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

被引：79

作者：

Dart, Richard C. ^{[1
,11
]}

Borron, Stephen W. ^{[2
]}

Caravati, E. Martin ^{[3
]}

Cobaugh, Daniel J. ^{[4
]}

Curry, Steven C. ^{[5
,6
]}

Falk, Jay L. ^{[7
]}

Goldfrank, Lewis ^{[8
]}

Gorman, Susan E. ^{[9
]}

Groft, Stephen ^{[10
]}

Heard, Kennon ^{[1
,11
]}

Miller, Ken ^{[13
,14
]}

Olson, Kent R. ^{[15
,16
]}

O'Malley, Gerald ^{[17
]}

Seger, Donna ^{[18
]}

Seifert, Steven A. ^{[19
]}

Sivilotti, Marco L. A. ^{[20
,21
]}

Schaeffer, Tammi ^{[1
,11
]}

Tomassoni, Anthony J. ^{[22
,23
]}

Wise, Robert ^{[24
]}

Bogdan, Gregory M. ^{[1
,12
]}

Alhelail, Mohammed ^{[1
]}

Buchanan, Jennie ^{[1
]}

Hoppe, Jason ^{[1
]}

Lavonas, Eric ^{[1
,11
]}

Mlynarchek, Sara ^{[1
]}

Phua, Dong-Haur ^{[1
]}

Rhyee, Sean ^{[1
]}

Varney, Shawn ^{[1
]}

Zosel, Amy ^{[1
]}

机构：

[1] Rocky Mt Poison & Drug Ctr Denver Hlth, Denver, CO USA

[2] Univ Texas Hlth Sci Ctr San Antonio, Dept Surg, San Antonio, TX 78229 USA

[3] Univ Utah, Hlth Sci Ctr, Utah Poison Control Ctr, Div Emergency Med, Salt Lake City, UT USA

[4] ASHP Res & Educ Fdn, Bethesda, MD USA

[5] Banner Good Samaritan Med Ctr, Dept Med Toxicol, Phoenix, AZ USA

[6] Banner Good Samaritan Med Ctr, Banner Poison Control Ctr, Phoenix, AZ USA

[7] Univ Florida, Dept Emergency Med, Orlando Reg Med Ctr, Orlando, FL USA

[8] NYU, Sch Med, New York City Poison Ctr, New York, NY USA

[9] Ctr Dis Control & Prevent, Div Strateg Natl Stockpile, Atlanta, GA USA

[10] Off Rare Dis Res, Bethesda, MD USA

[11] Univ Colorado Denver, Sch Med, Div Emergency Med, Aurora, CO USA

[12] Univ Colorado Denver, Sch Pharm, Dept Pharmaceut Sci, Aurora, CO USA

[13] Orange Cty Fire Author & Orange Cty Hlth Care Agc, Emergency Med Serv, Irvine, CA USA

[14] Natl Assoc EMS Phys, Lenexa, KS USA

[15] Univ Calif San Francisco, San Francisco, CA 94143 USA

[16] Calif Poison Control Syst, San Francisco Div, San Francisco, CA 94143 USA

[17] Albert Einstein Med Ctr, Dept Emergency Med, Div Res, Philadelphia, PA 19141 USA

[18] Vanderbilt Univ, Div Clin Pharmacol, Dept Med, Tennessee Poison Ctr,Med Ctr, Nashville, TN USA

[19] Univ New Mexico, Sch Med & Med Director, New Mexico Poison & Drug Informat Ctr, Albuquerque, NM 87131 USA

[20] Queens Univ, Dept Emergency Med, Kingston, ON K7L 3N6, Canada

[21] Queens Univ, Dept Pharmacol & Toxicol, Kingston, ON K7L 3N6, Canada

[22] Yale Univ, Sch Med, Dept Surg, Sect Emergency Med, New Haven, CT 06510 USA

[23] Yale New Haven Ctr Emergency Preparedness & Disas, New Haven, CT USA

[24] Int Joint Commiss, Div Stand & Survey Methods, Oak Brook Terrace, IL USA

来源：

ANNALS OF EMERGENCY MEDICINE | 2009年 / 54卷 / 03期

关键词：

POISONING ANTIDOTES; AVAILABILITY;

D O I：

10.1016/j.annemergmed.2009.01.023

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: We developed recommendations for antidote stocking at hospitals that provide emergency care. Methods: An expert panel representing diverse perspectives (clinical pharmacology, clinical toxicology, critical care medicine, clinical pharmacy, emergency medicine, internal medicine, pediatrics, poison centers, pulmonary medicine, and hospital accreditation) 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 the quantity of an antidote that should be stocked and the acceptable period for delivery of each antidote. Results: The panel recommended consideration of 24 antidotes for stocking. The panel recommended that 12 of the antidotes be available for immediate administration on patient arrival. In most hospitals, this period requires that the antidote be stocked in the emergency department. Another 9 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 identified additional antidotes that should be stocked by the hospital but are not usually needed within the first hour of treatment. The panel recommended that each hospital perform a formal antidote hazard vulnerability assessment to determine the need for antidote stocking in that hospital. Conclusion: The antidote expert recommendations provide a tool to be used in creating practices for appropriate and adequate antidote stocking in hospitals that provide emergency care. [Ann Emerg Med. 2009;54:386-394.]

引用

页码：386 / 394

页数：9

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