Insufficient stocking of cyanide antidotes in US hospitals that provide emergency care

Abstract

Objective: To identify the influence of catchment area, trauma center designation, hospital size, subspecialist employment, funding source, and other hospital characteristics on cyanide antidote stocking choice in US hospitals that provides emergency care.Materials and Methods: A web‑based survey was sent out to pharmacy managers through two listservs; the American Society of Health‑Systems Pharmacists and the American College of Clinical Pharmacy. A medical marketing company also broadcasted the survey to 2,659 individuals. We collected data on hospital characteristics (size, state, serving population, etc.,) to determine what influenced the hospital’s stocking choice.Results: The survey response rate was approximately 10% (n = 286). Thirty‑eight hospitals (16%) stocked at least 4 antidote kits. Safety profile, recommendations from a poison control center, and ease of use had the strongest influence on stocking decisions.Conclusions: Survey of 286 US hospital pharmacy managers, 38/234 (16%) hospitals had sufficient stocking of cyanide antidotes. Antidote preference was based on safety, ease of use, and recommendations by the local poison center, over cost.

Keywords: Antidotes; cyanide; pharmacies; poisoning; stocking