I'm sorry; this is the BAEM approved list of antidotes to poisoning and
their uses
http://www.emergencymed.org.uk/BAEM/Clinical%20Effectiveness%20Committee/dow
nloads/Antidote_list_June_2006-Summary.pdf
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Dr Brahma Balakrishnan
Sent: 15 March 2007 00:44
To: [log in to unmask]
Subject: Re: Antidotes
Dear all,
A silent lurker enquires:
Where is the list of antidotes??
Thanking you & with warm regards
Dr.Brahma Balakrishnan
Clinical Director
Wijaya International Medical Center
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-----Original Message-----
From: Accident and Emergency
Academic List
[mailto:[log in to unmask]]
On Behalf Of James McFetrich
Sent: Thursday, March 15, 2007 5:27
AM
To: [log in to unmask]
Subject: Re: Antidotes
Sorry, am I missing something?
Whereabouts is this list of
antidotes?
James
James McFetrich
SpR Emergency Medicine
Northern Deanery
[log in to unmask]
-----Original Message-----
From: Accident and Emergency
Academic List
[mailto:[log in to unmask]]
On Behalf Of Rowley Cottingham
Sent: 14 March 2007 20:19
To: [log in to unmask]
Subject: Re: Antidotes
There is duplication of
benzatropine and procyclidine for
dystonic reactions
- and diazepam is listed as well
but not for dystonia for which it
is
perfectly suited (well, I
personally haven't used diazepam
for 15 years and
diazemuls for 5; midazolam and
lorazepam are much more suitable)
so that's
two can be ditched.
Three agents are listed for cyanide
poisoning. Why? Hydroxycobalamin is
the
best current treatment, although to
be perfectly honest if the patient
has
reached an ED they will probably
survive whatever.
Methylene blue is a Victorian
antidote for methaemoglobinaemia -
ascorbic
acid reduces the ferric ion
instantly and doesn't turn the
patient a
disconcerting greenish colour but
pink.
Fomepizole and absolute alcohol are
both listed for methyl alcohol
poisoning.
For what it is worth, Anexate is
misspelt.
Bicarbonate is listed at an
unnecessarily high concentration -
8.4% should
not be used clinically any more.
Hypertension is not a poisoning.
Convulsions (more Victoriana) and
agitation
are not poisonings.
Methionine (which is oral) and NAC
are both listed for paracetamol
poisoning; as vomiting is a common
feature of severe paracetamol
poisoning
it is not wise to use tablets for
treatment. Just list one.
The dose of glucagon listed has
never worked for me for beta
blocker
poisoning - there is a desperate
need for a presentation of 20mg. I
like
Steve Barden's definition of the
minimum dose of glucagon as 1mg
more than
your hospital holds.
If Vit K is mentioned so should FFP
and F7a be.
Pralidoxime is listed as to be
available within the hour but is
stated to be
only held centrally.
There is not enough background to
explain choices; look at the
flumezanil
entry as this simply lists it as
something not to be used!
And so on.
-----Original Message-----
From: Accident and Emergency
Academic List
[mailto:[log in to unmask]]
On Behalf Of Coats Tim - Professor
of
Emergency Medicine
Sent: 14 March 2007 09:25
To: [log in to unmask]
Subject: Antidotes
Rowley,
Have started a new thread for this.
I was interested that you didn't
like the antidote list, which I
must say
that I thought was OK. This is an
interesting area - what in
particular
would you change? Regards, Tim.
-----Original Message-----
From: Accident and Emergency
Academic List
[mailto:[log in to unmask]]
On Behalf Of Rowley Cottingham
Sent: 13 March 2007 23:48
To: [log in to unmask]
Subject: Re: Fitness to Drive
leaflets
This thread stimulates me to think
about advice sheets. We all have
advice
leaflets/cards of various sorts but
there is no standardisation of
this. As
we even have a national standard
list of antidotes (out of date and
duplicative, but never mind)I would
have thought CEM ought to have a
standard set of advice boilerplates
for local adaptation with phone
numbers,
URLs etc. We are particularly proud
of our head injury ones written
with the
neurosurgeons, but we have just
realised we don't have one for
people sent
home after a procedure involving
sedation, for example.
/Rowley./
> *From:* Vic
<[log in to unmask]>
> *To:* [log in to unmask]
> *Date:* Tue, 13 Mar 2007 07:54:48
-0000
>
> I agree, but what happens if a
patient with a retinal haemorrhage
in
> his left eye drives over a twin
baby buggy that Essex girl has
pushed
> in to the road. He will claim
medical condition as an excuse and
> doctor should have told him.
"Doctor did tell you not to drive"
says
> prosecution, "but the doctor knew
I had to get the car home".
>
> It happened when I was a student,
the doctor took a long time to get
> over the fact he hadn't made it
very, very clear.
>
> Vic
>
> -----Original Message-----
> From: Accident and Emergency
Academic List
>
[mailto:[log in to unmask]]
On Behalf Of Adrian Fogarty
> Sent: 13 March 2007 01:08
> To: [log in to unmask]
> Subject: Re: Fitness to Drive
leaflets
>
> Good points Vic, but I think a
custodial sentence would be
unlikely in
> this sort of scenario.
>
> AF
>
> ----- Original Message -----
> From: "Vic"
<[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, March 12, 2007 4:11
PM
> Subject: Re: Fitness to Drive
leaflets
>
>
> There are no patient leaflets as
such, but look at
>
http://www.dvla.gov.uk/medical/atag
lance.aspx which gives you an Adobe
> .pdf file that you can print the
appropriate pages from. Are you
> getting your staff to record that
they have told the person they are
> not fit to drive and to warn them
that because they have been told
> they are not fit to drive they
are driving without insurance or a
> licence, and therefore could be
imprisoned if they have an accident
> whilst ignoring your advice?
>
>
>
> Vic Calland
>
>
>
> -----Original Message-----
> From: Accident and Emergency
Academic List
>
[mailto:[log in to unmask]]
On Behalf Of Bell, Simon
> Sent: 12 March 2007 11:57
> To: [log in to unmask]
> Subject: Fitness to Drive
leaflets
>
>
>
> Dear list
> Not wanting to re-invent the
wheel, does anyone have a patient
> leaflets on
> fitness to drive after certain
medical diagnoses eg fits, TIA,
Stroke,
> un-explained collapse etc.
>
> I want such a leaflet to give out
to those patients we discharge. I
> would be most grateful if anyone
feels they could share. Please
email
> me off the list
[log in to unmask]
> Many thanks
> Simon
>
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