Hospitals lack poison antidotes, survey finds

Dubai // Every hospital in Abu Dhabi has been ordered to stock at least 15 different antidotes to poison after a survey found that only 10 per cent of hospitals had adequate reserves.

By June the new standard will require hospital emergency units to have at least enough antidote to treat a 70kg adult for 24 hours after admission for poisoning.

Reported poisoning cases almost doubled from 60 in 2009 to 119 last year, and there were five cases of death due to poisoning in the UAE in 2010. Children under the age of four constituted nearly half of all poison cases.

The survey showed only ten per cent of hospitals in Abu Dhabi had adequate stock of the universally accepted 12 essential antidotes that should be available in all emergency units.

In response, the Health Authority - Abu Dhabi (HAAD) introduced the Antidote Stocks Standards in Healthcare Facilities.

"We did a two-part survey with hospitals and emergency departments in 2009 where we examined the 12 essential antidotes," said Dr Yasser Sharif, section head of Medication and Medical Product Safety and head of the Poison and Drug Information Centre.

"We found that many hospitals did not have guidelines on how to use antidotes."

Dr Sharif said they also found many hospitals did not have a sharing plan with other hospitals to cope with stock shortages.

Under the new rules, each hospital will sign an agreement with three other hospitals to ensure effective sharing.

"We created the antidote lists from international guidelines, then we sat with our stakeholders, in both public and private hospitals in Abu Dhabi," Dr Sharif said. "Based on their feedback, we formulated our standard."

Internationally, the accepted stock list of antidotes for hospitals includes 12 essentials. HAAD added three to the list.

"The timely use of antidotes is potentially lifesaving, and maintaining a sufficient stock of antidotes is the responsibility of any facility that provides emergency care," Dr Sharif said.

The Antidote Stocks Standard will act as an interim advisory guide for a period of six months and will become mandatory at all HAAD-licensed facilities on June 1.

Hospitals will be required to report their antidote stock level every month. "We want to ensure there is full compliance. They must report to the centre so we can establish effective policies," he said.

"They must have continuous supply of antidotes and replenish their supplies," said Dr Sharif. "If a poisoned patient requires an antidote that is not stocked at a particular hospital, then either the patient must be transferred or the antidote must be obtained from another hospital."

In addition, only a licensed healthcare professional will be allowed to administer the antidote.

Dr Sharif said the standards would apply to all licensed healthcare facilities and emergency departments, but not to medical centres that do not provide emergency care.

"We are mandating that if a poisoned patient is admitted, they have to stabilise the patient before transfer to another hospital. They will be legally liable if there is a death."

Dr Hashem Tarifi, director of the pharmacy at Tawam Hospital, said this effort would ensure all hospitals were synchronised.

"We took a workshop with HAAD and this will undoubtedly lead to improved communication, cohesiveness and functioning," he said. "It means that the antidote is there when you need it and that everybody uses them in a timely manner."

Dr Zuhdi abu Shaaban, a clinical pharmacist at Al Ain hospital, said: "This will help us in planning and we can ensure the emergency services always have the quantity needed, since timing is essential."

Hospitals and healthcare practitioners who want to attend workshops or find out more about the standard list of antidotes are encouraged to contact the HAAD Poison and Drug Information Centre. "We are happy to answer all questions from healthcare professionals and the general public regarding any poison cases," Dr Sharif said.

HAAD Poison and Drug Information Centre can be contacted free on 800-424 from Sunday to Thursday, 7am to 3pm. Alternatively, e-mail pdic www.haad.ae/antidote_stock_standard