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    The availability of toxicological analyses for poisoned patients in Ireland.

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    Authors
    Cassidy, Nicola
    Herbert, John X
    Tracey, Joseph A
    Affiliation
    National Poisons Information Centre, Beaumont Hospital, Dublin, Ireland. nicolacassidy@beaumont.ie <nicolacassidy@beaumont.ie>
    Issue Date
    2010-05
    MeSH
    Guidelines as Topic
    Humans
    Ireland
    Laboratories, Hospital
    Poisoning
    Questionnaires
    
    Metadata
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    Citation
    The availability of toxicological analyses for poisoned patients in Ireland. 2010, 48 (4):373-9 Clin Toxicol (Phila)
    Journal
    Clinical toxicology (Philadelphia, Pa.)
    URI
    http://hdl.handle.net/10147/126496
    DOI
    10.3109/15563651003772938
    PubMed ID
    20507249
    Abstract
    The National Poisons Information Service and the Association of Clinical Biochemists in the United Kingdom published guidelines on laboratory analyses for poisoned patients in 2002. In 2003, U.S. guidelines were prepared by an expert panel of analytical toxicologists and emergency department (ED) physicians. Some professional associations in different countries quote these guidelines but there are no data to support adherence to these recommendations in the medical literature.
    To analyze the availability of 15 quantitative laboratory analyses, specifically relating to the management of the poisoned patient, in Ireland.
    A questionnaire relating to the provision of toxicological analyses was compiled and distributed to 39 acute care hospital laboratories in Ireland. The availability of 15 quantitative analyses (carbamazepine, carboxyhemoglobin, digoxin, ethanol, ethylene glycol, iron, lithium, methemoglobin, methanol, paracetamol, paraquat, phenobarbital, salicylate, theophylline, and valproic acid), specifically relating to the management of the poisoned patient, was analyzed. The reporting units for these analyses were also collected. The acute care hospitals were sorted into groups according to their number of ED attendances: A) <20,000, B) 20,000-30,000, C) 30,000-40,000, D) 40,000-50,000, and E) >50,000 based on ED activity data for 2008. The median number of assays provided by each hospital group was calculated.
    The response rate was 100%, allowing complete national data to be ascertained. Hospital laboratories provided a more comprehensive testing service when ED attendances exceeded 30,000 per annum. Sixteen hospital laboratories (41.0%) performed at least 10 of the 15 toxicological investigations. The most widely available assay was paracetamol (74.4%, n = 29) and the least widely available assays were methanol, ethylene glycol, and paraquat (2.6%, n = 1). Only one hospital laboratory provided all 15 analyses. Hospital laboratories in groups A and B carried out a median number of 3/15 assays (range 0-8) and 4/15 assays (range 0-10), respectively. Hospital laboratories where ED attendances exceeded 30,000 per annum carried out a median number of 11/15 toxicological assays (range 1-15). There was a lack of consistency in the reporting units with both molar and mass units used.
    There is wide availability of toxicological analyses among hospital laboratories in Ireland. Most analyses were provided with 24-h availability. Hospitals with ED attendances in excess of 30,000 provided a more comprehensive laboratory service with respect to the number of analyses performed. The lack of consistency with units used by Irish hospital laboratories could present challenges with the reporting and interpretation of quantitative results. This study could be carried out in other countries to establish what analyses are available for the treatment of poisoned patients.
    Item Type
    Article
    Language
    en
    ISSN
    1556-9519
    ae974a485f413a2113503eed53cd6c53
    10.3109/15563651003772938
    Scopus Count
    Collections
    Beaumont Hospital

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