Poisoning with table salt while treating drug poisoning

IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Journal of forensic sciences Pub Date : 2024-09-10 DOI:10.1111/1556-4029.15623
Anna Smędra MD, PhD, Katarzyna Wochna DMD, PhD, Jacek Gruchała MD, PhD, Jarosław Berent MD, PhD
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Abstract

Hypernatremia is an increase in serum sodium concentration above 145 mmol/L. There are many causes of elevated sodium levels in the blood serum. One is incorrect actions performed by medical staff. The symptoms of excessively high serum sodium levels depend on the severity of hypernatremia, the rate of its increase and the accompanying volume disorders. Severe symptoms include altered consciousness, increased muscle tone and reflexes, convulsions, psychomotor hyperactivity or drowsiness (up to coma), respiratory failure, and even death. We present the case of a 45-year-old man who took seven tablets of a blood pressure-lowering drug, and paramedics subsequently administered a concentrated solution of table salt to induce vomiting. However, vomiting did not occur, leading to hypernatremia. Ultimately, the man survived but developed persistent cognitive dysfunction, including disordered short-term memory and encoding and retrieval of information from long-term memory, weakening of attention function and fatigue, and disorders in abstract thinking. The patient's family went to the prosecutor's office to investigate the possibility of medical malpractice. Experts found that the paramedics' actions were incorrect. Although it has been known for many years that table salt solutions should not be used to induce vomiting, unfortunately, both laypeople and medical professionals are still using this technique. Iatrogenic salt poisoning may end not only in serious health complications but also in legal consequences.

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治疗药物中毒时食盐中毒
高钠血症是指血清钠浓度升高超过 145 毫摩尔/升。导致血清中钠浓度升高的原因有很多。其一是医务人员的错误操作。血清钠含量过高的症状取决于高钠血症的严重程度、升高速度和伴随的容量失调。严重的症状包括意识改变、肌张力和反射增强、抽搐、精神运动亢进或嗜睡(甚至昏迷)、呼吸衰竭,甚至死亡。我们介绍的病例中,一名 45 岁的男子服用了 7 片降压药,医护人员随后给他注射了食盐浓溶液催吐。然而,呕吐并没有发生,导致了高钠血症。最终,这名男子虽然活了下来,但出现了持续的认知功能障碍,包括短期记忆和长期记忆信息的编码和检索紊乱、注意力功能减弱和疲劳,以及抽象思维障碍。患者家属到检察院调查医疗事故的可能性。专家发现,医护人员的行为是错误的。尽管人们多年前就知道不应使用食盐溶液催吐,但遗憾的是,无论是普通人还是专业医务人员,仍然在使用这种方法。先天性盐中毒不仅可能导致严重的健康并发症,还可能导致法律后果。
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来源期刊
Journal of forensic sciences
Journal of forensic sciences 医学-医学:法
CiteScore
4.00
自引率
12.50%
发文量
215
审稿时长
2 months
期刊介绍: The Journal of Forensic Sciences (JFS) is the official publication of the American Academy of Forensic Sciences (AAFS). It is devoted to the publication of original investigations, observations, scholarly inquiries and reviews in various branches of the forensic sciences. These include anthropology, criminalistics, digital and multimedia sciences, engineering and applied sciences, pathology/biology, psychiatry and behavioral science, jurisprudence, odontology, questioned documents, and toxicology. Similar submissions dealing with forensic aspects of other sciences and the social sciences are also accepted, as are submissions dealing with scientifically sound emerging science disciplines. The content and/or views expressed in the JFS are not necessarily those of the AAFS, the JFS Editorial Board, the organizations with which authors are affiliated, or the publisher of JFS. All manuscript submissions are double-blind peer-reviewed.
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