<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1887-8571</journal-id>
<journal-title><![CDATA[Sanidad Militar]]></journal-title>
<abbrev-journal-title><![CDATA[Sanid. Mil.]]></abbrev-journal-title>
<issn>1887-8571</issn>
<publisher>
<publisher-name><![CDATA[Ministerio de Defensa]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1887-85712023000100004</article-id>
<article-id pub-id-type="doi">10.4321/s1887-85712023000100004</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Sumisión química en los Servicios de Urgencias de la Red Hospitalaria]]></article-title>
<article-title xml:lang="en"><![CDATA[Chemical submission in the Emergency Services of the Hospital Network]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Viudes]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Llorente-Ballesteros]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guzmán-Rosario]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mena-Pérez-Montaut]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villegas-Vallbona]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Urquía-Grande]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Central de la Defensa Gómez Ulla Servicio de Anestesiología y Reanimación ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Central de la Defensa Gómez Ulla Instituto de Toxicología de la Defensa ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Central de la Defensa Gómez Ulla Servicio de Urgencias ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Academia Central de la Defensa Escuela Militar de Sanidad ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Academia Central de la Defensa Escuela Militar de Sanidad ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital Central de la Defensa Gómez Ulla Instituto de Toxicología de la Defensa Área de Cromatografía]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2023</year>
</pub-date>
<volume>79</volume>
<numero>1</numero>
<fpage>18</fpage>
<lpage>21</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1887-85712023000100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1887-85712023000100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1887-85712023000100004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Antecedentes y objetivos: la escopolamina se emplea de forma subrepticia para cometer actos ilícitos. El número de casos de sospecha de consumo de esta sustancia en los servicios sanitarios de urgencias parece haber aumentado en los últimos años. No existe una clara y rigurosa relación con el número de casos descritos en la literatura científica, debido a la dificultad que supone su detección en los sujetos que se encuentran bajo sus efectos. Se plantea la profundización sobre la sumisión química, al describirse un caso clínico registrado en el Servicio de Urgencias del Hospital Central de la Defensa Gómez Ulla y una mejora del abordaje de este tipo de casos desde el triaje.  Material y método: el estudio del caso registrado se ha basado en la descripción del método de detección analítico de la escopolamina y se ha apoyado en una revisión bibliográfica empleando distintas bases especializadas en referencia a intoxicación por escopolamina y su empleo en actos delictivos.  Resultados: se identificó escopolamina. Al ser una sustancia cuya detección es tiempo-dependiente, el Hospital Central de la Defensa Gómez Ulla estableció un protocolo junto con el Instituto de Toxicología de la Defensa en 2018, a fin de realizar analíticas de identificación de sustancias empleadas en los casos de sospecha de sumisión química.  Conclusiones: se plantea la necesidad de establecer protocolos de tipo multidisciplinar adecuados en los servicios de urgencias, estableciendo un diagnóstico diferencial en casos con alteraciones en el nivel de consciencia, al existir la posibilidad de intoxicación por escopolamina y sospecha de sumisión química, ya que la detección de la sustancia es tiempo-dependiente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[SUMMARY  Antecedents and objectives: Scopolamine is used to commit illegal acts. The number of suspected cases of this substance in the Emergency Services seems to have increased in recent years. There is no clear and rigorous relationship with the number of cases described in the scientific literature, due to the difficulty of its detection in subjects who are under its effects. A further study on Chemical Submission is proposed, by describing a clinical case registered in the Emergency Service of the Gómez Ulla Central Defense Hospital and an improvement in the approach to this type of cases from triage.  Material and methods: The study of the registered case has been based on the description of the analytical method and supported by a bibliographic review using different specialized bases in reference to Escopolamine poisoning and its use in criminal acts.  Results: Being a substance whose detection is time-dependent, the Gómez Ulla Central Defense Hospital established a protocol together with the Defense Toxicology Institute in 2018 in order to carry out identification analyzes of substances used in cases of Suspected Submission Chemistry.  Conclusions: The need to establish appropriate multidisciplinary protocols in the Emergency Services arises. Propose a differential diagnosis in cases with alterations in the level of consciousness, as there is the possibility of scopolamine intoxication and suspicion of Chemical Submission, since the detection of the substance is time-dependent.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Escopolamina]]></kwd>
<kwd lng="es"><![CDATA[Intoxicación]]></kwd>
<kwd lng="es"><![CDATA[Sumisión química]]></kwd>
<kwd lng="en"><![CDATA[Scopolamine]]></kwd>
<kwd lng="en"><![CDATA[Intoxication]]></kwd>
<kwd lng="en"><![CDATA[Chemical submission]]></kwd>
</kwd-group>
</article-meta>
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