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

Abstract

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.

An Appraisal of Antidotes’ Effectiveness: Evidence of the Use of Phyto-Antidotes and Biotechnological Advancements

“…Although adequate measures are available in most developed countries to combat poisoning when reported early, more efficient methods of dissemination and administration of these antidotes are also under appraised. Studies, however, revealed inadequate stocking [5,6,[20][21][22] and in some cases, absence of some essential antidotes [4] as major hindrances. This is in sharp contrast to the experience in most rural areas and developing countries where antidotes are hardly available, leaving them with the only option of herbal antidotes.…”

“…However, relevant antisera not being stocked and in insufficient amounts remains a daunting problem. This problem has been repeatedly documented for a range of antidotes in many developed nations, including the United Kingdom (UK), Canada, the US [20,21], Qatar [22] and Korea [5].…”

Pesticide surveillance and deaths by suicide

“…Buckley and colleagues note the availability of more emergency departments, postgraduate training in toxicology, updated treatment guidelines, and wider availability of antidotes in Sri Lanka over the study period. 3 Data from several lowincome countries highlight the limited and variable availability of treatment resources for managing poisoning, 8,9 flagging the potential for improvements in care alongside pesticide regulation in averting deaths from pesticides.…”

Expert consensus for a national essential antidote list: E-Delphi method

“…Unfortunately, the stocking of antidotes has been a “persistent concern” for over 35 years [ 1 ]. Countries have conducted regular audits on antidotes stocking, and many researchers have recommended the development of a national list and stocking guidelines to standardize care [ 4 , 6 , 7 ]. A globally recognized consensus guideline recommended a “list” of antidotes to be stocked for timely delivery of essential antidotes to the emergency department [ 1 ].…”