Abstract：
UNASSIGNED: To differentiate the severity of acute opioid toxicity and describe both the clinical and physiological features associated with heroin overdose in a cohort of witnessed overdose cases.
UNASSIGNED: Witnessed heroin overdose cases over a 12-month period (30 June 2018 - 30 June 2019) at the Medically Supervised Injecting Room (MSIR) in Melbourne, Australia were examined. The severity of acute opioid toxicity was classified according to the level of clinical intervention required to manage the overdose cases where an escalating level of care was provided. Heroin overdose cases were classified into one of three graded severity categories and a fourth complicated heroin overdose category.
UNASSIGNED: A total of 1218 heroin overdose cases were identified from 60,693 supervised injecting visits over the study period. On the spectrum of toxicity, 78% (n = 955) of overdose cases were classified as Grade 1 severity, 7% (n = 83) as Grade 2 severity, and 13% (n = 161) as Grade 3 acute opioid toxicity severity cases, as well as 2% (n = 19) classified as complicated heroin overdose cases. The median onset time for heroin overdose cases was 17 min (IQR 11-28 min) from the time the individual was ready to prepare and inject heroin until clinical intervention was initiated.
UNASSIGNED: We demonstrated that heroin overdose is a dynamic illness and cases differ in the severity of acute opioid toxicity. The risk of airway occlusion including positional asphyxia was an early and consistent feature across all levels of toxicity, while exaggerated respiratory depression together with exaggerated depression of consciousness was increasingly observed with greater levels of toxicity. We also demonstrated the importance of early intervention in overdose cases, where in a large cohort of heroin overdose cases there were no fatal outcomes, a very low hospitalisation rate and most cases were able to be managed to clinical resolution on-site.
UNASSIGNED: Witnessed heroin overdose cases over a 12-month period (30 June 2018 - 30 June 2019) at the Medically Supervised Injecting Room (MSIR) in Melbourne, Australia were examined. The severity of acute opioid toxicity was classified according to the level of clinical intervention required to manage the overdose cases where an escalating level of care was provided. Heroin overdose cases were classified into one of three graded severity categories and a fourth complicated heroin overdose category.
UNASSIGNED: A total of 1218 heroin overdose cases were identified from 60,693 supervised injecting visits over the study period. On the spectrum of toxicity, 78% (n = 955) of overdose cases were classified as Grade 1 severity, 7% (n = 83) as Grade 2 severity, and 13% (n = 161) as Grade 3 acute opioid toxicity severity cases, as well as 2% (n = 19) classified as complicated heroin overdose cases. The median onset time for heroin overdose cases was 17 min (IQR 11-28 min) from the time the individual was ready to prepare and inject heroin until clinical intervention was initiated.
UNASSIGNED: We demonstrated that heroin overdose is a dynamic illness and cases differ in the severity of acute opioid toxicity. The risk of airway occlusion including positional asphyxia was an early and consistent feature across all levels of toxicity, while exaggerated respiratory depression together with exaggerated depression of consciousness was increasingly observed with greater levels of toxicity. We also demonstrated the importance of early intervention in overdose cases, where in a large cohort of heroin overdose cases there were no fatal outcomes, a very low hospitalisation rate and most cases were able to be managed to clinical resolution on-site.
摘要：
UNASSIGNED：为了区分急性阿片类药物毒性的严重程度，并描述一组目击过量病例中与海洛因过量相关的临床和生理特征。
UNASSIGNED：在墨尔本的医疗监督注射室（MSIR）见证了12个月（2018年6月30日至2019年6月30日）的海洛因过量病例，澳大利亚被检查。急性阿片类药物毒性的严重程度根据管理过量病例所需的临床干预水平进行分类，其中提供了不断升级的护理水平。海洛因过量病例分为三个严重程度类别之一和第四个复杂的海洛因过量类别。
UNASSIGNED：在研究期间，从60,693次有监督的注射访问中，共发现了1218例海洛因过量病例。在毒性谱上，78％（n=955）的过量病例被归类为1级严重程度，7%(n=83)为2级严重程度，13%(n=161)为3级急性阿片类药物毒性严重病例，以及2％（n=19）被归类为复杂的海洛因过量病例。从个体准备准备和注射海洛因到开始临床干预，海洛因过量病例的中位起效时间为17分钟（IQR11-28分钟）。
UNASSIGNED：我们证明海洛因过量是一种动态疾病，急性阿片类药物毒性的严重程度不同。包括位置性窒息在内的气道闭塞风险是所有毒性水平的早期和一致特征。虽然越来越多地观察到过度的呼吸抑制和过度的意识抑制，但毒性水平更高。我们还证明了在用药过量病例中早期干预的重要性，在大量海洛因过量病例中，没有致命的结果，非常低的住院率和大多数病例能够在现场临床解决.
UNASSIGNED：在墨尔本的医疗监督注射室（MSIR）见证了12个月（2018年6月30日至2019年6月30日）的海洛因过量病例，澳大利亚被检查。急性阿片类药物毒性的严重程度根据管理过量病例所需的临床干预水平进行分类，其中提供了不断升级的护理水平。海洛因过量病例分为三个严重程度类别之一和第四个复杂的海洛因过量类别。
UNASSIGNED：在研究期间，从60,693次有监督的注射访问中，共发现了1218例海洛因过量病例。在毒性谱上，78％（n=955）的过量病例被归类为1级严重程度，7%(n=83)为2级严重程度，13%(n=161)为3级急性阿片类药物毒性严重病例，以及2％（n=19）被归类为复杂的海洛因过量病例。从个体准备准备和注射海洛因到开始临床干预，海洛因过量病例的中位起效时间为17分钟（IQR11-28分钟）。
UNASSIGNED：我们证明海洛因过量是一种动态疾病，急性阿片类药物毒性的严重程度不同。包括位置性窒息在内的气道闭塞风险是所有毒性水平的早期和一致特征。虽然越来越多地观察到过度的呼吸抑制和过度的意识抑制，但毒性水平更高。我们还证明了在用药过量病例中早期干预的重要性，在大量海洛因过量病例中，没有致命的结果，非常低的住院率和大多数病例能够在现场临床解决.
