[Active involvement of pharmacists in initial treatments for acute poisoning and overdosed patients in the intensive care unit].

We have developed guidelines of pharmaceutical activity which describes how pharmacists are actively involved in supporting the initial treatment of poisoning and overdosed patients in the Intensive Care Unit (ICU). These guidelines are derived from the original procedural manual that consisted of protocol charts. The charts provide the pharmacist including ICU staff members with directions for the collection of clinical information and the forms to use for documentation. We focused on appropriate collection and proper preservation of collected samples in order to perform diagnostic analysis when needed. The original Information Record Form, completed by the participating pharmacist, documents all information regarding the patient's care. This record provides for integration of the diverse and complicated clinical information of the patient so that the physician can gain a comprehensive picture of the patient. The guidelines, manual book, materials for sample collection and the Information Record Form are stored in a container called the "Poisoning Aid Set", which will be available in the ICU. The guidelines are activated once an emergency call from paramedics is received regarding a suspected poisoning patient. According to the guidelines, the emergency room (ER) physician immediately contacts the pharmacist who will provide his professional services as a member of the treatment team. We have applied these guidelines to 29 poisoning patients and have critically evaluated for effectiveness. Early participation by pharmacists, by reviewing timely, accurate and competent clinical information enabled the pharmacist to identify the suspected drug from the biological samples obtained. From our experiences, we conclude that this active involvement of pharmacist in the initial treatment of poisoning and overdosed patients in the ICU was both supportive and beneficial to the patient. In addition, the participation of pharmacist as a member of a treatment team provided an excellent opportunity to collaborate with the entire ICU staff members.