The PIRATE mnemonic: providing a structured approach in the care for intoxicated patients at the emergency department.
Acute toxicology
Emergency department
Intoxications
Mnemonic
Journal
International journal of emergency medicine
ISSN: 1865-1372
Titre abrégé: Int J Emerg Med
Pays: England
ID NLM: 101469435
Informations de publication
Date de publication:
01 Mar 2024
01 Mar 2024
Historique:
received:
09
11
2023
accepted:
22
02
2024
medline:
2
3
2024
pubmed:
2
3
2024
entrez:
1
3
2024
Statut:
epublish
Résumé
Expertise in toxicology is essential for acute care providers, as intoxicated patients frequently present to Emergency Departments. These patients can be challenging for care providers because they often present with uncertain substance exposure and unknown dose and timing of these exposures. The Dutch Society of Emergency Physicians has developed an mnemonic to support treating physicians in a structured approach for the management of (undifferentiated) intoxicated patients. The PIRATE mnemonic was developed, which includes the following aspects and sequence of care for the intoxicated patient: primary survey, investigation & identification, risk assessment, ADME (comprising pharmacokinetic therapeutic targets: absorption, distribution, metabolism, elimination), therapy and evaluation. The toxicology section of the Dutch Society of Emergency Physicians developed the PIRATE mnemonic to provide a structured approach in the management of patients presenting with acute intoxications to Emergency Departments. It summarizes the essential steps and priorities required in the care of intoxicated patients. Further, it provides a common strategy for all specialties involved in the care of the acutely intoxicated patient, contributing to developing greater competence in poisoning management.
Sections du résumé
BACKGROUND
BACKGROUND
Expertise in toxicology is essential for acute care providers, as intoxicated patients frequently present to Emergency Departments. These patients can be challenging for care providers because they often present with uncertain substance exposure and unknown dose and timing of these exposures.
METHODS
METHODS
The Dutch Society of Emergency Physicians has developed an mnemonic to support treating physicians in a structured approach for the management of (undifferentiated) intoxicated patients.
RESULTS
RESULTS
The PIRATE mnemonic was developed, which includes the following aspects and sequence of care for the intoxicated patient: primary survey, investigation & identification, risk assessment, ADME (comprising pharmacokinetic therapeutic targets: absorption, distribution, metabolism, elimination), therapy and evaluation.
CONCLUSION
CONCLUSIONS
The toxicology section of the Dutch Society of Emergency Physicians developed the PIRATE mnemonic to provide a structured approach in the management of patients presenting with acute intoxications to Emergency Departments. It summarizes the essential steps and priorities required in the care of intoxicated patients. Further, it provides a common strategy for all specialties involved in the care of the acutely intoxicated patient, contributing to developing greater competence in poisoning management.
Identifiants
pubmed: 38429763
doi: 10.1186/s12245-024-00606-4
pii: 10.1186/s12245-024-00606-4
doi:
Types de publication
Journal Article
Langues
eng
Pagination
30Informations de copyright
© 2024. The Author(s).
Références
Gijsen R, Kommer GJ, Deuning C. Feb. Acute care use ED. www.vzinfo.nl/acute-zorg/gebruik/seh . Last amendment date 7 2023. In Dutch.
American College of Emergency Physicians. The role of emergency medicine in toxicology (position paper). Ann Emerg Med. January 1983;12:56.
Verheij C, Rood PPM, Deelstra CK, Levendag MLL, Koch BCP, Polinder S, Schuit SCE, Haagsma JA. Emergency Department visits due to intoxications in a Dutch university hospital: occurrence, characteristics and health care costs. PLoS ONE. 2019;14(12):e0226029.
doi: 10.1371/journal.pone.0226029
pubmed: 31856178
pmcid: 6922372
Hobgood C, Anantharaman V, Bandiera G, Cameron P, Halpern P, Holliman J, Jouriles N, Kilroy D, Mulligan T, Singer. A on behalf of the International Federation of Emergency Medicine. Model curriculum for Emergency Medicine specialists. 2010. https://assets.nationbuilder.com/ifem/pages/202/attachments/original/1649025601/IFEM_Graduate_Model_Curriculum_2010.pdf?1649025601 .
Educational Committee of EUSEM (European Society for Emergency Medicine). and EMERGE (Emergency Medicine Examination Reference Group in Europe) on behalf of the UEMS Section of Emergency Medicine. European Core Curriculum for Emergency Medicine, version 2.0. 2019. https://euseum.org/images/Curriculum_2.0_WEB.pdf .
Dutch Society of Emergency Physicians (DSEP/NVSHA). National education modules for emergency residents https://www.nvsha.nl/aios/opleiding-aios/landelijke-onderwijsmodules/ Accessed 15 Oct 2023.
Bush B, Cheema N, Frost A, et al. Identifying the gaps: needs Assessment to Guide Development of a dedicated Toxicology Curriculum for Emergency Medicine residents. J Med Toxicol. 2021;17:271–7.
doi: 10.1007/s13181-021-00834-7
pubmed: 33844171
pmcid: 8206434
Cline DM, Ma OJ, Cydulka RK, Meckler GD, Thomas SH. ; Handel, Dan. Tintinalli’s Emergency Medicine Manual 7th Edition. Date Published: 2012-06-07. ISBN 10: 0071781846.
Hoffman R, Howland MA, Lewin N, Nelson L. ; Goldfrank, Lewis. Goldfrank’s Toxicologic Emergencies, Tenth Edition. Date Published: 2014-12-23. ISBN 10: 0071801847.
https://www.nvsha.nl/downloads/zakkaarten/ .
Website of EXTRIP Workgroup. Available at: https://www.extrip-workgroup.org/ . Accessed 15 Oct 2023.