The National Poisons Information Service and the Royal College of Emergency Medicine carried out an audit in 2010/2011 into antidote availability and demonstrated variable stocking of antidotes for the management of poisoned patients.1 To assess if antidote stocking had improved since the 2010/2011 audit and introduction of the 2013 Guidelines, questionnaires were sent to Chief Pharmacists in all 215 acute hospitals in England, Wales and Northern Ireland in October 2014. Data were collected on the timing of availability (category A antidotes should be available immediately, category B within 1 h and category C can be held supraregionally) and stock levels.2
One hundred and sixty-nine (78.6%) responses were received. Atropine, calcium gluconate and ﬂumazenil (category A) were the only antidotes available in all hospitals within the recommended time and stock levels. Forty-one (24.3%) hospitals held every category A antidote; this increased to 81 (47.9%) for those holding at least one cyanide antidote and all other category A antidotes. The proportion of hospitals stocking category A/B antidotes within the recommended time increased for 20 (90.9%) category A/B antidotes. Fomepizole (category B) availability increased to 62.1% of hospitals from 11.4% in 2010/2011. Other than penicillamine (63.3% hospitals), there was poor availability (2.4%–36.1%) of category C antidotes.
Availability of category A and B antidotes has improved since the 2010/2011 audit and 2013 Guidelines. However, there remains signiﬁcant variability particularly for category C antidotes. More work is required to ensure that those treating poisoned patients have timely access to antidotes focusing particularly on category C antidotes.
- Thanacoody RHK, Aldridge G, Laing W, Dargan PI, Nash S, Thompson JP, Vale A, Bateman N, Thomas S. National audit of antidote stocking in acute hospitals in the UK. Emerg Med J 2013; 30: 393–396.
- Bailey GP, Rehman B, Wind K, Wood DM, Thanacoody R, Bash S, Archer JRH, Eddleston M, Thompson JP, Vale JA, Thomas SHL, Dargan PI. Taking stock: UK national antidote availability increasing, but further improvements are required. European Journal of Hospital Pharmacy 2016; 23: 145–150.
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