J Korean Soc Clin Toxicol.  2013 Jun;11(1):9-18.

The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center

Affiliations
  • 1Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. chrisryoo@gmail.com
  • 2Department of Emergency Medicine, Cheju Halla General Hospital, Jeju, Korea.
  • 3The research society for emergency antidotes stock and delivery system in Korea, Korea.

Abstract

PURPOSE
Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea.
METHODS
An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week.
RESULTS
From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8).
CONCLUSION
Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

Keyword

Antidotes; Stocking; Poisoning; Emergency service

MeSH Terms

Acetylcysteine
Antidotes
Deferoxamine
Emergencies
Ethanol
Flumazenil
Glucagon
Humans
Hydroxocobalamin
Immunoglobulins
Information Centers
Korea
Methylene Blue
Neurologic Manifestations
Pyridoxine
Suicide
Acetylcysteine
Antidotes
Deferoxamine
Ethanol
Flumazenil
Glucagon
Hydroxocobalamin
Immunoglobulins
Methylene Blue
Pyridoxine
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