Suicide attempt by intentional drug overdose: management in urgency and emergency services – integrative review
DOI:
https://doi.org/10.5902/2236583473413Keywords:
Suicide attempt, Emergency medical services, Poisoning, Drug overdose, MedicineAbstract
Objective: to analyze the characteristics of suicide attempts by intentional overdose of medication committed by adults and the management of these situations in urgent and emergency services. Method: this is an integrative review, with a search in the Latin American and Caribbean Literature in Health Sciences (LILACS) and Medical Literature and Retrivial System Online (MEDLINE) databases. The selection of articles occurred using the Mendeley® reference manager. For the analysis of the results, a narrative synthesis of evidence was developed. The recommendations of the Preferred Reporting Items for Systematic Review sand Meta-Analyses – PRISMA method were followed. Results: 11 studies were included for the synthesis of evidence. Most cases of intentional drug overdose occurred in women (n=7; 63.6%). As for selfadministered medications, there was a prevalence of anti-inflammatories/analgesics and antidepressants/anxiolytics. With regard to the management employed in the cases studied, most performed intravenous volume resuscitation (n=6; 54.5%) and gastrointestinal lavage with activated charcoal (n=6; 54.5%). Conclusion: a profile of suicide attempts by drug ingestion of females, with ingestion of anti-inflammatories/analgesics, was revealed. The main management involves the administration of intravenous volumes and the use of activated charcoal.
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References
Organização Mundial da Saúde (OMS). Folha informativa sobre suicídio. Genebra: OMS, 2018. Acesso em: 03 jun. 2021. Disponível em: https://www.paho.org/pt/topicos/suicidio
Organização Pan-Americana da Saúde (OPAS). Prevenção do suicídio. Manual dirigido a profissionais das equipes de saúde mental. Brasília: Organização Pan-Americana da Saúde/Ministério da Saúde/Universidade Estadual de Campinas, 2006.
Bernardes SS, Turini CA, Matsuo T. Profile of suicide attempts using intentional overdose with medicines, treated by a poison control center in Paraná State, Brazil. Cad. Saúde Pública. 2010; 26(7):1366-72. https://doi.org/10.1590/S0102-311X2010000700015
Queiros A, Leite R, Yoshida E, Estanagel T, Pereira M, dos Santos N. Profile for intentional drug medicaments. Rev Intersaúde. 2020; 1(2): 79-88. Acesso em: 03 jun. 2021. Disponível em: http://revista.fundacaojau.edu.br:8078/journal/index.php/revista_intersaude/article/view/130/78
Sistema Nacional de Informações Tóxico-farmacológicas (SINITOX). Dados de intoxicação. Acesso em: 03 ago. 2021. Disponível em: https://sinitox.icict.fiocruz.br/dados-nacionais
Brasil. Ministério da Saúde. Política Nacional de Atenção às Urgências. 3. ed. Brasília: Ministério da Saúde, 2006. Acesso em: 03 jun. 2021. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_atencao_urgencias_3ed.pdf.
Pereira JA, Ruas JPP, Flausino VO, Barbosa AFN, Ferreira TVS, Correia TC et al. Epidemiological profile of demand on hospital emergency units: a literature review. REAS/EJCH. 2019; 32(sn): e1178. https://doi.org/10.25248/reas.e1178.2019
Brasil. Suicídio: tentativas e óbitos por intoxicação exógena no Brasil, 2007 a 2016. Boletim Epidemiológico, Brasília. 2019; 50(15): 1-12. Acesso em: 03 jun. 2021. Disponível em: https://www.researchgate.net/publication/334524337_Suicidio_tentativas_e_obitos_por_intoxicacao_exogena_no_Brasil_2007_a_2016
Andrade LCV. Protocolo de Avaliação e Cuidados para o Suicídio. São Paulo: HCor, 2020. Acesso em: 03 jun. 2021. Disponível em: https://www.hcor.com.br/area-medica/wp--content/uploads/2020/11/23.-Protocolo-Suicidio.pdf?fbclid=IwAR0uyW9To4iCiWLdJCOf-5cr9pwg2lMmeUK9xYr8HRP4F
Agenda de Prioridades de Pesquisa do Ministério da Saúde (APPMS). Ministério da Saúde. Brasília: Ministério da Saúde, 2018. Acesso em: 03 jun. 2021. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/agenda_prioridades_pesquisa_ms.pdf
Organização das Nações Unidas (ONU). Transformando nosso mundo: a agenda 2030 para o desenvolvimento sustentável. 2015. Acesso em: 03 jun. 2021. Disponível em: https://nacoesunidas.org/pos2015/agenda2030/
Lacerda MR, Costanero RGS. Metodologias da pesquisa para a enfermagem e saúde: da teoria à prática. 1ª ed. Porto Alegre: Ed.: Moriá, 2016. 511 p.
Polit DF, Beck CT. Fundamentos da pesquisa em enfermagem: avaliação de evidências para a prática de enfermagem. 9th ed. Porto Alegre: ArtMed, 2018.
Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. 2. ed. Philadelphia: Lippincot Williams & Wilkins, 2011.
Page MJ, Mckenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372(71): 1-9. https://doi.org/10.1136/bmj.n71
Bowers V, Mason M, Clinkscales M. Managing acute salicylate toxicity in the emergency department. Adv Emerg Nurs J. 2019; 41(1): 76-85. https://doi.org/10.1097/TME.0000000000000227
Sungur S, Bilge U, Acar N, Unluoglu I. Retrospective evaluation of adult poisoning cases admitted to emergency department of a University Hospital in Turkey. Niger J Clin Pract. 2018; 21(8): 1023-8. https://doi.org/10.4103/njcp.njcp_291_17
Seegobin K, Maharaj S, Deosaran A, Reddy P. Severe beta blocker and calcium channel blocker overdose: Role of high dose insulin. Am J Emerg Med. 2018; 36 (4): 736.e5-736.e6. https://doi.org/10.1016/j.ajem.2018.01.038
Martins LS, Andrade Filho A. Use Of Lipid Solution In Beta-Blocking Severe Intoxication: Case Report. Rev Med Minas Gerais 2017; 27: e-1911. http://dx.doi.org/10.5935/2238-3182.20170093
Maskell K, Tse A, Wolf C, Troendle M. Acute on chronic ivabradine overdose: a case report. J Med Toxicol. 2016;12(2):189-91. http://dx.doi.org/10.1007/s13181-016-0537-9
Al-abri SA, Anderson IB, Pedram F, Colby JM, Olson KR. Massive naproxen overdose with serial serum levels. J Med Toxicol. 2015; 11(1): 102-5. https://doi.org/10.1007/s13181-014-0396-1
Santana NO, Góis AFT. Rhabdomyolysis as a manifestation of clomipramine poisoning. São Paulo med. J. 2013; 131(6); 432-5. http://dx.doi.org/10.1590/1516-3180.2013.1316541
Montiel V, Goulart T, Hantoson P. Diltiazem poisoning treated with hyperinsulinemic euglycemia therapy and intravenous lipid emulsion. Eur J Emergerg med. 2011; 18(2):121-3. https://doi.org/10.1097/mej.0b013e32834130ab
Mullins ME, Pinnick RV, Terhes JM. Life-threatening Diphenhydramine Overdose Treated With Charcoal Hemoperfusion and Hemodialysis. Annals of Emergency Medicine. 1999; 33(1): 104-7. https://doi.org/10.1016/s0196-0644(99)70425-7
Holzer M, Sterz F, Schoerkhuber W, Behringer W, Domanovits H, Weinmar D, et al. Successful resuscitation of a verapamil-intoxicated patient with percutaneous cardiopulmonary by-pass. Crit Care Med. 1999; 27(12):2818-23. https://doi.org/10.1097/00003246-199912000-00035
Hassan, E. Treatment of meprobamate overdose with repeated oral dose of activated charcoal. Ann Emerg Med. 1986; 15(1): 73-6. https://doi.org/10.1016/S0196-0644(86)80491-7
Vieira LP, Santana VTP; Suchara EA. Characterization of suicide attempts by exogenous substances. Cad. Saúde Colet., Rio de Janeiro. 2015; 23(2); 118-23. https://doi.org/10.1590/1414-462X201500010074
Fundação Oswaldo Cruz (FIOCRUZ). Centro de Informação Científica e Tecnológica. Sistema Nacional de Informações Tóxicos-Farmacológicas, Estatística anual de casos de intoxicação e envenenamento. Brasil, 2011. Disponível em: http://www.fiocruz.br/sinitox/cgi/cgilua.exe/sys/start.htm?sid=5. Acesso em: 18 maio 2021.
Manual de Procedimentos Operacionais Padrão (POP) Enfermagem, Secretaria Municipal de Saúde de Campinas – SP. Versão 3, 2020. 319p. Disponível em: https://saude.campinas.sp.gov.br/saude/enfermagem/POP_Enfermagem_2020.pdf
Brasil. Ministério da Saúde. Advocacia Geral da União. Nota técnica n. 275/2013: Carvão vegetal ativado. Brasilia: [s.n]. 2013; 3p.
Mintegi S, Dalziel SR, Azkunaga B, Prego J, Arana-Arri E, Acedo Y, et al. International variability in gastrointestinal decontamination with acute poisonings. Pediatrics. 2017; 140(2): e20170006. https://doi.org/10.1542/peds.2017-0006
Chiew AL, Isbister GK, Kirby KA, Page CB, Chan BSH, Buckley NA. Massive paracetamol overdose: an observational study of the effect of activated charcoal and increased acetylcysteine dose (ATOM-2). Clinical Toxicology. 2017; 55 (10): 1055-65. https://doi.org/10.1080/15563650.2017.1334915
Buckley NA, Dawson AH, Isbister GK. Treatments for paracetamol poisoning. BMJ. 2016; 353:i2579. Acesso em 12 ago 2021. Disponível em: https://www.bmj.com/content/353/bmj.i2579
Villarreal J, Kahn CA, Dunford JV, Patel E, Clark RF. A retrospective review of the prehospital use of activated charcoal. The American Journal of Emergency Medicine. 2015; 33(1):56-9. https://doi.org/10.1016/j.ajem.2014.10.019
Bezerra ACP, Gomes CBS, Macêdo L, Diniz MAOD, Caldas RTA, Silva TGL, Oliveira TL, Mariz SR. Utilização da lavagem gástrica e do carvão ativado como medidas de intervenção terapêutica na intoxicação exógena. Revista Eletrônica Acervo Saúde. 2020; 12(12): e4990. https://doi.org/10.25248/reas.e4990.2020
Boyer EW, Weibrecht KW. Salicylate (aspirin) poisoning in adults. In S. J. Traub (Ed.), UpToDate. Waltham, MA: UpToDate. 2017.
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