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Hospital in the Field: Prehospital Management of GHB Intoxication by Medical Assistance Teams

Published online by Cambridge University Press:  19 July 2012

Martin J. Dutch  and
Kristy B. Austin
Martin J. Dutch*
Affiliation:
St. John Ambulance Australia, Melbourne, Australia
Kristy B. Austin
Affiliation:
St. John Ambulance Australia, Melbourne, Australia
*
Correspondence: Martin J. Dutch, FACEM St John Ambulance Australia (VIC) 170 Forster Road Mount Waverly Victoria 3149 Australia E-mail mdutch@stjohnvic.com.au
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Abstract

Introduction

Recreational use of gamma-hydroxybutyrate (GHB) is increasingly common at mass-gathering dance events in Australia. Overdose often occurs in clusters, and places a significant burden on the surrounding health care infrastructure.

Objective

To describe the clinical presentation, required interventions and disposition of patrons with GHB intoxication at dance events, when managed by dedicated medical assistance teams.

Methods

Retrospective analysis of all patrons attending St. John Ambulance medical assistance teams at dance events in the state of Victoria (Australia), from January 2010 through May 2011.

Main outcome measures

Clinical presentation, medical interventions and discharge destination.

Results

Sixty-one patients with GHB intoxication attended medical teams during the study period. The median age was 22 years, and 64% were male. Altered conscious state was present in 89% of attendances, and a GCS <9 in 44%. Hypotension, bradycardia and hypothermia were commonly encountered. Endotracheal intubation was required in three percent of patrons. Median length of stay onsite was 90 minutes. Ambulance transport to hospital was avoided in 65% of presentations.

Conclusions

The deployment of medical teams at dance events and music festivals successfully managed the majority of GHB intoxications onsite and avoided acute care ambulance transfer and emergency department attendance.

DutchMJ , AustinKB . Hospital in the Field: Prehospital Management of GHB Intoxication by Medical Assistance Teams. Prehosp Disaster Med. 2012;27(4):1-5.

Keywords

ambulanceemergency medicineemergency medical servicesEMSfirst aidprehospitaltoxicologytransport
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 27 , Issue 5 , October 2012 , pp. 463 - 467
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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References

1. Pre-review of gamma-hydroxybutyric acid (GHB). The World Health Organisation Expert Committee on Drug Dependence. http://www.who.int/medicines/areas/quality_safety/5GHBPreReview.pdf. Accessed April 23, 2012.Google Scholar
2. Harraway, T, Stephenson, L. Gamma hydroxybutyrate intoxication: the Gold Coast experience. Emerg Med Australas. 1999;11(1):45-48.Google Scholar
3. Dietze, PM, Cvetkovski, S, Barratt, MJ, Clemens, S. Patterns and incidence of gamma-hydroxybutyrate (GHB)-related ambulance attendances in Melbourne, Victoria. Med J Aust. 2008;188(12):709-711.Google Scholar
4. Munir, VL, Hutton, JE, Harney, JP, et al. Gamma-hydroxybutyrate: a 30 month emergency department review. Emerg Med Australas. 2008;20(6):521-530.Google Scholar
5. Galicia, M, Nogue, S, Miro, O. Liquid ecstasy intoxication: clinical features of 505 consecutive emergency department patients. Emerg Med J. 2011;28(6):462-466.Google Scholar
6. Liechti, ME, Kupferschmidt, H. Gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL): analysis of overdose cases reported to the Swiss Toxicological Information Centre. Swiss Med Wkly. 2004;134(35-36):534-537.Google Scholar
7. Miro, O, Nogue, S, Espinosa, G, et al. Trends in illicit drug emergencies: the emerging role of gamma-hydroxybutyrate. J Toxicol Clin Toxicol. 2002;40(2):129-135.Google Scholar
8. Chin, RL, Sporer, KA, Cullison, B, et al. Clinical course of gamma-hydroxybutyrate overdose. Ann Emerg Med. 1998;31(6):716-722.Google Scholar
9. Liechti, ME, Kunz, I, Greminger, P, et al. Clinical features of gamma-hydroxybutyrate and gamma-butyrolactone toxicity and concomitant drug and alcohol use. Drug Alcohol Depend. 2006;81(3):323-326.CrossRefGoogle ScholarPubMed
10. Caldicott, DG, Chow, FY, Burns, BJ, et al. Fatalities associated with the use of gamma-hydroxybutyrate and its analogues in Australasia. Med J Aust. 2004;181(6):310-313.Google Scholar
11. Twelve GHB overdoses at dance festivals. The Age Newspaper Web Site. http://www.theage.com.au/articles/2004/03/08/1078594297520.html. Accessed April 23, 2012.Google Scholar
12. Ravers overdose on ‘tainted drugs’. The Age Newspaper Web Site. http://www.theage.com.au/national/ravers-overdose-on-tainted-drugs-20081221-7318.html. Accessed April 23, 2012.Google Scholar
13. 10 overdose at dance party, mainly on GHB. The Age Newspaper Website. http://www.theage.com.au/national/10-overdose-at-dance-party-mainly-on-ghb-20090102-78sy.html. Accessed April 23, 2012.Google Scholar
14. Two critical, dozens ill after GHB overdose. The Age Newspaper Web Site. http://www.theage.com.au/national/two-critical-dozens-ill-after-ghb-overdose-20090411-a33o.html. Accessed April 23, 2012.Google Scholar
15. Code of practice for running safer dance parties. Department of Human Services Web Site. http://docs.health.vic.gov.au/docs/doc/9275A2581AAFFAC6CA25789500804526/$FILE/dance.pdf. Accessed April 23, 2012.Google Scholar
16. Fisher, DW. The health care imperative. Hosp Pract (Off Ed). 1992;27(8):12.Google Scholar
17. Mountain, D. Introduction of a 4-hour rule in Western Australian emergency departments. Emerg Med Australas. 2010;22(5):374-378.Google Scholar