Dart Richard C, Borron Stephen W, Caravati E Martin, Cobaugh Daniel J, Curry Steven C, Falk Jay L, Goldfrank Lewis, Gorman Susan E, Groft Stephen, Heard Kennon, Miller Ken, Olson Kent R, O'Malley Gerald, Seger Donna, Seifert Steven A, Sivilotti Marco L A, Schaeffer Tammi, Tomassoni Anthony J, Wise Robert, Bogdan Gregory M, Alhelail Mohammed, Buchanan Jennie, Hoppe Jason, Lavonas Eric, Mlynarchek Sara, Phua Dong-Haur, Rhyee Sean, Varney Shawn, Zosel Amy
Rocky Mountain Poison & Drug Center - Denver Health, Denver, CO, USA.
Ann Emerg Med. 2009 Sep;54(3):386-394.e1. doi: 10.1016/j.annemergmed.2009.01.023. Epub 2009 May 5.
We developed recommendations for antidote stocking at hospitals that provide emergency care.
An expert panel representing diverse perspectives (clinical pharmacology, clinical toxicology, critical care medicine, clinical pharmacy, emergency medicine, internal medicine, pediatrics, poison centers, pulmonary medicine, and hospital accreditation) was formed to create recommendations for antidote stocking. Using a standardized summary of the medical literature, the primary reviewer for each antidote proposed guidelines for antidote stocking to the full panel. The panel used a formal iterative process to reach their recommendation for the quantity of an antidote that should be stocked and the acceptable period for delivery of each antidote.
The panel recommended consideration of 24 antidotes for stocking. The panel recommended that 12 of the antidotes be available for immediate administration on patient arrival. In most hospitals, this period requires that the antidote be stocked in the emergency department. Another 9 antidotes were recommended for availability within 1 hour of the decision to administer, allowing the antidote to be stocked in the hospital pharmacy if the hospital has a mechanism for prompt delivery of antidotes. The panel identified additional antidotes that should be stocked by the hospital but are not usually needed within the first hour of treatment. The panel recommended that each hospital perform a formal antidote hazard vulnerability assessment to determine the need for antidote stocking in that hospital.
The antidote expert recommendations provide a tool to be used in creating practices for appropriate and adequate antidote stocking in hospitals that provide emergency care.
我们为提供急诊护理的医院制定了解毒剂储备建议。
成立了一个代表不同专业领域（临床药理学、临床毒理学、重症医学、临床药学、急诊医学、内科、儿科、中毒控制中心、肺病学和医院评审）的专家小组，以制定解毒剂储备建议。每位解毒剂的主要评审员利用医学文献的标准化摘要，向整个专家小组提出解毒剂储备指南。该小组采用正式的迭代过程，以确定每种解毒剂的储备数量建议以及每种解毒剂的可接受交付时间。
该小组建议考虑储备24种解毒剂。该小组建议其中12种解毒剂在患者到达时可供立即使用。在大多数医院，这要求解毒剂储备在急诊科。另外9种解毒剂建议在决定使用后1小时内可供使用，这使得如果医院有快速提供解毒剂的机制，解毒剂可储备在医院药房。该小组确定了医院应储备的其他解毒剂，但在治疗的第一小时内通常不需要。该小组建议每家医院进行正式的解毒剂危害脆弱性评估，以确定该医院解毒剂储备的需求。
解毒剂专家建议提供了一种工具，可用于为提供急诊护理的医院制定适当和充足的解毒剂储备方案。
