Hospitals have variable stock levels of antidotes

Hospital stock control of antidotes to treat poisoned patients have improved but there is still “significant” differences between NHS trusts, according to research published in the European Journal of Hospital
Pharmacy
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on 18 November 2015.

Researchers set out to discover whether hospitals in England, Wales and Northern Ireland had improved their antidote stock control after new guidelines were introduced in 2013. Guidelines were introduced following the results of an audit carried out in 2010–2011 that showed “variable” levels of available antidotes — for example, 15.0% of hospitals failed to carry any antidotes for alcohol poisoning and 4.6% had no antidotes for cyanide poisoning. 

The researchers sent a questionnaire to chief pharmacists at 215 acute trusts which asked them about their stocks of category A, B and C antidotes. 

Only 24.3% of hospitals held every category A antidote – these are antidotes, for example, for the treatment of drug poisoning such as paracetamol, opioid painkillers and cyanide. Some 47.9% of hospitals held at least one cyanide antidote and all other category A antidotes. They found that only category A antidotes of atropine, calcium gluconate and flumazenil were available in all hospitals within the recommended time and recommended stock levels. 

All category B antidotes that should be available within an hour were stocked in 17.6% of hospitals; 36.7% of hospitals held all category B antidotes. 

Other than penicillamine, which was stocked in 63.3% of hospitals, there was poor availability of trusts stocking category C antidotes of between 2.4% and 36.1%. 

The researchers said availability of category A and B antidotes has improved since the 2010–2011 audit and the guidelines. But there was still “significant variability particularly for category C antidotes” and that “more work is required to ensure that those treating poisoned patients have timely access to antidotes.”