The mastery of antidotes

Aim: To describe various types of Chinese hospitals' emergency department (ED) physicians' knowledge of antidotes and the comparative availability of toxicological treatments at these hospitals. Methods: We emailed a written survey to the ED doctors of 900 hospitals in China. The hospitals' names and addresses were obtained and randomly selected from the 6214 hospitals registered by the Chinese Medical Association. The survey included 23 questions on antidotes to commonly seen poisonings as well as questions on the availability of antidotes and decontamination techniques at each hospital. Results: Six hundred and fifty three hospital emergency directors responded to the survey 72.6% response rate). Overall knowledge of antidotes is not high and varied depending on antidote. Physicians in Eastern China, those working in tertiary-level hospitals and those working in hospitals with higher numbers of beds performed significantly better. On average, only 35.6% of the 23 antidotes were available in all reporting hospitals; 54.1% can get these antidotes from nearby hospitals and 42.0% can get them from a local CDC poison control center. However, only 57.3% can get a requested antidote within two hours. Gastric lavage is the most widely used decontamination procedure, and the availability of extracorporeal decontamination techniques is between 67.2% and 79.6% (depending on type). Conclusion: Knowledge of specific antidotes correlated significantly with size, type, and region of hospital in China rather than with individual physician characteristics. Significant antidotes remain unavailable or unavailable within 2 h in about half of all hospitals surveyed, although all major acute decontamination treatments and techniques seem quite prevalent.