The Roles of Antidotes in Emergency Situations

Antidotes are commonly used to reduce or eliminate the toxic effects of a poison. Often, there is no acceptable substitute. Although recognized over 25 years ago, numerous publications documenting insufficient stocking of antidotes by hospitals in the United States and many other countries continue to be published.1-4The medical and financial implications can be enormous. Failing to use the antidote for acetaminophen, for example, can lead to acute liver failure, which may result in liver transplant or death. In the United States, there is no regulation requiring hospitals to adequately stock antidotes. A joint position statement of the American College of Medical Toxicology and the American Academy of Clinical Toxicology acknowledges the issues and calls for several measures to address the problem. Consensus guidelines for antidote stocking by hospitals that accept emergency patients have been published.5 These guidelines recommend 44 antidotes for stocking, of which 23 should be available for immediate administration. In most hospitals, this timeframe requires that the antidote be stocked in the emergency department or other location that allows immediate administration. Another 14 antidotes were recommended for availability within 1 hour of the decision to administer, allowing the antidote to be stocked in the hospital

Automated summary

Antidotes are commonly used to reduce or eliminate the toxic effects of poisons. Insufficient stocking of antidotes by hospitals has been a long-standing issue, with potential medical and financial implications. In the United States, there is no regulation requiring hospitals to adequately stock antidotes, but consensus guidelines have been published recommending specific quantities of antidotes to be stocked.