometimes required large doses of intravenous @entity1245 (up to 730 mg in 44 hours), one-to-one nursing, and security staff. Two of 14 @entity1 presenting with predominantly CNS disturbance required intubation (14%). Mean in-hospital stay for all @entity1 was 18 hours (range 1 to 92 hours). CONCLUSIONS: A few @entity1 undergoing outpatient @entity836 -accelerated detoxification during a six-month period subsequently required @entity341 management. The clinical features encountered in this group of @entity1 can be subdivided into GI or CNS predominance, with different management strategies. Most presentations can be managed in the @entity341 or an associated observation ward, but departmental resources must be available for one-to-one nursing and security personnel. @entity1 presenting with @entity2146 should be sedated with @entity1245 ; large doses may be required. Close monitoring of respiratory function is mandatory, and advanced airway management may be required.
