Evaluate the impact of hospital types on the availability of antidotes for the management of acute toxic exposures and poisonings in Malaysia

Al-Sohaim, Sulaiman I; Awang, Rahmat; Zyoud, Sa’ed H.; Rashid, Sazaroni M D; Hashim, Sirajuddin

doi:10.1177/0960327111405861

Cited by 19 publications

(23 citation statements)

References 23 publications

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“…Currently, there are no generally recognised specific criteria that define the preparedness of an ED for the management of acute toxic exposures and poisonings. A list of commonly required resources and items which might be used for the treatment of acute poisoning was compiled from the published recommendations [8,11,16,27-31]. …”

Section: Discussionmentioning

confidence: 99%

Availability of treatment resources for the management of acute toxic exposures and poisonings in emergency departments among various types of hospitals in Palestine: a cross-sectional study

Zyoud

Al-Jabi

Bali

et al. 2014

Scand J Trauma Resusc Emerg Med

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BackgroundPoisoning exposures continue to be a significant cause of morbidity and mortality worldwide. The lack of facilities, treatment resources, and antidotes in hospitals may affect the treatments provided and outcomes. This study aimed to determine the availability of gastrointestinal (GI) decontamination, stabilisation, elimination enhancement resources, and antidotes for the management of acute toxic exposures and poisonings in emergency departments (EDs) among various types of governmental and private hospitals in Palestine.MethodsA cross-sectional study using semi-structured questionnaire was performed. Data were collected based on hospital resources; GI decontamination, stabilisation, elimination enhancement resources and antidotes from Palestinian hospitals.ResultsEighteen hospitals (94.7%) have responded. Among them, paracetamol poisoning was the most frequently reported cases by EDs (mean frequency score = 7.6 ± 2.1), followed by bee stings (mean = 6.9 ± 2.7) and organophosphate poisoning (mean = 6.7 ± 2.7). The availabilities of most resources related to GI decontamination items varied substantially with hospital type, but these differences were not statistical significant. The availability of stabilisation resources was not significantly different between hospitals types. For the availability of techniques used to enhance the elimination of toxic substances, there were variations between the hospitals types. However, these differences were not statistical significant, except for haemodialysis (p = 0.003) which was more available in governmental hospitals. For the availability of antidotes, none of the hospitals had sufficient stock of all antidotes listed. In relation to hospital type, there was variability in the availability of antidotes, but this did not reach statistical significance, except for deferoxamine (p < 0.001), which was available in all governmental hospitals but none of the private hospitals.ConclusionsThe availability of treatment resources and antidotes in Palestinian hospitals was not adequate except for stabilisation resources. The availability of such resources acts as a marker for the level of readiness of hospital EDs in Palestine for the management of acute toxic exposure and poisoning. The implementation of a minimum list of antidotes and treatment resources would be useful to increase the level of resources. Coordination between Palestinian poison control and drug information centre and hospitals is also important.

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Section: Discussionmentioning

confidence: 99%

Availability of treatment resources for the management of acute toxic exposures and poisonings in emergency departments among various types of hospitals in Palestine: a cross-sectional study

Zyoud

Al-Jabi

Bali

et al. 2014

Scand J Trauma Resusc Emerg Med

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“…The distance between the general hospital and the district one is not more than 100 km. Each state has at least one general hospital, and is supported by district hospitals, polyclinics as well as rural clinics [17]. The General Hospitals are the biggest government hospitals in each state of Malaysia.…”

Section: Study Area and Sample Sizementioning

confidence: 99%

Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

et al. 2011

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Acute poisoning is a common medical emergency in Malaysia. Life can be saved if the patient is diagnosed properly and receives the appropriate treatment such as gastrointestinal decontamination techniques and resources to increase poison elimination according to clinical guidelines at a reasonable time. The aims of this study were to determine the availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in accident and emergency departments in Malaysia, and to compare the availability of such facilities among various types of hospitals. A comparative, descriptive cross-sectional study was conducted using a structured questionnaire. Seventy-four (58.3%) out of the targeted 127 hospitals replied and completed the questionnaire. The availabilities of most items related to stabilization resources were far better in general hospitals compared to district hospitals with specialists and district hospitals without specialists. These items were mechanical ventilators (p = 0.011), non-invasive positive pressure ventilators (0.024), pacemakers (p = 0.019), and transcutaneous cardiac pacing (p < 0.001). The availability of decontamination resources varied substantially with hospital type. Nevertheless, these differences did not reach statistical significance in any of the cases, whereas sodium sulphate, sorbitol, and polyethylene glycol were almost never available. The availabilities of most items related to elimination enhancement resources were far better in general hospitals and district hospitals with specialists compared to district hospitals without specialists. These items were haemodialysis (p = 0.046), haemoperfusion (p = 0.002), haemofiltration (p = 0.002), acid diuresis (p = 0.04), peritoneal dialysis (p < 0.001), and exchange transfusion (p < 0.001). Most Malaysian hospitals have certain important immediate interventions such as gastrointestinal decontamination techniques and resources to increase poison elimination. The availabilities of most facilities were far better in the general hospitals. Coordination between the National Poison Centre in Malaysia and hospitals should be established regarding the emergency facilities for effective management of poisoning cases in each hospital in order to direct the poisoned patients to the hospital where the appropriate management resources is available.

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“…Although emergency supportive care is considered the foundation of toxicological emergency management, unintentional and intentional poisoning continue to be a major contributor to annual mortality rates worldwide [2]. Morbidity, mortality, and the length of hospitalization may be reduced by the appropriate and well-timed use of antidotes [3]. The mainstay in the proper management of a patient in need for an antidote is the immediate administration of the needed antidote and its availability in the hospital emergency.…”

Section: Introductionmentioning

confidence: 99%

“…Data on the availability of antidotes globally is scarce, however recent studies have shown that antidotes are inadequately stocked in many countries and their availability also varies significantly among hospitals within the same country [3–6]. Accordingly, Dart et al, developed recommendations for antidote stocking and categorizing their availability according to the immediacy of their use in USA [7].…”

Section: Introductionmentioning

confidence: 99%

“…Considering such guidelines are still largely missing in Lebanon, it is therefore recommended to first document antidotes stocking before developing the guidelines [7]. Data also shows that antidote stoking varies by the hospital sector (public or private), bed capacity, presence of particular medical specialists (e.g., emergency care), and number of expected poisoning cases [3, 4]. Lebanon, a country of 4 million inhabitants in the Middle East, has a healthcare system dominated by the private sector, where less than 17 % of its hospitals are administered by the public sector [8].…”

Section: Introductionmentioning

confidence: 99%

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National study on the adequacy of antidotes stocking in Lebanese hospitals providing emergency care

Mansour

Al-Bizri

El-Maamary

et al. 2016

BMC Pharmacol Toxicol

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BackgroundAntidotes stocking is a critical component of hospital care for poisoned patients in emergency. Antidote stocking represents a major health challenge worldwide and in Lebanon. Systematic data monitoring of antidote stocking in Lebanese hospitals is lacking. The objective of this study is to assess the adequacy of antidotes stocking in Lebanese hospitals according to type and quantity and explore the characteristics associated with their differential availability.MethodsData collection to assess antidote availability and its correlate was undertaken through a self-administered questionnaire. The questionnaires were distributed by the unit of surveillance at the Ministry of Public Health to eligible hospitals providing emergency care services. The list of essential antidotes was adapted from the World Health Organization (WHO) list and the British Columbia Drug and Poison Information Centre.ResultsAmong the 85 Lebanese hospitals surveyed none had in stock all the 35 essential antidotes required. The frequency of stocking by type of antidote varied from a minimum of 1.2 % of the hospitals having a (cyanide kit) to 100 % availability of (atropine and calcium gluconate). Teaching hospitals and those with a large bed-capacity reported a higher number of available antidotes for both immediate and non-immediate use than non-teaching hospitals while controlling for the hospital geographical region and public vs private sector.ConclusionThe Lebanese hospitals have a suboptimal stock of essential antidotes supply. It is recommended that the Lebanese Ministry of Public Health monitors closely on the hospital premises the adequacy and availability of essential antidotes stock.Electronic supplementary materialThe online version of this article (doi:10.1186/s40360-016-0092-7) contains supplementary material, which is available to authorized users.

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Evaluate the impact of hospital types on the availability of antidotes for the management of acute toxic exposures and poisonings in Malaysia

Cited by 19 publications

References 23 publications

Availability of treatment resources for the management of acute toxic exposures and poisonings in emergency departments among various types of hospitals in Palestine: a cross-sectional study

Availability of treatment resources for the management of acute toxic exposures and poisonings in emergency departments among various types of hospitals in Palestine: a cross-sectional study

Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia

National study on the adequacy of antidotes stocking in Lebanese hospitals providing emergency care

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