Availability of antidotes for the treatment of acute poisoning in Queensland public hospitals.
OBJECTIVE
To determine the sufficiency of stock levels of 13 antidotes in Queensland hospitals.


METHODS
A self-report survey was sent to 128 Queensland hospitals with acute care facilities. The stock level of the following antidotes was determined: acetylcysteine, anti-digoxin Fab antibodies (digibind), atropine, calcium gluconate, cyanokit, desferrioxamine, flumazenil, glucagon, intravenous ethanol, methylene blue, naloxone, pralidoxime and pyridoxine. Other factors sampled were bed capacity, rural, remote and metropolitan areas classification, use of formal stock reviews by pharmacists or nurses, existence of formal borrowing agreements with other facilities for non-stocked antidotes, distance to the nearest referral hospital and time taken to transfer antidotes from another hospital.


METHODS
Pharmacists or nurses responsible for maintaining antidote stocks in Queensland hospitals.


METHODS
Proportions of hospitals with sufficient antidote stock to treat a 70-kg adult for four or more hours using previously published guidelines.


RESULTS
Survey response rate was 73.4%. No hospital had sufficient stock of all 13 antidotes. The proportion of hospitals with sufficient stocks varied from 0% (pyridoxine) to 68.1% (acetylcysteine). Larger hospitals had a higher frequency of sufficient antidote stocks. Only 16% of hospitals claimed to be able to acquire an antidote from another facility within 30 min.


CONCLUSIONS
Most Queensland hospitals stocked some important antidotes, but few had sufficient stock to treat a 70-kg patient or acquire an antidote within the recommended time frame of 30 min. Specific antidote stocking guidelines might be required for Queensland hospitals. A formalised program for stock rotation with rural facilities should be explored.
Nissen
Lisa M
LM
University of Queensland, Brisbane, Australia.
Wong
Kai Hang
KH
Jones
Anthea
A
Roberts
Darren M
DM
D000328:Adult; D000931:Antidotes / Q000600:supply & distribution*; D004636:Emergency Service, Hospital; D006779:Hospitals, Public; D006801:Humans; D011041:Poisoning / Q000628:therapy*; D011793:Queensland
D000931:Antidotes