title: Differences in treatment advice for common poisons by poisons centres--an international comparison.
abstract: OBJECTIVE
  To investigate how poisons centres advise on management of common drug poisonings and compare advice on gut decontamination with the EAPCCT/AACT Position Statements.
  
  
  METHODS
  An interactive questionnaire was sent to 14 poisons centres asking about working practices, "top 20" enquiries in 2002, and management of 4 specific drug poisonings.
  
  
  RESULTS
  Replies were received from centres in 11 countries. Annual telephone enquiry numbers varied from 620 (Sri Lanka) to over 50,000 (Germany for 2000). Recommendations for gut decontamination for acetaminophen poisoning were: activated charcoal (AC) alone (5 centres); gastric lavage (GL) alone (1); AC and/or GL (3); AC, GL and/or ipecac (2). Only 40% (4/10) recommended AC and 50% (3/6) GL within 1 hour. Intervention doses for gut decontamination ranged from 100-200 mg/kg (nine centres) and for "high-risk" groups 75-100 mg/kg (3). Plasma concentration for N-acetylcysteine (NAC) treatment ranged from 150 mg/L (four centres) to 200 mg/L (6) at 4 hours. Results were similarly varied for three other common drug poisons (benzodiazepines, amitriptyline, and paroxetine).
  
  
  CONCLUSIONS
  Most poisons centres have protocols that differ in terms of gut decontamination, timing, and intervention doses. Many centres recommend charcoal or gastric lavage after the 1-hour limit proposed in the Position Statements. There is scope for rationalization of approaches to the management of common poisons.
authors: National Poisons Information Service (Edinburgh), Scottish Poisons Information Bureau, Royal Infirmary, Edinburgh, UK. Alison.good@luht.scot.nhs.uk
authors: Alison M
authors: AM
authors: Good
authors: Catherine A
authors: CA
authors: Kelly
authors: D Nicholas
authors: DN
authors: Bateman
mesh_terms: D000082:Acetaminophen / Q000506:poisoning; D000931:Antidotes / Q000008:administration & dosage; D002606:Charcoal / Q000008:administration & dosage; D003666:Decontamination / Q000379:methods; D004638:Emergency Treatment / Q000379:methods*; D005751:Gastric Lavage; D006801:Humans; D007391:International Cooperation; D007486:Ipecac / Q000008:administration & dosage; D011039:Poison Control Centers; D011041:Poisoning / Q000628:therapy*; D011795:Surveys and Questionnaires
chemical_list: D000931:Antidotes; D002606:Charcoal; D000082:Acetaminophen; D007486:Ipecac