非法兴奋剂的使用继续对不同的卫生部门构成重大挑战。在澳大利亚,四种特殊的兴奋剂,即苯丙胺及其衍生物,甲基苯丙胺,摇头丸或3,4-亚甲二氧基-甲基苯丙胺(MDMA),和可卡因对ED造成重大挑战,因为管理使用兴奋剂的患者可能是劳动力和资源密集型的。虽然澳大利亚有与兴奋剂相关的救护车出勤率和住院率的数据,对使用兴奋剂的人的ED介绍知之甚少。本文的目的是系统地回顾与澳大利亚使用兴奋剂的人的ED表现率和模式有关的现有文献。在EBSCOhost上进行了搜索,CINAHL完成,和PubMed数据库,以及谷歌学者。搜索术语由以下术语的组合组成:1)兴奋剂和ED和澳大利亚;2)兴奋剂和紧急情况介绍或事故和紧急情况和澳大利亚,3)苯丙胺或甲基苯丙胺或摇头丸或可卡因和ED和澳大利亚。符合纳入标准的文章被纳入审查,并接受质量评估。数据是从选定的论文中提取的,包括病人的人口统计,列报率,兴奋剂的类型,介绍的原因,警察或救护车服务的参与,合并症,心理健康问题,分类代码,招生,和分离。使用系统审查和荟萃分析(PRISMA)指南的首选报告项目报告审查结果。如果研究是在2011年1月至2021年12月之间发表的英语同行评审文章,并且其中包括使用非处方非法兴奋剂的澳大利亚ED患者的数据,则符合资格。如果研究不包括与兴奋剂相关的ED介绍或专注于与处方兴奋剂相关的ED介绍,包括利他林和Adderall,非兴奋剂药物,或咖啡因治疗注意力缺陷障碍(ADD)或注意力缺陷多动障碍(ADHD)。对入选的文章进行了质量评价,严谨,以及两位作者的偏见风险。这些研究使用纽卡斯尔渥太华量表(NOS)进行横断面评估,队列,和病例对照研究,具体取决于研究中确定的方法。本研究共纳入19篇文章。男性占使用兴奋剂的年龄范围为0至65岁的人的ED表现的53%至85%,并且更有可能由警察或救护车运送。使用兴奋剂的人出现在不同的心理和行为问题,如精神病,自我伤害,自杀意念,幻觉,鼓动,和侵略性,以及医疗条件,包括心悸,恶心和呕吐,和严重的身体伤害。
The use of illicit stimulants continues to pose a significant challenge to different health sectors. In Australia, four particular stimulants, namely amphetamines and their derivatives, methamphetamine, ecstasy or 3,4-methylenedioxy-methamphetamine (MDMA), and cocaine cause a significant challenge to EDs as managing patients who use stimulants can be labor and resource intensive. While Australian data are available for stimulant-related ambulance attendances and hospitalizations, little is known about ED presentations of people who use stimulants. The aim of this paper is to systematically review the available literature related to the rates and patterns of ED presentations of people who use stimulants in Australia. A search was conducted on EBSCOhost, CINAHL Complete, and PubMed databases, as well as Google Scholar. Search terms consisted of combinations of the following terms: 1) stimulant AND ED AND Australia; 2) stimulants AND emergency presentations OR accident and emergency AND Australia, 3) amphetamine OR methamphetamine OR ecstasy OR cocaine AND ED AND Australia. Articles that met the inclusion criteria were included in the review and subjected to a quality appraisal. Data were extracted from the selected papers, including patient demographics, presentation rates, type of stimulant, reasons for presentations, police or ambulance service involvement, comorbidities, mental health issues, triage codes, admissions, and separations. The results of the review are reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were eligible if they were English-language peer-reviewed articles published between January 2011 and December 2021 and if they included data on Australian ED presentations of people who use non-prescription illicit stimulants. Studies were excluded if they did not include stimulant-related ED presentations or focused on ED presentations related to prescription stimulants, including Ritalin and Adderall, non-stimulant drugs, or caffeine for attention deficit disorder (ADD) or attention-deficit hyperactivity disorder (ADHD). The selected articles were appraised for quality, rigor, and risk of bias by two authors. The studies were assessed using the Newcastle Ottawa Scale (NOS) for cross-sectional, cohort, and case-control studies depending on the methodology identified in the study. A total of 19 articles were included in this study. Males represented 53 to 85% of ED presentations of people who use stimulants with an age range of 0 to 65 and are more likely to be transported by police or ambulance. People who use stimulants presented to EDs with varying psychological and behavioral concerns such as psychosis, self-harm, suicidal ideations, hallucinations, agitations, and aggressiveness, as well as medical conditions, including heart palpitations, nausea and vomiting, and significant physical injuries.