Expert consensus guidelines for stocking of antidotes in hospitals that provide emergency care.
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.
Dart
Richard C
RC
Rocky Mountain Poison & Drug Center - Denver Health, Denver, CO, USA. rdart@rmpdc.org
Borron
Stephen W
SW
Caravati
E Martin
EM
Cobaugh
Daniel J
DJ
Curry
Steven C
SC
Falk
Jay L
JL
Goldfrank
Lewis
L
Gorman
Susan E
SE
Groft
Stephen
S
Heard
Kennon
K
Miller
Ken
K
Olson
Kent R
KR
O'Malley
Gerald
G
Seger
Donna
D
Seifert
Steven A
SA
Sivilotti
Marco L A
ML
Schaeffer
Tammi
T
Tomassoni
Anthony J
AJ
Wise
Robert
R
Bogdan
Gregory M
GM
Alhelail
Mohammed
M
Buchanan
Jennie
J
Hoppe
Jason
J
Lavonas
Eric
E
Mlynarchek
Sara
S
Phua
Dong-Haur
DH
Rhyee
Sean
S
Varney
Shawn
S
Zosel
Amy
A
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
D000931:Antidotes