Availability of treatment resources for the management of acute toxic exposures and poisonings
in emergency departments among various types of hospitals in Palestine: a cross-sectional study
Sammanfattning
BACKGROUND:
Poisoning exposures continue to be a significant cause of morbidity and mortality worldwide. The
lack of facilities, treatment resources, and antidotes in hospitals may affect the treatments provided
and outcomes. This study aimed to determine the availability of gastrointestinal (GI)
decontamination, stabilisation, elimination enhancement resources, and antidotes for the
management of acute toxic exposures and poisonings in emergency departments (EDs) among
various types of governmental and private hospitals in Palestine.
METHODS:
A cross-sectional study using semi-structured questionnaire was performed. Data were collected
based on hospital resources; GI decontamination, stabilisation, elimination enhancement resources
and antidotes from Palestinian hospitals.
RESULTS:
Eighteen hospitals (94.7%) have responded. Among them, paracetamol poisoning was the most
frequently reported cases by EDs (mean frequency score = 7.6 ± 2.1), followed by bee stings (mean =
6.9 ± 2.7) and organophosphate poisoning (mean = 6.7 ± 2.7). The availabilities of most resources
related to GI decontamination items varied substantially with hospital type, but these differences
were not statistical significant. The availability of stabilisation resources was not significantly
different between hospitals types. For the availability of techniques used to enhance the elimination
of toxic substances, there were variations between the hospitals types. However, these differences
were not statistical significant, except for haemodialysis (p = 0.003) which was more available in
governmental hospitals. For the availability of antidotes, none of the hospitals had sufficient stock of
all antidotes listed. In relation to hospital type, there was variability in the availability of antidotes,
but this did not reach statistical significance, except for deferoxamine (p < 0.001), which was
available in all governmental hospitals but none of the private hospitals.
CONCLUSIONS:
The availability of treatment resources and antidotes in Palestinian hospitals was not adequate
except for stabilisation resources. The availability of such resources acts as a marker for the level of
readiness of hospital EDs in Palestine for the management of acute toxic exposure and poisoning.
The implementation of a minimum list of antidotes and treatment resources would be useful to
increase the level of resources. Coordination between Palestinian poison control and drug
information centre and hospitals is also important.