DROGENNOTFALL – Richtig handeln | Nitazene, GHB, Monkey Dust & Lachgas

Alcohol remains the most frequent cause of intoxication in emergency medical services, emergency rooms, and at large events. And not every patient who is impaired, agitated, or exhibits unusual behavior is actually intoxicated: hypoglycemia, hyperthermia, trauma, stroke, sepsis, and other acute medical causes must always be considered. Treat the patient – ​​not the suspected substance. What do you really need to know in a drug emergency at a festival, a large event, in emergency medical services, or in the emergency room? Together with Christoph Hüser, senior physician at the Charité Poison Control Center, emergency physician, and founder of toxinfo.de, we discuss current drug intoxications and their clinical management. The focus is not on supposedly reliable information about the substance consumed, but rather on the ABCDE approach, toxidromes, and dangerous complications. We will discuss, among other things: • Synthetic opioids such as nitazine and fentanyl derivatives • Naloxone in respiratory depression and the risk of re-sedation • Why a negative rapid opioid test does not rule out opioid intoxication • Synthetic cathinones, "bath salts," and monkey dust • Agitation, hyperthermia, hyponatremia, rhabdomyolysis, and vascular complications • GHB, GBL, and 1,4-butanediol • Nitrous oxide, functional vitamin B12 deficiency, and neurological damage • The NICO study on intubation in intoxication-induced coma • The high-risk takedown of massively agitated patients • Active cooling in heatstroke The central message: We don't treat the name of a drug, but rather the symptoms, the toxidrome, and the acutely life-threatening complications. CHAPTER 00:00 Drug emergencies at festivals and large events 00:48 What is really new about "new drugs"? 02:48 ABCDE and the concept of toxidromes 04:07 Synthetic opioids, nitazene, and naloxone 06:49 Cathinones, "bath salts," and monkey dust 09:37 GHB, GBL, and 1,4-butanediol 10:57 Nitrous oxide: B12 deficiency, dependence, and acute damage 13:31 NICO study: Intubation in intoxication-induced coma 15:02 Severe agitation and takedown CREDITS Host: Felix Bangert Expert: Christoph Hüser Camera: Lennart Lulow Scientific advisor: Prof. Martin Möckel FURTHER INFORMATION ☀️ The toxidrome sun as a diagnostic tool in the emergency room Hüser C, Bernhard M, Biermann H et al. Emergency Rescue Med, 2024 https://doi.org/10.1007/s10049-024-01... 🩺 Toxidromes in the Emergency Department Hüser C, Lülsdorff RH, Hackl M. Emergency Department up2date 2023;05:273–288 https://doi.org/10.1055/a-1850-3465 🏥 Using toxidromes in the ICU Vodovar D, Gosselin S, Wiener SW. Intensive Care Med 2025;51:404–408 https://doi.org/10.1007/s00134-024-07... 🫁 NICO Study: Noninvasive Airway Management of Comatose Patients With Acute Poisoning Freund Y et al. JAMA 2023;330:2267–2274 https://doi.org/10.1001/jama.2023.24391 📊 REITOX Annual Report 2025 – Situation of Illegal Drugs in Germany https://www.dbdd.de/situation/jahresb... 🧪 Evaluation Report on Drug Checking in Berlin https://www.berlin.de/lb/drogen-sucht... ⚠️ Current Drug Checking Warnings from Berlin https://drugchecking.berlin/aktuelle-... ℹ️ Information on Substances, Toxicromes, and Poisoning https://www.toxinfo.de DISCLAIMER This video is for medical training and continuing education purposes only. This information does not replace individual medical assessment, local standard operating procedures (SOPs), guidelines, specialist information, or consultation with a poison control center. Diagnostics and treatment must always be adapted to the specific clinical situation, available resources, and applicable local standards. Dosages and procedures must be independently verified before use. In case of suspected acute poisoning, contact a poison control center as soon as possible. In medical emergencies, call 112. The information presented here is not intended as a guide for acquiring, manufacturing, or consuming psychoactive substances. Consumption is associated with significant health risks; composition, active ingredient content, and impurities are often unknown. #EmergencyMedicine #EmergencyMedicalServices #DrugIntoxication #Toxicology #NeverLoseTheWire