[Availability of antidotes in French emergency medical aid units].
OBJECTIVE
To study the availability of antidotes in French emergency medical aid units (SAMU).


METHODS
The physicians or nurses responsible for antidotes in French emergency medical aid units (SAMU) were interviewed by phone. The study involved 102 SAMU in metropolitan France. Four answers on availability of 37 antidotes were possible: the antidote was available in the emergency vehicle used for interventions; the antidote was available in the hospital-located SAMU; the antidote was available in the referral hospital (emergency unit, intensive care unit, operating room, pharmacy); the antidote was not available or not known to be available.


RESULTS
Adrenaline and atropine were available in all the intervention vehicles. Nine other antidotes were available in more than two-thirds of the vehicles: 30% glucose (101/102), isoprenaline (100/102), dobutamine (98/112), sodium bicarbonate (97/102), naloxone (95/102), calcium chloride or bicarbonate (89/102), flumazénil (83/102), sodium lactate (77/102), and magnesium sulfate (66/102). Among the other antidotes, hydroxocobalamine and propranolol were available in 24/102 intervention vehicles and activated charcoal in 22/102. Antidigitalic antibodies and 4-methylpyrazole were not available in any vehicle, and were available in less than 25% of the hospitals.


CONCLUSIONS
There is a great disparity of antidote availability. Certain essential antidotes, for which there is no alternative, are not available in emergency intervention vehicles and even in the hospital. The SAMU should develop an economically acceptable departmental management scheme for exceptional-use antidotes.
SAMU 93, Hôpital Avicenne, 125, route de Stalingrad, F93009 Bobigny. frederic.lapostolle@avc.ap-hop-paris.fr
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Lapostolle
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Alayrac
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Adnet
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JP
Maistre
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Leseur
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Lapandry
D000552:Ambulances; D000931:Antidotes / Q000600:supply & distribution*; D004632:Emergency Medical Services / Q000592:standards* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data; D005602:France; D019538:Health Care Surveys; D006801:Humans
D000931:Antidotes