Expert Consensus Guidelines for Stocking of Antidotes in Hospitals That Provide Emergency Care

被引:54
|
作者
Dart, Richard C. [1 ]
Goldfrank, Lewis R. [2 ]
Erstad, Brian L. [3 ]
Huang, David T. [4 ,5 ]
Todd, Knox H. [6 ]
Weitz, Jeffrey [7 ]
Bebarta, Vikhyat S. [8 ]
Caravati, E. Martin [9 ]
Henretig, Fred M. [10 ]
Delbridge, Theodore R. [11 ]
Banner, William [12 ]
Schneider, Sandra M. [13 ]
Anderson, Victoria E. [1 ]
机构
[1] Denver Hlth & Hosp Author, Rocky Mt Poison & Drug Ctr, Denver, CO 80204 USA
[2] NYU, Sch Med, Ronald O Perelman Dept Emergency Med, New York, NY USA
[3] Univ Arizona, Coll Pharm, Dept Pharm Practice & Sci, Tucson, AZ 85721 USA
[4] Univ Pittsburgh, Multidisciplinary Acute Care Res Org Ctr, Dept Crit Care, Pittsburgh, PA USA
[5] Univ Pittsburgh, Dept Emergency Med, Multidisciplinary Acute Care Res Org Ctr, Pittsburgh, PA USA
[6] EMLine, Mendoza, Argentina
[7] Hamilton Gen Hosp, Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada
[8] Univ Colorado, Sch Med, Dept Emergency Med, Sect Med Toxicol, Aurora, CO USA
[9] Univ Utah, Sch Med, Div Emergency Med, Salt Lake City, UT USA
[10] Univ Penn, Perelman Sch Med, Div Emergency Med, Dept Pediat,Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA
[11] East Carolina Univ, Dept Emergency Med, Greenville, NC USA
[12] Univ Oklahoma, Coll Pharm, Oklahoma Ctr Poison & Drug Informat, Oklahoma City, OK USA
[13] Hofstra Northwell Sch Med, Dept Emergency Med, Hempstead, NY USA
关键词
INSUFFICIENT STOCKING; POISONING ANTIDOTES; AVAILABILITY; MANAGEMENT; DRUGS;
D O I
10.1016/j.annemergmed.2017.05.021
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
We provide recommendations for stocking of antidotes used in emergency departments (EDs). An expert panel representing diverse perspectives (clinical pharmacology, medical toxicology, critical care medicine, hematology/oncology, hospital pharmacy, emergency medicine, emergency medical services, pediatric emergency medicine, pediatric critical care medicine, poison centers, hospital administration, and public health) was formed to create recommendations for antidote stocking. Using a standardized summary of the medical literature, the primary reviewer for each antidote proposed guidelines for antidote stocking to the full panel. The panel used a formal iterative process to reach their recommendation for both the quantity of antidote that should be stocked and the acceptable timeframe for its delivery. The panel recommended consideration of 45 antidotes; 44 were recommended for stocking, of which 23 should be immediately available. In most hospitals, this timeframe requires that the antidote be stocked in a location that allows immediate availability. Another 14 antidotes were recommended for availability within 1 hour of the decision to administer, allowing the antidote to be stocked in the hospital pharmacy if the hospital has a mechanism for prompt delivery of antidotes. The panel recommended that each hospital perform a formal antidote hazard vulnerability assessment to determine its specific need for antidote stocking. Antidote administration is an important part of emergency care. These expert recommendations provide a tool for hospitals that offer emergency care to provide appropriate care of poisoned patients.
引用
收藏
页码:314 / 325
页数:12
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