Quality of poisoning management advice in the Monthly Index of Medical Specialties Annual.
BACKGROUND
The Monthly Index of Medical Specialties (MIMS) contains Therapeutic Goods Administration-approved product information supplied by manufacturers. It is widely used by health-care professionals but is not specifically designed as a toxicology reference.


OBJECTIVE
To determine how widespread the use of MIMS is as a toxicology reference. To evaluate the quality of poisoning management advice it contains.


METHODS
First, a survey of 500 consecutive calls to the NSW Poison Information Centre (PIC) was undertaken asking health-care workers which toxicology references were consulted prior to calling and which references they would use if the PIC were not available. Second, a consensus opinion for poisoning management was obtained, for 25 medications which are either commonly involved in poisoning or potentially life-threatening in overdose, by review of 5 current toxicology references for contraindicated treatments, ineffective treatments and specific recommended treatments and antidotes. MIMS poisoning management advice was then compared with this toxicology consensus opinion.


RESULTS
In total, 276 doctors and 222 nurses were surveyed. Prior to calling the PIC 22.8% of doctors and 6.8% of nurses consulted MIMS. In total, 25.7% of doctors and 39.6% nurses stated they would use the MIMS for poisoning management advice if the PIC were not available. For the 25 drugs assessed, 14 contained inaccurate poisoning management: 1 recommended ineffective treatments and 14 omitted specific treatments or antidotes.


CONCLUSIONS
The MIMS is often used as a toxicology reference by physicians prior to calling the PIC. It contains a number of significant inaccuracies pertaining to management of poisonings and should not be used as a primary reference for poisoning advice.
Mallows
James
J
Department of Emergency Medicine, Nepean Hospital, Kingswood, New South Wales, Australia. mallowj@wahs.nsw.gov.au
Chan
Betty
B
Graudins
Andis
A
D001315:Australia; D062787:Drug Overdose / Q000628:therapy*; D004635:Emergency Medicine / Q000706:statistics & numerical data; D016529:Emergency Nursing / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007255:Information Services / Q000592:standards* / Q000706:statistics & numerical data; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic / Q000592:standards; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012014:Reference Books, Medical; D018570:Risk Assessment / Q000379:methods; D014116:Toxicology / Q000295:instrumentation*