Intoxicación por el humo de los incendios: tratamiento antidótico a base de vitaminas

Disponibilidad de antídotos en los ámbitos sanitarios de Cataluña

BACKGROUND AND OBJECTIVE

Acute poisoning can be treated in different hospital and extrahospital health services. Thus, availability of antidotes in hospital pharmacies, emergency departments and health centres play an important role in poisoning treatment.

MATERIAL AND METHOD

This is a descriptive and transversal study of antidotes availability in different health services of Catalonia (Spain). From April to May 2005, a proper questionnaire was sent to 50 different health centres: 28 basic health centres (including medical ambulances) and 22 hospitals with a distinct medical complexity level, to assess the qualitative (QLA) and quantitative availability (QTA) of antidotes.

RESULTS

QLA resulted to be 82% in extrahospital health centres and 50% in medical ambulances. QTA was 94% for ambulances, whereas, in health centres, differences were observed between rural (55%) and urban (33%) areas. Regarding basic general hospitals (level 1), reference hospitals (level II) and high technology hospitals (level III) the QLA showed values of 39, 54 and 55%, respectively, and the QTA came about 70, 54 y 54.5%, in that order. Furthermore, lack of adequate stocking was observed for compounded formulations, such as albumin, starch, ipecacuanha syrup or IV ethanol, and for essential antidotes as snake antivenin, digoxin immune Fab or hydroxocobalamine.

CONCLUSIONS

There is understocking of poisoning antidotes throughout the health services of Catalonia. Heterogeneity was observed between services with a medical complexity level. The main deficiencies are found in antidotes that, to date, are available as compounded formulations or imported from other countries.

[Availability of antidotes in the event of accidents or attacks with chemical weapons]

BACKGROUND

In this report, we aimed to determine the availability of six antidotes for victims of accidents or attacks with chemical weapons.

MATERIAL AND METHOD

Telephone interviews with 6 Catalan hospitals and 8 hospitals from the community of Castilla y León. We evaluated the availability of antidotes in the hypothetical event of a massive intoxication with 600 affected people.

RESULTS

Only 3 out of the 14 hospitals had all 6 antidotes. Only atropine and, in Catalan hospitals, sodium thiosulfate were available in enough quantities to treat all victims. With regard to the remaining antidotes, the percentage of treated patients would have been fewer than 50%. The less available antidote was hydroxocobalamine.

CONCLUSIONS

We have found both qualitative and quantitative deficiencies of antidotes for the treatment of people intoxicated by chemical weapons.