title: Expert consensus guidelines for stocking of antidotes in hospitals that provide emergency care.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Rocky Mountain Poison & Drug Center - Denver Health, Denver, CO, USA. rdart@rmpdc.org
authors.forename: Richard C
authors.initials: RC
authors.lastname: Dart
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Borron
authors.forename: E Martin
authors.initials: EM
authors.lastname: Caravati
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cobaugh
authors.forename: Steven C
authors.initials: SC
authors.lastname: Curry
authors.forename: Jay L
authors.initials: JL
authors.lastname: Falk
authors.forename: Lewis
authors.initials: L
authors.lastname: Goldfrank
authors.forename: Susan E
authors.initials: SE
authors.lastname: Gorman
authors.forename: Stephen
authors.initials: S
authors.lastname: Groft
authors.forename: Kennon
authors.initials: K
authors.lastname: Heard
authors.forename: Ken
authors.initials: K
authors.lastname: Miller
authors.forename: Kent R
authors.initials: KR
authors.lastname: Olson
authors.forename: Gerald
authors.initials: G
authors.lastname: O'Malley
authors.forename: Donna
authors.initials: D
authors.lastname: Seger
authors.forename: Steven A
authors.initials: SA
authors.lastname: Seifert
authors.forename: Marco L A
authors.initials: ML
authors.lastname: Sivilotti
authors.forename: Tammi
authors.initials: T
authors.lastname: Schaeffer
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Tomassoni
authors.forename: Robert
authors.initials: R
authors.lastname: Wise
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Bogdan
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alhelail
authors.forename: Jennie
authors.initials: J
authors.lastname: Buchanan
authors.forename: Jason
authors.initials: J
authors.lastname: Hoppe
authors.forename: Eric
authors.initials: E
authors.lastname: Lavonas
authors.forename: Sara
authors.initials: S
authors.lastname: Mlynarchek
authors.forename: Dong-Haur
authors.initials: DH
authors.lastname: Phua
authors.forename: Sean
authors.initials: S
authors.lastname: Rhyee
authors.forename: Shawn
authors.initials: S
authors.lastname: Varney
authors.forename: Amy
authors.initials: A
authors.lastname: Zosel
mesh_terms: D000931:Antidotes / Q000600:supply & distribution*; D004356:Drug Storage; D004363:Drug Utilization; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine; D006801:Humans; D010607:Pharmacy Service, Hospital
chemical_list: D000931:Antidotes