Poison antidotes in short supply at hospitals

Some New Zealand hospitals carry stocks of outdated anti-poison treatments while others have insufficient supplies of current antidotes. Photo / NZME.

Been bitten by a venomous snake, nipped by a deadly spider or are suffering the unpleasant symptoms of cyanide poisoning?

Apparently your postcode could determine your access to life-saving antivenom treatment or poison antidotes, a new survey has revealed.

Some New Zealand hospitals carry stocks of outdated anti-poison treatments while others have insufficient supplies of current antidotes.

Palmerston North Hospital's pharmacy still has Fuller's earth powder, which was used to treat Paraquat poisoning and has now been superseded by activated charcoal.

But at least five of the country's 24 public hospital emergency departments do not hold enough cyanide antidote to manage a single cyanide-exposed patient for 24 hours. Only 17 have enough antidote on hand for such an event, according to the survey, published today in the NZ Medical Journal.

The general lack of reserve stocks of cyanide antidote could spell trouble in the event of an industrial accident poisoning multiple people, unless supplies could be quickly obtained from other hospitals.

The survey was requested by the Ministry of Health after the 2013 scare - which proved to be groundless - over the risk of botulism from milk whey protein.

"The location and assessment of the national stock holding of botulism antitoxin became a priority," medical toxicologist Dr John Fountain and colleagues say in their journal paper.

Auckland Hospital is the sole stock holder of a botulism antitoxin.

"Of those antidotes held, few were found in sufficient quantity to fully treat a single patient for 24 hours ... [which] is cause for consideration."

One exception included N-acetylcysteine, used to treat paracetamol overdose, given the frequency of such events.

The researchers recommend re-establishing a national antidote database and rapidly shipping the less commonly used drugs around the country, by plane when necessary.

The ministry's acting director of public health, Dr Stewart Jessamine, said it wants to explore options for improving pharmaceutical storage and supply, and implementation of a national antidote database.

The antidotes

Drugs held at only one hospital nationwide:

• Botulism antitoxin - Auckland City Hospital

• Polyvalent snake antivenom (covers bites from several types of snakes) - Auckland City Hospital

• Diphtheria antitoxin - Auckland City Hospital

• Potassium iodide (given in cases of exposure to radioactive materials) - Middlemore Hospital