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"Might I suggest that for common poisons the lab be the source of
advice to clinicians"
Dear Mike,
This not easy. Never mind the local lab. I am not sure how often the other poison units are contacted.Wards/ A&Es tend ALWAYS to contact Guy's unit first. The centre appears to fax back details of the management of the 'poison in question, following which the local lab is asked to follow the advice given. Hopefully when the National Poison Unit web site is up and running we could also have an access to information given or question anything that appears to be unrealistic.
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Ahmed Waise FRCP FRCPath
Cosultant Chemical Pathologist
Friarage Hospital,
Northallerton, North Yorks
DL6 1JG
Tel 01609 763030
Fax 01609 764632
EMail: [log in to unmask]
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From: Mike Addison[SMTP:[log in to unmask]]
Reply To: [log in to unmask]
Sent: 02 August 1999 11:01
To: [log in to unmask]
Cc: [log in to unmask]
Subject: Re: thyroxine OD
Yet another blinder from Guys!! Besides measurement of FT4 what
else did they suggest. Treatment would surely be symptomatic
and the FT4 could easily wait until the next day. Guys, although
they will deny this, seem to suggest that in any suspected
poisoning the substance should be measured whether or not there
is any specific treatment or any known dose response. They also
put pressure on inquirers to get the measurement done as soon as
possible and if analysis is not available locally will offer to perform
them at Guys. As Dr Blumsohn suggests this type of advice puts
tremendous psychological pressure on those consulting them and
there may be legal difficulties if Guy's advice is not followed to the
letter.
There is a book out there for someone to edit a selection of Guys
stories.
Might I suggest that for common poisons the lab be the source of
advice to clinicians. Most of it is straight forward and there really is
no need for a medic to ring a poisons unit for simple paracetamol
overdose etc. On the other hand Guys and the other poisons units
(yes there are some) are essential for advice on the less commonly
taken substances.
Dr G.Michael Addison
Royal Manchester Children's Hospital
Pendlebury
Manchester M27 4HA
United Kingdom
Tel 0161-727-2250(AM)or 0161-220-5342(PM)
FAX 0161-727-2249
Email [log in to unmask]